Ọrịa mamịrị na-arịa ọrịa mamịrị

Ọrịa mamịrị na-arịa ọrịa shuga bụ ọrịa na-emebi emebi nke akwara na-akpata nsogbu nke metabolic na-ebute site na ọrịa shuga mellitus. A gosiputara oria a site na mmasi uche ya na dysfunction autonomic.

Ọrịa neuropathy na-arịa ọrịa shuga zuru ebe niile ma chọpụta, dịka ndị edemede dị iche iche si kwuo, na 30-50% nke ndị ọrịa nwere ụdị ọrịa shuga ọ bụla.

Ihe Ndị Na-akpata Esemokwu

Ọrụ kachasị na usoro pathologies nke ọrịa mamịrị na-arịa ọrịa mamịrị bụ nke microangiopathies, ya bụ, mmebi nke arịa ọbara nke pere mpe nke na-azụ ma akụkụ akwara na akwara. Inye ọbara nke ezughi oke na akwara anụ ahụ na-akpata nsogbu metabolic na ya ma na-atụnye ụtụ nke ngwaahịa nrụgide oxidative. N'ihi nke a, akwara anụ ahụ na-emegharị, ifịk ifịk eletriki na-akawanye njọ. Na njedebe, eriri akwara na-enwe atrophies.

Ihe na - eme ka mmadụ nwekwuo ike ịrịa ọrịa mamịrị:

nká
ọbara mgbali ike
agbasa hyperglycemia,
ọrịa ogologo oge ọrịa shuga,
ise siga
oke ibu.

Ofdị ọrịa ahụ

Dabere na topography, enwere:

nsogbu akwara autonomic. Ejikọtara ya na mmebi nke ihe dị n'ime ahụ,
nsogbu neuropathy akụkụ. Ọ na-emetụta akwara spinal.

N'ime omume, a na-eji nhazi ọkwa syndromic mee ihe:

Polyneuropathy agbagoro mepere. Dabere na ọnụnọ nke sensory ma ọ bụ akwara ụgbọala, a na-ekewa ya na neuropathy na moto, n'otu n'otu. Site na mmerụ ahụ n'otu oge na akwara ozi akwara, ha na-ekwu maka neuropathy jikọtara ọnụ.
Autonomic (ahịhịa) neuropathy. Ekesinye ya n’ime sudomotor, akwara obi, iku ume, urogenital na eriri afọ.
Multifocal (focal) neuropathy. Ọ gụnyere demyelinating na-adịghị ala ala, ọwara mmiri, neuropathy cranial, plexopathy (radiculoneuropathy), amyotrophy.

Mgbe ụfọdụ n'ụdị dị iche, a na-amata neuropathy Central, nke na-egosipụta onwe ya:

nnukwu ihe ọghọm nke ụbụrụ,
encephalomyelopathy
nnukwu nsogbu uche.

Ọnọdụ nke ọrịa

A na - ahuta uzo ato nke nsogbu akwara n’ile:

Subclinical.
Clinical (enweghi mgbu, nnukwu ihe mgbu na-adịghị ala ala).
Ọgwụ ọgbụgba n’oge (ọrịa shuga, nrụrụ ụkwụ, wdg).

Ọrịa neuropathy na-arịa ọrịa shuga zuru ebe niile ma chọpụta, dịka ndị edemede dị iche iche si kwuo, na 30-50% nke ndị ọrịa nwere ụdị ọrịa shuga ọ bụla.

Ejiri ụdị ọrịa metụtara akpịrị na-arịa ọrịa shuga:

mmetụta anụ ahụ, ọnụnọ, ọnya akpụkpọ (paresthesia),
akwara gbasara ahụ,
mgbu na mkpịsị aka ya, na aka ya,
ọnwụ nke ọkụ ọkụ
mụbara mgbaka ike (hyperesthesia),
ike adighi ike
Na-eme ka ike ogwe ume dị adị,
nhazi nke ngaghari na ọghọm ya.

