Mafomu, Zizindikiro, ndi Chithandizo cha matenda ashuga a shuga

Matenda a diabetes a neuropathy ndi kuwonongeka kwa mitsempha yomwe imayambitsidwa ndi zovuta za metabolic odwala omwe ali ndi matenda osokoneza bongo. Amayamba pokhapokha pakutha kuwongolera mphamvu zama glucose, motsutsana ndi maziko a zizolowezi zoipa ndi zina zokhudzana ndi matenda. Matendawa amadziwika ndi kuchepa kwa zomverera, zovuta za kayendedwe kazinthu komanso kusokonekera kwa ziwalo zamkati. The pathological mkhalidwe amafunika kuunika kwathunthu odwala matenda ashuga komansowofatsa.

Zambiri

Matenda a shuga a shuga ndi amodzi mwa zovuta zomwe zimapezeka kwambiri odwala matenda ashuga 30-50%. Matenda a diabetes a neuropathy akuti amapezeka pamaso pa zizindikiro zakuwonongeka kwa mitsempha mwa anthu omwe ali ndi matenda ashuga, kupatulapo zina zomwe zimayambitsa kusokonezeka kwamanjenje. Matenda a diabetes a neuropathy amadziwika ndi kuphwanya kwamitsempha yama neva, kukhudzika, kusokonezeka kwa dongosolo lamanjenje ndi / kapena autonomic. Chifukwa cha kuchuluka kwa mawonetseredwe azachipatala, matenda am'mimba amatsutsana ndi akatswiri pazokhudza endocrinology, neurology, gastroenterology, ndi podiatry.

Gulu

Kutengera zolemba pamwambapa, zotumphukira za ma neuropathy zimasiyanitsidwa ndi kuphatikizika kwakukulu kwa mitsempha ya msana mu njira ya pathological ndi autopous neuropathy ngati kuphwanya kwa mkati mwa ziwalo zamkati. Malinga ndi syndromic gulu la anthu odwala matenda ashuga, pali:

I. Zizindikiro za symmetric polyneuropathy:

• Ndi kupweteka kwamankhwala am'mitsempha yama sensor (sensor neuropathy)
• Ndi zowonongeka zambiri zamagalimoto zamoto (motor neuropathy)
• Ndikuphatikiza kuwonongeka kwa mitsempha yamagetsi ndi ma motor (sensorimotor neuropathy)
• Hyperglycemic neuropathy.

II. Dongosolo la matenda ashuga neuropathy:

• Mtima
• M'mimba
• Urogenital
• Wowayankha
• Injini yotumiza

III. Focal kapena multifocal diabetesic neuropathy syndrome:

• Cranial neuropathy
• Tunnel neuropathy
• Amiotrophy
• Radiculoneuropathy / Plexopathy
• Matenda osachiritsika a demyelinating polyneuropathy (HVDP).

Olemba angapo amasiyanitsa chapakati pa neuropathy ndi mitundu yake: diabetesic encephalopathy (encephalomyelopathy), kusokonezeka kwamitsempha yama ubongo (PNMK, stroke), kusokonezeka kwamalingaliro chifukwa cha kuvunda kwa metabolic.

Malinga ndi gulu la azachipatala, poganizira momwe chiwonetsero cha matenda a shuga chikuwonekera, magawo angapo a njirayi ndi osiyana:

1. Subclinical neuropathy.

2. Matenda a m'mitsempha:

• kupweteka kosatha
• kupweteka kwapweteka
• mawonekedwe osapweteka kuphatikiza kuchepa kapena kuwonongeka kwathunthu kwa chidwi

3. Gawo la zovuta mochedwa (kuchepa kwa mitsempha ya miyendo, phazi la matenda ashuga, etc.).

Diabetes neuropathy imatchula metabolic polyneuropathies. Udindo wapadera wa pathogenesis ya matenda ashuga a m'mimba ndi amomwe amachokera mu mitsempha - michereopathies yomwe imasokoneza magazi kupita kumitsempha. Zovuta zingapo zama metabolic zomwe zimapangidwa motsutsana ndi maziko amtunduwu zimayambitsa edema ya minyewa yamanjenje, kusokonezeka kwa mitsempha, kukhudzika kwa mitsempha, kuchuluka kwa oxidative, kukulitsa zovuta za autoimmune ndipo, pamapeto pake, kufalikira kwa ulusi wamitsempha.

Zambiri za chiopsezo chokulirapo kwa matenda ashuga okalamba ndi zaka, nthawi yayitali ya matenda ashuga, hyperglycemia, matenda oopsa, Hyperlipidemia, kunenepa kwambiri, ndi kusuta.

Peripheral Polyneuropathy

Peripheral polyneuropathy imadziwika ndi kakonzedwe ka zovuta zamagalimoto ndi zomverera, zomwe zimatchulidwa kwambiri kuchokera kumapeto. Matenda a diabetes a neuropathy amawonetsedwa ndi kuwotcha, dzanzi, kumva kuwawa kwa khungu, kupweteka m'mapazi ndi kumapazi, zala, kukokana kwakanthawi kochepa.

