medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2015-18-24-29medsovet-447Research ArticleЗАБОЛЕВАНИЯ ПЕРИФЕРИЧЕСКОЙ НСDISEASES OF THE PERIPHERAL NSВедение пациентов с диабетической полиневропатией: современные рекомендации по диагностике и лечению, возможности фармакотерапииManagement of patients with diabetic polyneuropathy: current guidelines for diagnosis and treatment, prospects for pharmacotherapyГоловачеваВ. А.GolovachevaV. A.noemail@neicon.ruПарфеновВ. А.ParfyonovV. A.noemail@neicon.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation2015301220150182429Copyright © Головачева В.А., Парфенов В.А., 20152015Головачева В.А., Парфенов В.А.Golovacheva V.A., Parfyonov V.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/447

Ранняя диагностика и своевременная рациональная терапия ДП позволяют предупредить инвалидность, увеличить продолжительность и улучшить качество жизни пациентов с сахарным диабетом (СД). Наиболее оптимальный для практической деятельности алгоритм диагностики ДП продолжает обсуждаться. Настоящая статья посвящена наиболее распространенной форме ДП - диабетической дистальной симметричной сенсорно-моторной полиневропатии (ДСПН). Оптимальный контроль уровня гликемии, образовательная программа, образ жизни (диета, поддержание или достижение нормального веса, лечебная гимнастика, поддержание повседневной активности) и, при наличии показаний, когнитивно-поведенческая терапия - эффективные нелекарственные способы улучшения течения СД и ДСПН. В симптоматической терапии невропатической боли при ДСПН достигнуты значимые успехи, однако данная терапия не замедляет процесс повреждения периферических нервов. Продолжаются поиски терапии, направленной на изменение течения ДСПН. В России в качестве возможной патогенетической терапии ДСПН обсуждаются препараты альфа-липоевой кислоты и комплексы витаминов группы В. Кокарнит - комплексный препарат, содержащий витамины группы В и метаболически активные вещества. Обсуждаются перспективы применения данного препарата в лечении пациентов с ДСПН

Early diagnosis and timely rational therapy of DP allow to prevent disability, increase duration and improve the quality of life of patients with diabetes mellitus (DM). The most feasible practical diagnostic algorithm for DP is still a matter of debate. The article focuses on the most common form of DP - diabetic distal symmetrical sensorimotor polyneuropathy (DSSP). Effective non-pharmaceutical methods to improve the course of DP and DSSP include optimum control of blood glucose level, educational programs, lifestyle (diet, maintaining or achieving a healthy weight, therapeutic exercises, maintaining everyday activity) and, when indicated, cognitive-behavioral therapy. Symptomatic treatment of neuropathic pain in DSSP achieved significant success, however it fails to inhibit the damage to the peripheral nerves. The search for therapies aimed at changing the course of DSSP continues. In Russia, alpha-lipoic acid and vitamin B complex are discussed as possible pathogenetic treatments of DSSP. Cocarnit is a combination medicine containing vitamins B and metabolically active substances. Prospects for the use of the drug in the treatment of patients with DSSP are considered.

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The authors declare that there are no conflicts of interest present.