Ogologo ihe mgbu na-akpata ehighị ụra, na-esote nnukwu ịda mbà n'obi

Site n'ụdị ụkwara akwara na -akpata ọrịa akpịrị, a na-ahụ ọnya nke akwara ozi akwara na-ahụ ihe dị n'ime ahụ, nke na-eduga n'ọgba aghara nke ọrụ ha. A na-ekpebi onyonyo nke ụdị ọrịa a bụ nke otu akụkụ ahụ na-arịa oke oke:

Ọkpụkpụ akwara akwara obi. Ọ na - etolite n’ime afọ mbụ nke ọrịa shuga. Tachycardia, orthostatic hypotension (mbelata ọbara mgbali mgbe onye ọrịa na-akwaga n'ọnọdụ kwụ ọtọ), na mgbanwe ụfọdụ na electrocardiogram (ịgbatị oge QT) bụ ihe e ji mara ya. O nwere ike ịbawanye n'ụdị infarction myocardial na-enweghị mgbu.
Gastrointestinal diabetic neuropathy. Egosiputara nke ogwu site na hyperalivation, gastroparesis (motiil gastric na-akpata nsogbu), gastroesophageal reflux. A na-ahụkarị ndị ọrịa nwere ọnya afọ na duodenal, ọnya ụyọkọ ọbara, gastritis acid na-arịa, ọrịa gallstone, na ịba ọcha n'anya.
Urogenital diabetic neuropathy. Enwere mmebi nke ureters na eriri afọ, nke na-eduga n'ịkwụ ụfụ ma ọ bụ njide urinary, ma na -emekwa ihe ndị ị na-achọ maka mmepe nke usoro nje na ọnya ụyọkọ akwara (cystitis, pyelonephritis). N'ime ụmụ nwoke, urogenital neuropathy nwere ike imebi mmetụ ihe mgbu nke testicles na dysfunction erectile, yana ụmụ nwanyị - anorgasmia na nkụ nke mucosa nwanyị.
Sudomotor ọrịa mamịrị na-arịa ọrịa mamịrị. Ejiri mara ọsụsọ nke anụ ahụ niile (Central hyperhidrosis) na ọsụsọ nke nkwụ na ụkwụ (bekee anal ma ọ bụ hypohydrosis). A na-ahụ ngosipụta nke neuropathy nke ọma n'abalị n'abalị na mgbe ị na-eri nri.
Neuropathy arịa ọrịa mamịrị. Ya na mbelata usoro njikọ nke surfactant, hyperventilation nke ngụgụ, akụkụ nke oge mkpọnwụ.

Iji gbochie mmepe nke neuropathy mamịrị, ọ dị mkpa ịchịkwa ọkwa nke glucose n'ọbara, rie nri ma bie ezigbo ndụ.

Diagnostics

Nchoputa nke neuropathy mamịrị, ọkachasị n'ụkpụrụ nke ọrịa ahụ, na - esikarị ike. Nke mbu, a na-enyocha anamnesis, mgbe ahụ a na-eme nnyocha, nke gụnyere:

mkpebi siri ike nke ịta glucose, insulin, haemoglobin glycosylated, C-peptide n'ime ọbara ọgbụgba,
mmuta ọbara mgbali
mkpebi siri ike nke akwara nke akwara,
nyocha nke ọma n’ụkwụ iji mata ihe corns, corns, ọnya ọgbụgba, nrụrụ.

Na mgbakwunye na endocrinologist, ndị ọzọ dị warara ọkachamara (neurologist, gastroenterologist, cardiologist, gynecologist, andrologist urologist, ophthalmologist, podologist, orthopedist) na-ekere òkè na nchoputa nke neuropathy mamịrị.

Na ọnụnọ nke akara ngosipụta nke mmebi nke usoro akwara obi, algorithm bụ isi akwụkwọ nyocha ECG, echocardiography, ule obi (ule orthostatic, ule Valsalva). Emere ule ọbara maka ọdịnaya nke lipoproteins na cholesterol.