Kusazindikira kutsika kwa kutentha, chidwi chambiri kukhudza, ngakhale chochepa kwambiri. Zizindikirozi zimakonda kukulira usiku. Matenda a diabetes a neuropathy amaphatikizidwa ndi kufooka kwa minofu, kufooka kapena kuchepa kwa chidwi, komwe kumapangitsa kusintha kwa kayendedwe ka gait komanso kusayenda bwino kwa kayendedwe. Kupweteka kwambiri ndi paresthesias kumabweretsa kusowa tulo, kusowa kudya, kuchepa thupi, kukhumudwa kwa malingaliro a odwala - kukhumudwa.

Mavuto obwera chifukwa cha zotumphukira za matenda a shuga a m'mimba amatha kukhala zilonda zam'mapazi, kupindika ngati zala, kugwa kwa phazi la phazi. Peripheral polyneuropathy nthawi zambiri amatsogolera mawonekedwe a neuropathic a matenda a shuga.

Etiology ndi pathogenesis

Chomwe chimayambitsa matenda ashuga a m'mimba ndi matenda ashuga, momwe kuchuluka kwa glucose m'magazi sikumayendetsedwa bwino. Nthawi zambiri, izi zimachokera ku 3.3 mmol / L mpaka 5.5 mmol L.

Matenda a shuga amachititsidwa ndi shuga. Izi zimabweretsa chisokonezo munthawi yantchito ya kagayidwe kazakudya: kuphwanya ma microcirculation, kuchuluka kwambiri kwa zinthu za glycolization, kuchuluka kwa ma radicals aulere, komanso kuchepa kwa ntchito ya antioxidant. Chithandizo chimalumikizidwa makamaka pamalumikizidwe awa a pathogenesis.

Chifukwa cha kusokonezeka kwa kagayidwe kazakudya zam'mimba, michereopathies imabuka (kuphwanya kapangidwe kazinthu zamagazi), komwe kumayambitsa kusowa kwa mitsempha. Zotsatira zake, edema ya mitsempha ya mitsempha imayamba, minofu yamatumbo imakhala yovuta, ndipo chifukwa chake, kufalikira kwa mitsempha kumakulirakulira kapena kuyimitsidwa.

Chifukwa chodzikundikira mwachangu ma radicals omasuka komanso kufooka kwa dongosolo loletsa antioxidant, kufalitsa ma cell immune kungapangike komwe kumayipa mitsempha ndikuwongolera kuwonongeka kwake. Njira izi zimatsogolera ku chithunzi chachipatala.

Pali zinthu zingapo zomwe zimathandizira, ndipo nthawi zina zimayambitsa kupezeka kwa matenda a shuga. Uwu ndi nthawi yayitali ya matenda a shuga, gawo lowonongeka, kusuta, kunenepa kwambiri, kuthamanga kwa magazi, ukalamba, kusagwirizana ndi malangizo a dokotala, komanso kumwa mowa.

Amayambitsa ndi pathogenesis

Matenda a shuga amayendera limodzi ndi kuphwanya njira za kagayidwe kachakudya. Kutsika kwa glucose kumabweretsa kufa ndi maselo amitsempha, ndipo kuchuluka kwake kumayambitsa mapangidwe aulere. Njira zoyipa zoterezi zimayambitsa kukula kwa mantha komanso kutupa kwa mafupa amitsempha.

Ngati kuchuluka kwa magazi kulumikizana ndi zomwe tafotokozazi, ndiye kuti kuphipha kwamitsempha yamagazi yaying'ono yomwe imadyetsa minofu ya mitsempha kumachitika. Maselo samalandira okosijeni wokwanira ndi michere ndipo amafa. Zotsatira zake, zimakhala zosatheka kuyendetsa mitsempha m'njira. Izi zimadzetsa kuwonongeka m'moyo wabwino komanso mawonekedwe a matendawa.

Pali zinthu zingapo zomwe zimawonjezera mwayi wokhala ndi matenda a shuga. Amapezeka makamaka mwa anthu okalamba kapena omwe ali ndi matenda ashuga kwa zaka zoposa 15. Odwala omwe ali ndi vuto la kuthamanga kwa magazi, kunenepa kwambiri, zizolowezi zoipa, kapena hyperlipidemia atenga matendawa.

Matenda a shuga angayambire kutsutsana ndi kuwonongeka kwa mawotchi mu mitsempha kapena njira za kutupa mwa iwo. Gulu lowopsa lomwe limakhala ndi anthu omwe ali ndi cholowa chamatendawa.

General neuropathy

Makulidwe a matenda am'mimba a shuga am'magulu amodzi amagawika mu: sensory, motor, pamodzi.

Sensory neuropathy yodziwika ndi kusokonezeka kwa chidwi chifukwa cha kuwonongeka kwa mitsempha yomwe imayang'anira kuthanso kwa thupi. Wodwala sangathe kusiyanitsa zinthu pokhudza, kudziwa komwe kukuzizira, komwe kwatentha, zomwe zingayambitse kuvulala kwakukulu. Komabe, usiku, kumva tactile kumawonjezeka, ndipo ngakhale kukhudza kansalu kovulaza kumatha kupweteketsa. Nthawi zina, ma receptor ena amayankha ndi kukwiya kamodzi (kukhudza): tinnitus, fungo losamveka komanso kusuntha pakamwa.

Matenda a neuropathy kuwonetsedwa ndi kuwonongeka kwa mitsempha yomwe imayendetsa miyendo. Izi zimabweretsa kusokonezeka kwa mawonekedwe, kufooka kwa minofu, ndipo mtsogolo - atrophy yathunthu. Nthawi zambiri pamakhala kupindika komanso kutupa kwa mafupa, komwe kumaphwanya matalikidwe ndikuyambitsa kukomoka.

Mtundu Wophatikiza yodziwika ndi kuwonekera kwa malingaliro ndi kuwonongeka kwa galimoto mwa odwala matenda ashuga.

Autonomic neuropathy

Kugawika kwa kudziyimira pawokha kwa matenda a shuga: kupuma, urogenital, m'mimba, mtima, endocrine, kusokoneza magwiridwe amtundu wa thukuta, matenda a ubongo kapena ubongo. Mitundu iliyonse imasokoneza ntchito ya dongosolo linalake, lomwe limachepetsa moyo ndipo limabweretsa mavuto akulu ambiri.

Magawo otukuka

Matenda a diabetes a neuropathy amapita mu magawo angapo a chitukuko, omwe amasiyanasiyana mwakuya kwa chithunzi chachipatala.

• Gawo lachigawo chodziwika bwino limadziwika ndi maonekedwe oyamba a zoyipa zoyambira: dzanzi lamapeto, kusokonekera kwamphamvu, ndi zina zambiri.
• Gawo lazachipatala limadziwika ndi kutayika kokwanira, kuwonongeka kwa thanzi komanso kusokonekera kwa ziwalo zamkati ndi machitidwe ake (chidziwitso chimatengera mawonekedwe).
• Gawo la zovuta likuwonekedwa ndikupanga zotsatira zoyipa zingapo, zomwe nthawi zambiri sizisintha.

Chithunzi cha chipatala cha matenda ashuga a m'matumbo chimatengera mtundu wa matendawa. Peripheral imawonetsedwa ndi dzanzi, maonekedwe a goosebumps ndi kumva kuluma miyendo. Manja ndi mapazi ake amakhala ndi kutentha kochepa kuposa thupi. Wodwalayo amasokonezedwa ndi kufooka m'misempha, kusokonekera kwa kayendedwe ka kayendedwe komanso kaphatikizidwe kachilombo koyipa ngati vulala.

Anthu odwala matenda ashuga nthawi zambiri amakhala ndi vuto la kupweteka kwa mwendo komanso chiwopsezo chowonjezereka. Zomverera zosasangalatsa zingayambitse kukhudza pang'ono pa dzanja. Chisoni chimalimba usiku, zomwe zimapangitsa kugona, kusokoneza kugona kwa wodwalayo komanso mkhalidwe wake wamaganizidwe (mpaka kukula kwa kuvutika maganizo).

Ndi autonomic neuropathy, zizindikiro za kusagwira bwino ntchito kwamkati ndi machitidwe zimawonedwa.

Kusokonezeka kwa mtima wamitsempha yamagetsi (mawonekedwe amtima): kutsitsa magazi, kusokonezeka kwa mtima komanso kukomoka. Wodwala amakhala ndi chiopsezo chowonjezereka cha matenda a mtima kapena myocardial ischemia. Matenda a mtima okhudzana ndi matenda am'mimba amatha kukhala zaka zoyambirira pambuyo pakupezeka kwa matenda ashuga.

Kusokonezeka kwa m'mimba thirakiti (mawonekedwe am'mimba): nseru, kusanza, kupweteka komanso kusamva bwino m'mimba, kuchepa, kutentha kwa mtima, kusowa kwa chakudya, komwe kumapangitsa kutopa kwambiri kwa thupi. Nthawi zina, motsutsana ndi maziko a neuropathy, matenda am'mimba amayamba: zilonda zam'mimba kapena zilonda zam'mimba (zomwe zimayambitsidwa ndi Helicobacter pylori bacterium), hepatosis yamafuta kapena matenda a gastroesophageal Reflux.

Matenda enanso amakhala ndi chizungulire, kukokana, kukodza pafupipafupi, komanso kuchepa thukuta la mapazi ndi manja. Nthawi zambiri odwala odwala matenda ashuga, pamakhala kusowa poyendetsa zogonana, kukwiya, komanso kusamba kwa msambo.

Zizindikiro

Ngati muli ndi zododometsa, muyenera kufunsa dokotala ndipo mukayezetsa kuchipatala. Pochita koyamba, adotolo amaphunzira ma anamnesis, amadziwa bwino za moyo wa wodwalayo, akumveketsa kukhalapo kwa zizolowezi zoyipa ndi matenda amtundu. Izi zimakuthandizani kuti muwone zoopsa zomwe zimapangitsa kuti pakhale zovuta za matenda ashuga.