Nnyocha nke akwara ozi gbasara obi ọria mamịrị gụnyere:

ihe ngosi ihe omumu
ihe nlere
nyocha nke mgbanwe na ụdị iche iche nke uche (sensory, tactile, vibrational, temperature, pain).

Site na usoro akpịrị na-arịa ọrịa shuga, ọ nwere ike ịdị mkpa iji mepụta biopsy nke anụ ahụ na (ma ọ bụ) akwara nwa ehi, sochiri nyocha akụkọ ihe mere eme banyere ihe ndị enwetara.

N'iji akara nke pathology nke eriri afọ, ana - egosi ihe ndị a:

Ule Helicobacter
Ultrasound nke eriri afọ,
odika ihe onyonyo nke afọ na eriri afọ.
Endoscopy.

Nchọpụta ụdị urogenital nke neuropathy mamịrị gụnyere

urinalysis
Nnwale Nechiporenko,
Ihe atụ nke Zimnitsky,
electromyography nke akwara nke eriri afo,
akwara intraven
cystoscopy
Ultrasound nke akụrụ na eriri afọ na mkpebi siri ike nke ọnụọgụ nsị.

Ofgwọ ọrịa neuropathy na-arịa ọrịa mamịrị dị ogologo ma sie ike, na-emetụta usoro dị iche iche nke usoro pathological. Ọ dị mkpa iji nweta nkwụghachi ụgwọ kachasị elu maka ọrịa shuga. Maka nke a, site na ịchịkwa glucose na ọbara ọbara, a na-ahọrọ usoro ọgwụgwọ hypoglycemic dị mkpa ma ọ bụ insulin. Na mgbakwunye, achọrọ mgbanwe ndụ.

ezigbo ike atụmatụ (table No. 9 dị ka Pevzner),
mmega ahụ nkịtị,
njikwa ahụ gị.

Iji meziwanye usoro metabolic, a na-enye vitamin B, antioxidants (vitamin E, alpha-lipoic acid), ihe metụtara traktị (usoro zinc na magnesium).

Site na mgbu dị ukwuu, a na-egosipụta ọgwụ mgbochi mgbochi steroidal, yana anticonvulsants.

A na-eji usoro ọgwụgwọ anụ ahụ: acupuncture, ọgwụgwọ ọkụ, ọgwụgwọ laser, magnetotherapy, mkpali eletriki nke akwara, ịhịa aka n'ahụ.

Nlekọta ụkwụ kwesịrị ekwesị dị mkpa:

jiri ude pụrụ iche mee ka akpụkpọ ahụ ụkwụ ya nwee mmiri.
oge ịsa ahụ ụkwụ
pedicure ahụike
na-eyi akpụkpọ ụkwụ dị mma nke na-akụghị ụkwụ ma gharakwa ete ya (ọ dị mkpa, yie akpụkpọ ụkwụ orthopedic).

Ekwesịrị ịgwọ ụdị ọgwụgwọ nke ahịhịa na-arịa ọrịa mamịrị na-eburu n'uche njirimara nke ọrịa syndrome malitere.

Nsogbu na nsonaazụ nwere ike ime

Nsogbu ndị gbara ọkpụrụkpụ ụdị ọrịa ịrịa ọrịa mamịrị bụ:

ọdịda nke ụkwụ ukwu,
hama na-egbu mgbu nke ukwu-ha;
ntụpọ akpụkpọ ahụ nke akụkụ ala,
ọrịa mamịrị n'ụkwụ.

Ogologo oge mgbu na ụkwụ na aka iji ọrịa neuropathy na-arịa ọrịa mamịrị na-akpata ehighị ụra na, na-esote, ịda mbà n'obi dị ukwuu.

Ọzọkwa, neuropathy na-arịa ọrịa mamịrị nwere ike ibute mmepe nke:

asymptomatic hypoglycemia,
imebi thermoregulation,
ọgbụgba ọbara ọbara
diplopia
ike na-aga n’ihu (ọrịa ịrịa ọrịa suga).