Pakufufuza kwakuthupi, dokotalayo amawunika momwe miyendo imathandizira komanso momwe amathandizira kuzizira, kukhudza ndi kugwedezeka, amayeza kuthamanga kwa magazi, amatupa pamimba ndi kumvetsera kugunda kwa mtima. Dokotala amalipira chidwi kwambiri ndi khungu la miyendo, kudziwa kukhalapo kwa zilonda, mabala omwe amachiritsa kwa nthawi yayitali komanso matenda oyamba ndi fungus. Izi zimatha kubweretsa gangore.

Kuyesa kuchuluka kwa thanzi ndikutsimikizira kupezeka kwa matenda ashuga a m'mimba, kuyesedwa kwa ma labotale ndikolembedwa: kuyezetsa magazi konse komanso zamitsempha yamagazi ndi kuyesa kwamkodzo kwamkodzo. Onetsetsani kuti mwazindikira kuchuluka kwa insulin, hemoglobin ndi glucose.

Kufufuza kwazitsulo kumaphatikizapo njira zotsatirazi: ECG, ultrasound yam'mimba, kuyesedwa kwa FEGDS ndi X-ray (mwina pogwiritsa ntchito zosiyana). Kuphatikiza apo, kufunsira ndi madotolo ocheperako kungafunike: neurologist, orthopedist, cardiologist, endocrinologist, andrologist, gynecologist and gastroenterologist.

Njira zozizira zimagwiritsidwa ntchito pochiza matenda a shuga. Choyamba, adokotala amatenga njira zoyenera zothandizira kukhazikitsa matenda ashuga. Pachifukwa ichi, wodwalayo amapatsidwa insulin kapena mankhwala ena omwe amasintha shuga m'magazi (Liquid, Glimepiride kapena Gliclazide). Kuphatikiza apo, mankhwala amalembedwa omwe amawonjezera chidwi cha thupi pakupanga insulin (Metformin, Troglitazone, Ciglitachone) komanso kusokoneza mayamwidwe am'mimba kuchokera m'matumbo (Miglito, Acarbose). Nthawi zina, mankhwalawa atha kuwonjezera zizindikiro za matendawa. Izi ndichifukwa cha machitidwe obwezera m'mitsempha (nthawi yobwezeretsa idutsa).

Mu diabetesic neuropathy, tikulimbikitsidwa kuti azitsatira zakudya zapadera (makamaka mtundu wa matenda ashuga a 2). Dokotala amapanga mndandanda wazinthu zoletsedwa ndi zotsimikizika, komanso kulemba mndandanda wazitsanzo. Kutsatira mfundo izi za kadyedwe kumathandizira kuti shuga akhalebe gawo logulira chakudya, kusintha kagayidwe kazakudya ndikuthandizira kupewa zovuta. Ngati pakufunika kulemera kwa thupi, kulimbitsa thupi kumalimbikitsidwanso.

Kuti muchepetse vutoli, wodwalayo amapatsidwa mankhwala oletsa kupweteka ndi mankhwala omwe amabwezeretsa mitsempha. Chifukwa chaichi, mankhwala osapweteka a antiidal (Nimesulide, Indomethacin), mankhwala okhala ndi thioctic acid (Thioctacid, Thiogamma, Tiolept), antidepressants (Amitriptyline), anticonvulsants (Pregabalin ndi Gabapentin), mankhwala oletsa kupha mankhwala komanso anti-arrhythmias.

Njira zothandizira thupi.

Zithandizo za anthu

Zochizira matenda am'mimba a shuga, njira zamankhwala azikhalidwe zimagwiritsidwanso ntchito. Komabe, musanagwiritse ntchito, onetsetsani kuti mwakumana ndi dokotala kuti musadzivulaze komanso kupewa zovuta.

Pansipa pali maphikidwe otchuka a mankhwala achikhalidwe.

• Pakani zest ya ndimu ndikuyiphatikiza ndi phazi. Konzani compress ija ndi bandeji ndikuvala thonje. Chitani izi usiku wonse kwa masiku 14.
• Gwiritsani mafuta a camphor kuti musenzeze miyendo yanu.
• Monga mafuta odzola, gwiritsani ntchito dothi lobiriwira kapena lamtambo. Dilizani 50-100 g ya zopangira zamadzi m'madzi mpaka zamkati zikapezeka. Lemberani kumalo omwe akukhudzidwa ndikukonzekera ndi bandeji. Sungani compress mpaka dothi litha. Bwerezani izi tsiku lililonse.Kutalika kwa chithandizo sikuyenera kupitilira masabata awiri.
• Tengani kulowetsedwa kwa calendula tsiku lililonse. Pokonzekera zakumwa zochiritsira 2 tbsp. l Thirani 400 ml ya madzi otentha pamaluwa ndi kupita kwa maola awiri. Sakani chifukwa kulowetsedwa ndi kumwa tsiku lililonse 100 ml pamimba yopanda kanthu.
• A decoction a chamomile ndi nettle. Sakanizani zitsamba zofanana. Supuni ziwiri za osakaniza kutsanulira 250 ml ya madzi otentha ndi kuwira kwa mphindi 15 kusamba kwa madzi. Thirani mankhwala wozenekera ndikugawa magawo atatu ofanana, omwe amayenera kuledzera masana.