Site na nchoputa mbu na ọgwụgwọ n’ọrụ nke ọrịa mamịrị na-arịa ọrịa mamịrị, ọ ga-ekwe omume ịkwụsị ọrịa ahụ. Prognosis maka ụdị ọrịa neuropathy na-arịa ọrịa anaghị adị mma.

Mgbochi

Iji gbochie mmepe nke neuropathy mamịrị, ịchọrọ:

njikwa glucose n'ọbara,
nri nri
ịrụ ọrụ nkịtị,
rube isi na usoro insulin ma ọ bụ nchịkwa ọgwụ na-ebelata shuga nke dọkịta nyere,
n'oge ọgwụgwọ nke concomitant ọrịa,
Nnyocha mgbochi oge niile nke endocrinologist, neurologist na ndị ọkachamara ndị ọzọ tụrụ aro.

Vidiyo si na YouTube na isiokwu nke edemede:

Mmụta: gụsịrị akwụkwọ na Tashkent State Medical Institute na ogo ya na nlekọta ahụike na 1991. Ugboro ugboro were ọzụzụ ọmụmụ dị elu.

Ahụmịhe ọrụ: onye na - ahụ maka ọgwụ na - ebubata ngalaba nke ụlọ ịmụ nwa, onye na - ebugharị ngalaba ngalaba.

A chịkọtara ma nye ya maka ebumnuche ọhụụ. Lee dọkịta gị na ihe ịrịba ama mbụ ọrịa. Medication medicationụ onwe gị ọgwụ dị ize ndụ nye ahụ ike!

Peripheral Polyneuropathy

Peripheral Polyneuropathy mara ihe mmerụ ahụ na-emetụta akụkụ akwara nke elu na ala. Enwere mmetụta na-enwu ọkụ, ọnụnọ, ihe mgbu, ọkachasị n'abalị, mmetụ nke "mkpọda mkpọda."

Adịghị aka nwere aka na ụkwụ, enweghị ike nke ọgọdọ, inwe mmetụta na ogwe aka na ụkwụ. Ihe ngosi nke ụdị polyneuropathy na-abụkarị ihe mbido ọrịa shuga na-arịa ọrịa shuga.

Ọrịa akwara

Ngosiputa nke akwara ogwu banyere oria akwara di iche-iche di iche-iche, nke na-eduga n’inwe ihe isi ike nchoputa.

Carddị ụbụrụ na - ebilite site na mmebi nke akwara autonomic, na - enye ihe dị na sistem ahụ obi. N'ihi mmebi nke akwara ahụ, mmetụta ọmịiko na ụbụrụ akwara na-amalite inwe mmerụ ahụ, ngwangwa ngwangwa pụtara - tachycardia, nke na-adịgide n'oge mmega ahụ na izu ike, hyperension orthostatic, akụkụ nke mwepu nke uche - enwere ike ịkọwa ọnọdụ mmekọrịta. Ọkpụkpụ akwara akwara autonomic bụ isi ihe na-akpata infarction myocardial na-enweghị mgbu na ndị ọrịa nwere ọrịa mellitus.

Na ụdị eriri afọ neuropathies na - ebute nsogbu nke ọrụ na mkpochapụ nke afọ, eriri afọ, gastroesophageal reflux. Ọtụtụ mgbe, enwere dyskinesia nke gallbladder, ọrịa gallstone, nsogbu nke peristalsis.

Udị urogenital gosiputara site na imebi ụda nke eririka na ure, urination nke ukwuu, njigide ma ọ bụ nnyonye anya, belatara ikike. Ọrịa ọnya afọ na-agakọ. N'ihi na ụdị iku ume iku ume usoro nke okuku ume iku ume, akwara nke ehihie bụ ihe eji mara.

Pathogenesis na nhazi ọkwa

Ihe ndị a na-arụ ọrụ dị mkpa na pathogenesis nke DPN:

1. Microangiopathy (mgbanwe na arụ ọrụ na / ma ọ bụ usoro nhazi na okpu ndị ọrụ maka microcirculation nke eriri akwara).

2. Nsogbu nke metabolic:

Ime ihe nke polyol shunt (uzo ozo nke glucose metabolism, nke ewegharia ya na sorbitol (site na iji enzyme aldose reductase) wee ruzie fructose, nnabata nke metabolites ndị a na-eduga na mmụba na osmolarity nke oghere intercellular).
Mbelata ọkwa nke myo-inositol, nke na-eduga n'ịbelata mkpokọta nke phosphoinositol (ihe mejupụtara nke mkpụrụ ndụ akwara), bụ nke na - eme ka mbelata ike metabolism na nsogbu akwara.
Enweghi enzymatic na enzymatic glycation nke protein (glycation nke myelin na tubulin (ihe owuwu nke akwara) na-eduga na demyelination na nrụgide nke akwara akwara, glycation nke protein nke okpuru ulo nke okpu ala na-eduga n'ọdịda ya na metabolic na akwara akwara).
Mmụba oxidative na-abawanye (ụba oxidation nke glucose na lipids, mbelata nchebe antioxidant na-eme ka nchịkọta nke radicals na-enwe mmetụta cytotoxic kpọmkwem).
Mmepe nke ogige autoimmune (dika ụfọdụ akụkọ si kwuo, ọgwụ mgbochi na insulin na - egbochi ihe itolite akwara, nke na - eduga na nbibi nke eriri akwara).

E gosipụtara mmekọrịta dị n'etiti ihe dị iche iche nke pathogenesis nke DPN na eserese 1.

Nkewa na ngosiputa nke ulo ogwu nke DPN

Nnukwu sensọ ma ọ bụ sensorimotor neuropathy

Na ọnya ọnya nke nwere akwara pere mpe:

na-egbu mgbu ma ọ bụ nkọ mgbu agba,
hyperalgesia
paresthesia
ụfụ nke mgbu ma ọ bụ ọnọdụ uche,
ọnya ụkwụ,
enweghi mgbu visceral.

Pred nwere nnukwu mmebi:

okfu nke inwe mmetụta uche
ọnwụ nke mmetụta uche
ntụpọ.

Ọgwụ Neuropathy

Nnukwu mgbu neuropathy

Ọrịa mgbu na-adịghị ala ala demyelinating neuropathy

Ọkpụkpụ akwara na-emegharị ahụ.
Ọsụsọ Sweating.
Asymptomatic hypoglycemia.
Autismic gastrointestinal neuropathy:
obi nke afọ,
inyoghi-inyoghi,
enteropathy na-arịa ọrịa shuga ("afọ ọsịsa nke ụbụrụ"),
afọ ntachi
mgbaka enweghi mgbaka.
Automatic neuropathy nke usoro akwara obi:
ischemia na-adịghị ụfụ,
orthostatic hypotension,
obi obibia nsogbu
orthostatic tachycardia,
tachycardia nke izu ike,
olu onodu
circadian mgbanwe,
mbelata mmega ahụ.
Autonomic neuropathy nke eriri afo.
Automatic neuropathy nke usoro ọmụmụ (nrụrụ etacile, ejaculation retrograde).

Nleba anya na otutu neuropathies

Oculomotor akwara (III).
Mgbatị akwara (VI).
Gbochie akwara (IV).

Asymmetric proximal obere ukwu neuropathy

Asymmetric proximal moto neuropathy.
Mgbu na azụ, hips, ikpere.
Adịghị ike na atrophy nke mgbanwe ahụ, ndị na - emegharị aka na uru nke apata ụkwụ.
Ọnwụ reflex si akwara quadriceps.
Ntinye obere ihe na-agbanwe.
Ibu ibu.

Ahụ mgbu dị na azụ, obi, afọ.
Ndalata uche ma ọ bụ dysesthesia.