Mavuto omwe angakhalepo

Kuperewera kwa chithandizo chanthawi yodwala matenda ashuga, kuphatikiza mankhwala molakwika komanso kulephera kutsatira zomwe dokotala anganene kungayambitse zovuta. Zonsezi ndizowopsa kuumoyo ndi moyo, chifukwa chake, ngati zizindikiro zowopsa zikuwoneka, musachedwe kuyendera kwa dokotala.

Nthawi zambiri, odwala amadziwika kuti apanga phazi la matenda ashuga (limakhudza kuduladula miyendo), kulowerera m'mitsempha, zotupa za pakhungu m'manja ndi miyendo zomwe sizichiritsa kwa nthawi yayitali.

Zinthu zotsatirazi zimawonjezera chiopsezo cha zovuta: zizolowezi zoyipa, makamaka kusuta, kusadya bwino komanso kukana kumwa mankhwala omwe mumamwa.

Kupewa

Kutsatira njira zodzitetezera kuthandizira kupewa matendawa. Choyamba, muyenera kusiya zizolowezi zoipa ndikukhala ndi moyo wathanzi. Ntchito yofunikira kwambiri yodzitetezera imachitika pakutsata mfundo za zakudya zomwe anthu odwala matenda ashuga amakumana nazo. Izi zimathandiza kupewetsa kuchuluka kwa glucose, thanzi labwino komanso kunenepa kwambiri.

Ngati pali zinthu zomwe zikuwonetsetsa kuti matendawa atakula, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga ndikusunga matenda osokoneza bongo, kumwa mankhwala omwe adalembedwa ndi adokotala ndikuwunika momwe magwiridwe antchito am'kati ndi machitidwe amathandizira.

Matenda a diabetes a neuropathy ndi oopsa omwe amafunikira chisamaliro chamankhwala choyenera, mankhwala ndi physiotherapy. Kukaona dokotala panthawi yake kumatsimikizira kuti zotsatira zake zidzakhala zabwino komanso kusinthiratu kwa matenda. Ndi mavuto, zovuta za matenda ashuga zimasokonekera kwambiri, ndipo nthawi zina zimatha kutha.

Matenda a shuga a shuga: Zizindikiro

Matenda a diabetes a neuropathy amathanso kukhudza mitsempha yomwe imawongolera minofu ndi ziwalo zamkati. Chifukwa chake, zizindikiro zake ndizosiyana kwambiri. Mwambiri, amagawika "zabwino" ndi "zoipa".

Zizindikiro za Neuropathic

"Zogwira" (zabwino) zizindikiro	"Zizindikiro za" "passive" (zoipa)
Kuyaka Zowawa Msana, "kugwedezeka kwa magetsi" Kung'ung'udza Hyperalgesia - mwamphamvu kwambiri kupweteka koyambira Allodynia - kumverera kwa zowawa mukakumana ndi chosapweteka chopweteka, mwachitsanzo, kuchokera pakukhudzidwa kopepuka	Kudzera "Imfa" Kudzera Kung'ung'udza Kukhazikika poyenda

Odwala ambiri ali ndi onse awiri

Mndandanda wazizindikiro zomwe zimayambitsa matenda ashuga:

• dzanzi ndi kumva kuwawa m'miyendo,
• kutsekula m'mimba (m'mimba)
• kukomoka kwa erectile mwa amuna (mwatsatanetsatane, onani "Kusabala kwa shuga - chithandizo chothandiza"),
• Kuwonongeka kwa chikhodzodzo - kukanika kwamikodzo kapena kutulutsa zonse,
• kupindika, kutikita minofu ya nkhope, pakamwa kapena m'maso,
• Mavuto amaso chifukwa cha kusokonekera kwa khungu.
• chizungulire
• kufooka kwa minofu
• kuvuta kumeza
• mawu osokoneza
• minofu kukokana
• anorgasmia mwa akazi,
• kupweteka kwa minofu kapena "magetsi amanjenjemera".

Tsopano tidzafotokozera mwatsatanetsatane zizindikiro za mitundu iwiri ya matenda ashuga, omwe odwala amafunika kudziwa, chifukwa ndiofala kwambiri.

Alpha lipoic acid zochizira matenda ashuga neuropathy - werengani apa mwatsatanetsatane.

Sensorimotor neuropathy

Zingwe zazitali kwambiri zimafikira kumapeto, ndipo ndizovuta kwambiri kuwonongeka kwa matenda ashuga. Sensomotor neuropathy imawonetsedwa ndikuti wodwalayo pang'onopang'ono amasiya kumva chizindikiro kuchokera m'miyendo yake. Mndandanda wazizindikiro izi umaphatikizapo kupweteka, kutentha, kupanikizika, kugwedezeka, malo m'malo.