Mkpakọ (ọwara):
- Mkpụkpụ aka elu: irighiri akwara na ọwara Carpal,
- ukwu aka: akwara nke tibial, akwara peroneal.
Gburugburu.

Ọgwụgwọ na mgbochi nke DPN

Ebumnuche bụ isi nke ọgwụgwọ na mgbochi nke DPN bụ njikarịcha nchịkwa glycemic. Ọtụtụ nnyocha emere n’afọ ndị na-adịbeghị anya, ejirila nwapụta n’egosi na mmadụ inweta ogo glucose ọbara dị mma n’ime otu ụbọchị na-egbochi mmepe nke ngosipụta nke DPN. Ọgwụ ịgwọ ọrịa neuropathy kachasị ugbu a na nke ruru eru agaghị enwe isi na-enweghị nkwụghachi ụgwọ maka ọrịa shuga.

A maara na ọrịa shuga enwere ụkọ nke ọtụtụ vitamin na ihe metụtara, n'agbanyeghị ọgwụgwọ maka DPN, a na-arụ ọrụ kachasị mkpa site na iwepu adịghị ike nke vitamin B .. vitamin Neurotropic (otu B) bụ coenzymes na-etinye aka na usoro biochemical dị iche iche, melite ike akwara, ma gbochie guzobe ngwaahịa ngwaahịa. glycation nke ndi na-edozi. Ejirila nhazi nke vitamin ndị a iji lelee DPN ogologo oge. Agbanyeghị, ojiji dị iche iche nke vitamin B ọ bụla na-agbakwunye ntakịrị injections ma ọ bụ mbadamba na ọgwụgwọ ndị ọrịa, nke na-eweta nnọọ nsogbu. Ọgwụ Neuromultivitis na-ezere ị additionalụ ọgwụ nke ọtụtụ ọgwụ, ebe ọ bụ na otu mbadamba, nke ihe nkiri gbara, nwerelarị:

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

Thiamine (vitamin B1) n'ime ahụ mmadụ n'ihi usoro phosphorylation ka agbanwere na cocarboxylase, nke bụ coenzyme metụtara n'ọtụtụ mmeghachi omume enzymatic. Thiamine na-arụ ọrụ dị mkpa na carbohydrate, protein na metabolism abụba, na-ekere òkè na usoro nke oke ụjọ ụjọ na synapses.

Pyridoxine (vitamin B6) dị mkpa maka ịrụ ọrụ nkịtị nke sistem na akụkụ akwara. N'ụdị phosphorylated, ọ bụ coenzyme tinyere aka na metabolism nke amino acid (decarboxylation, transamination, wdg). Ọ na - eme dị ka coenzyme nke enzymes kachasị mkpa nke na - arụ ọrụ na akwara anụ ahụ. Na-ekere òkè na biosynthesis nke ọtụtụ neurotransmitters, dịka dopamine, norepinephrine, adrenaline, histamine na γ-aminobutyric acid.

Cyanocobalamin (vitamin B12) dị mkpa maka ịkpụkọ ọbara na maticryryry erythrocyte, ọ na-esonye n'ọtụtụ mmeghachi azụ nke biochemical nke na-ahụ maka ọrụ dị mkpa: na nnyefe nke otu methyl (na iberibe carbon-ndị ọzọ), na njikọ nke nucleic, protein, na mgbanwe nke amino acid, carbohydrates, lipids. Ọ nwere mmetụta bara uru na usoro dị na usoro ụjọ (njikọ nke nucleic acid na mejupụtara nke libido na phospholipids). Codị coenzyme nke cyanocobalamin - methylcobalamin na adenosylcobalamin dị mkpa maka mmeghari mkpụrụ ndụ na uto.

Nnyocha nke steeti usoro ụjọ akwara na-arịa ndị ọrịa nwere ụdị ọrịa shuga 2 gosiri na Neuromultivitis nwere mmetụta dị mma na ntanetị ihu na ịma mma nke ụkwụ, ma belata belata ike nke mgbu mgbu. Nke a na-egosi mbelata ihe ize ndụ nke ịmalite ọnya ụkwụ trophic na mmụba nke ndụ ndị ọrịa nwere DPN distal. Ekwesịrị ịchọpụta na ịdị mma nke ịme usoro ọgwụgwọ na outpatient, ebe ọgwụ ahụ achọghị nchịkwa parenteral.

Alfa lipoic acid bụ coenzyme nke isi enzymes nke okirikiri nke Krebs, nke na-enye gị ohere iweghachi ike nke akwara, yana antioxidant (dị ka onye na-ahụ maka oxidizing eke), nke na-eme ka o kwe omume igbochi mmebi ọzọ nke ihe akwara ma chebe akwara anụ ahụ na radicals n'efu. Na mbu, nke izu 2-4. (opekata mpe - 15, optimally - 20) ka etinyere acid α-lipoic acid ka ọ bụrụ ntinye iv drip infusion nke 600 mg / ụbọchị. Mgbe nke ahụ gasịrị, ha na-agbanye were mbadamba nwere 600 mg nke α-lipoic acid, 1 mbadamba / ụbọchị maka ọnwa 1.5-2.

Maka ọgwụgwọ nke ụdị DPN na-egbu mgbu, nyocha dị mfe, ọgwụ mgbochi mkpali (acetylsalicylic acid, paracetamol) ka etinyere na ọgwụ ndị a dị n'elu. N'ime ha, ọ bara uru ịkọwa ọgwụ Neurodiclovit, nke nwere vitamin Diclofenac na B (B1, B6, B12), nke nwere ọgwụ analgesic, anti-inflammatory and antipyretic.

Ojiji nke otu ọgwụ ọgwụ dị ka ọgwụ tricyclic antidepressants (amitriptyline 25-50 - 100 mg n'abalị), n'ihupentin (ọgwụ mbụ - 300 mg, mmụba site na 300 mg kwa ụbọchị 1-3, oke kachasị - 3600 mg), pregabalin (ọgwụ mmalite) ka egosiri. - 150 mg, mụbaa na 300 mg n'ime ụbọchị 3-7, oke kachasị - 600 mg (kewara 2-3 usoro)), duloxetine (ọgwụ mbụ - 60 mg 1 r / ụbọchị, mgbe ụfọdụ mụbaa 60 mg 2 r. / ụbọchị, oke kachasị bụ 120 mg).

A na-eji ọgwụgwọ gastrointestinal neuropathy eme ihe:

na atony nke afọ: cisapride (5-40 mg 2-4 p. / ụbọchị 15 nkeji tupu nri), metoclopramide (5-10 mg 3-4 p / ụbọchị), domperidone (10 mg 3 p / ụbọchị),
ya na enteropathy (afọ ọsịsa): loperamide (nke mbụ bụ 2 mg, mgbe ahụ, 2-12 mg / ụbọchị ruo ugboro stool nke 1-2 p / ụbọchị, mana ọ bụghị karịa 6 mg maka kilogram 20 niile nke ndị ọrịa na otu ụbọchị).

Maka ọgwụgwọ autonomic neuropathy nke sistem obi (izu ike tachycardia), io-blockers, cardioselective β-blockers, ndị na-egbochi calcium Channel (dịka verapamil, Diltiazem Lannacher).

Maka ọgwụgwọ nke nrụrụ erectile, a na-eji ụdị 5 phosphodiesterase inhibitors (ọ bụrụ na enweghi contraindications), nchịkwa intracavernous nke alprostadil, prosthetics, ndụmọdụ gbasara mmụọ.

Maka mgbochi n'ozuzu nke hypovitaminosis na nsogbu, ndị ọrịa na-arịa ọrịa shuga ka a na-akwado usoro multivitamin. N'okwu a, nchịkwa nke vitamin B na usoro ọgwụgwọ ọgwụgwọ (Neuromultivitis) dịkwa irè.