Wodwala yemwe wakhala ndi sensorimotor neuropathy, mwachitsanzo, amatha kulocha msomali, amavulala, koma osamverera ndikuyenda modekha. Komanso, sangamve ngati phazi likuvulala ndi nsapato zolimba kwambiri kapena zosasangalatsa, kapena ngati kutentha kwa bafa ndikwambiri.

Panthawi imeneyi, mabala ndi zilonda zam'miyendo mwendo nthawi zambiri zimachitika, kusunthika kapena kuwonongeka kwa mafupa kumatha kuchitika. Zonsezi zimatchedwa matenda a shuga. Sensomotor neuropathy imatha kuwonetsedwa osati kutaya mtima, komanso kuwotcha kapena kupweteka m'miyendo, makamaka usiku.

Kukumbukira kwa wodwala wodwala matenda ashuga amtundu wa 2, omwe mavuto ake ammendo adasowa pambuyo poyambira shuga wamagazi ...

Diabetesic Autonomic Neuropathy

Dongosolo lamanjenje la autonomic limakhala ndi mitsempha yomwe imawongolera mtima, mapapu, mitsempha yamagazi, mafupa ndi adipose, dongosolo logaya chakudya, ma genitourinary system, ndi tiziwalo thukuta. Mitundu iliyonse yamtunduwu imatha kukhudzidwa ndi matenda ashuga othana ndi vuto la matenda ashuga.

Nthawi zambiri, zimayambitsa chizungulire kapena kukomoka ndi kukwera kwakuthwa. Chiwopsezo cha kufa mwadzidzidzi chifukwa cha mtima wa arrhythmias chikuwonjezeka pafupifupi kanayi. Kuchepetsa kuyenda kwa chakudya kuchokera m'mimba kupita m'matumbo kumatchedwa gastroparesis. Vutoli limabweretsa kuti kuchuluka kwa glucose m'magazi kumasintha kwambiri, ndipo zimavuta kuti shuga azikhala ndimagazi nthawi zonse.

Autonomic neuropathy imatha kupangitsa kuti kukodoka kwamitsempha kapena kuzimiririka. Zikatere, kachilomboka kamafalikira mu chikhodzodzo, chomwe chimadzuka ndikuvulaza impso. Ngati mitsempha yomwe imawongolera magazi amunayo ikukhudzidwa, ndiye kuti abambo amakumana ndi vuto la erectile.

Zomwe zimayambitsa matenda ashuga a shuga

Cholinga chachikulu cha mitundu yonse ya matenda ashuga a m'magazi ndi kuchuluka kwa shuga m'magazi, ngati amakhala wokwera kwa zaka zingapo. Pali njira zingapo zoyambitsa kuphatikizira kwa shuga. Tikambirana ziwiri zazikuluzikulu za izo.

Mafuta akwezedwa amawononga mitsempha yamagazi yaying'ono (capillaries) yomwe imadyetsa mitsempha. Patency ya capillaries pakuyenda kwa magazi imachepetsedwa. Zotsatira zake, mitsempha imayamba "kukwana" chifukwa chosowa mpweya, ndipo kayendetsedwe ka mitsempha kumachepa kapena kutha kwathunthu.

Glycation ndi kuphatikiza kwa glucose ndi mapuloteni. Mochulukitsa kuchuluka kwa shuga m'magazi, mapuloteni ochulukirapo amachitika motere. Tsoka ilo, kukomoka kwa mapuloteni ambiri kumayambitsa kusokonekera kwa magwiridwe awo. Izi zimagwiranso ntchito kuma protein omwe amapanga dongosolo lamanjenje. Zinthu zambiri zomaliza za glycation ndizoopsa m'thupi la munthu.

Momwe dokotala amapangira matenda

Kuti adziwe matenda a diabetes a neuropathy, dokotala amafufuza ngati wodwalayo akumva kukhudzidwa, kukakamizidwa, jekeseni waululu, kuzizira komanso kutentha. Kuzindikira kugwedezeka kumayendera pogwiritsa ntchito foloko. Kukhudzika kwa kukakamizidwa - ndi chipangizo chotchedwa monofilament. Dokotalayo apezanso ngati wodwalayo ali ndi vuto la bondo.

Mwachidziwikire, munthu wodwala matenda ashuga yekha amatha kudziyesa kuti asapeze neuropathy. Phunziro lodziyimira pawokha lakukhudza, mwachitsanzo, masamba a thonje ndi oyenera. Kuti muwone ngati mapazi anu akumva kutentha, chilichonse ofunda ndi ozizira achite.

Dokotala amatha kugwiritsa ntchito zida zamakono zachipatala kuti adziwike moyenera. Adziwitse mtundu wa matenda ashuga a m'mimba ndi gawo la kakulidwe kake, mwachitsanzo kuchuluka kwake kwa mitsempha. Koma chithandizo munthawi iliyonse chimakhala chofanana. Tidzakambirana pambuyo pake m'nkhaniyi.

Chithandizo cha matenda ashuga a Neuropathy

Njira yayikulu yothandizira matenda a matenda ashuga ndi kuchepetsa magazi ndi kuphunzira kusakhazikika, monga mwa anthu athanzi lopanda matenda a shuga. Njira zina zonse zochiritsira sizikhala ndi kachigawo kakang'ono ka mphamvu ya kayendedwe ka magazi m'magazi. Izi sizikugwira ntchito ku neuropathy kokha, komanso ku zovuta zina zonse za matenda ashuga. Tikupangira zolemba zanu:

Ngati matenda ashuga a m'mimba amachititsa kupweteka kwambiri, dokotala amatha kukupatsani mankhwala ochepetsa mavutowo.

Mankhwala omwe amagwiritsidwa ntchito ngati chizindikiro chothandizira kupweteka kwa matenda ashuga polyneuropathy

Gulu la mankhwala	Mutu	Mlingo watsiku ndi tsiku, mg	Kuopsa kwa mavuto
Tricyclic antidepressants	Amitriptyline	25-150	+ + + +
	Imipramine	25-150	+ + + +
Serotonin / Norepinephrine Reuptake Inhibitors	Duloxetine	30-60	+ +
	Paroxetine	40	+ + +
	Citalopram	40	+ + +
Mankhwala opatsirana	Gabapentin	900-1800	+ +
	Lamotrigine	200-400	+ +
	Carbamazepine	mpaka 800	+ + +
	Pregabalin	300-600
Zosangalatsa	Maloiletine	mpaka 450	+ + +
Ma opioids	Tramadol	50-400	+ + +

Yang'anani! Mankhwala onsewa ali ndi zotsatira zoyipa. Zitha kugwiritsidwa ntchito pokhapokha ngati dokotala akufotokozerani ngati zovuta sizipirira. Odwala ambiri akukhulupirira kuti kupilira zovuta za mankhwalawa ndi koopsa kuposa kupilira ululu chifukwa cha kuwonongeka kwa mitsempha. Komanso, mankhwalawa amatha kuwonjezera shuga.

Matenda a diabetes a neuropathy amachiritsika kwathunthu!

Pomaliza, takusungirani nkhani yabwino. Neuropathy ndi imodzi mwazosintha zovuta za matenda ashuga. Izi zikutanthauza kuti ngati muthanso kuchepetsa shuga m'magazi anu ndikulisunga bwino, ndiye kuti mukuyembekeza kuti zizindikilo za kuwonongeka kwa mitsempha zimatha.

Zimatha kutenga miyezi ingapo kufikira zaka zingapo mpaka mitsempha itayamba kuchira, koma izi zimachitikadi. Makamaka, chidwi cha miyendo imabwezeretseka, ndipo kuwopseza "phazi la matenda ashuga" kumatha. Izi zikuyenera kukulimbikitsani kuti muchite zonse zomwe mungathe kuti muchepetse shuga.

Kuchepa kwa Erectile mwa amuna kumatha kuchitika chifukwa cha kuwonongeka kwa mitsempha yomwe imawongolera mbolo, kapena chifukwa cha zotupa zomwe zimadyetsa magazi kulowa m'thupi la chimbudzi. Poyambirira, potency imabwezeretseka kwathunthu komanso kuwonongeka kwa zizindikiro zina za matenda ashuga. Koma ngati matenda ashuga adatha kuyambitsa mavuto ndi ziwiya, ndiye kuti matendawa akuipiraipira.

Tikukhulupirira kuti nkhani yathu lero yakhala yothandiza kwa odwala. Kumbukirani kuti, mpaka pano, palibe mankhwala omwe amathandizadi pochiza matenda a shuga. Zambiri pazotsatira za alpha-lipoic acid ndi mavitamini a B ndizosemphana. Mankhwala atsopano akangofika, tikukudziwitsani. Mukufuna kudziwa nthawi yomweyo? Saina nkhani yathu.

Njira zabwino zochizira matenda ashuga ndi kukhala ndi shuga. Mukawerenga tsamba lathu, mukudziwa kale njira yabwino yokwaniritsira izi. Kuphatikiza pa chakudya chamagulu owonjezera, timalimbikitsa kuti muyesere mavitamini a alpha lipoic acid okwanira ndi mavitamini. Zowona sizingabweletse mavuto mthupi, ndipo mapindu ake amakhala atanthauzo. Zowonjezera zimatha kufulumizitsa kumasulidwa kwanu kwa zizindikiro za mitsempha ya conduction.

Kuwonongeka kwa dongosolo lamanjenje lamkati

Matenda a shuga ndi chinthu chomwe chimayambitsa chitukuko cha matenda a shuga.

Mu chithunzi cha chipatala, matenda a cerebrosthenic syndrome amalamulira. Ichi ndi chikhalidwe chodziwika ndi kusokonezeka kwa tulo, kusokonezeka kwanzeru, chidwi, kukula kwa phobias ndi kukhumudwa (astenopochondriac syndrome). Mkhalidwe wofanana ndi wa neurosis umapezeka muzochita za wodwala, samakwiya, kuchuluka kwa nkhawa kumachulukanso. Izi zimachitika chifukwa cha kusokonekera kwadzidzidzi komanso kusintha kwakanthawi kwamayendedwe ndi moyo. Musaiwale kuti matenda ashuga ndi matenda osachiritsika omwe amasinthiratu ndikugonjera mtundu wa odwala. Amakakamizidwa kumwa mankhwala kwa moyo wake wonse, kudzikana lokoma, koma, mwatsoka, zimamupweteketsa chakudya, kuyang'anitsitsa kuchuluka kwa glucose, kuyendera dokotala, kuwopa zovuta ndi zina zambiri.

Akatswiri azachipatala amasiyanitsa magawo angapo a mavuto omwe amayambitsidwa ndi matendawa:

• Gawo loyamba likugwirizana ndi kukhala ndi matenda a shuga,
• Lachiwiri - ndi kukula kwamavuto,
• Chachitatu ndi kudya insulin nthawi zonse.

Ndi kukula kwa matendawa, kusintha kosalekeza kwa ubongo kumawonedwa ndi mawonetseredwe ena am'chipatala. Wodwalayo amatha kupeza tinnitus, chizungulire, kupweteka mutu pafupipafupi, kukumbukira ndi kusalankhula.

Chiwopsezo cha matenda a sitiroko chimawonjezeka nthawi zina chifukwa cha angiopathy. Mankhwala a ischemic ndi hemorrhagic stroko amakhala ovuta, otalika komanso osachita bwino ngati odwala opanda matenda a shuga.

Kuwonongeka kwa mitsempha

Mu 70% ya milandu, mafupa am'mitsempha am'munsi amawonongeka: motor, sensory and autonomic.

Mawonetseredwe oyamba azachipatala ndi kugunda kwamphamvu, kumva tulo, "goosebumps", kumverera kotsika, kumverera kwa thupi lachilendo m'misempha ya mwendo. Komanso, wodwalayo amadandaula za kubaya kapena kudula ululu. Kusintha kwadzidzidzi kumachitika mu minofu, yomwe ingayambitse kuchepa kwamitundu yonse yamtundu wamtundu wamtundu (wamtundu, wowawa, wamphamvu, wodzipereka). Minofu imakhala yofooka, yokonda kuchita ziwonetsero. Pali magawikidwe amawu pakati pa extensor ndi minofu yosinthika ya phazi.

Chifukwa cha kuwonongeka kwa mitsempha, kufooka kwa chidwi kumawonekera, makamaka bondo ndi Achilles.

Chizindikiro chotsogola mu kuphatikizika kwa matenda a shuga ndi kupweteka. Zomverera zosasangalatsa zimatha kuchitika ngakhale ndi mayendedwe kapena kukhudza komwe m'mbuyomu sikunapangitse zomverera zosasangalatsa. Dotoloyo adatchulapo hypnothesia, kusinthasintha kwa chidwi komanso kumva kupweteka kwambiri mopitirira muyeso, komwe sikunadziwike koyambirira. Kusasangalala kumapitilira kwanthawi yayitali ngakhale atachotsedwa ntchito wokhumudwitsa. Wodwalayo amawona kuwonjezeka kwa zowawa madzulo.

Matenda a matenda ashuga

Zilonda za kumapazi kwa matenda a shuga

Ndi kukula kwa zotumphukira neuropathy, wodwalayo atha kudwala matenda a shuga. Izi ndizowononga mafupa, mafupa, mawonekedwe a zilonda zam'mimba zam'mimba zopanda pake. Wodwalayo akapanda kuthana ndi vutoli ku dipatimenti yopanga opaleshoni kapena kuyesera kuthandizidwa ndi wowerengeka, ndiye kuti izi zayamba kukhala chizindikiro choti adzichepetse omwe akhudzidwa.

Zizindikiro zoyambirira ndi edema, redness of the khungu, ming'alu, mabala ang'onoang'ono omwe amatenga nthawi yayitali kuti achiritse komanso osachira, matenda oyamba ndi khungu ndipo zotuluka zake zimachitika. Matenda a matenda ashuga amakula ndi matenda a shuga osaletseka. Kuchiza kumachitika nthawi zambiri.

Kuwonongeka kwa dongosolo la autonomic mantha

Autonomic diabetesic neuropathy ndi chotupa cha gawo lopatula la mitsempha yomwe imayang'anira kugwira ntchito kwa gawo linalake. Nthawi zina pamatha kuwonongeka nthawi imodzi pamakina angapo.

Pali gulu lazachipatala lomwe ziwalo zomwe zakhudzidwa zimawonetsedwa.

Onani	Feature
Zamtima Autonomic Neuropathy	Mtima kudziwika matenda, tachycardia kupuma, ischemia, myocardial infarction, hypotension, utachepa masewera olimbitsa thupi. Zosintha zapadera za ECG.
Gastrointestinal Autonomic Neuropathy	Hypersalivation, gastroparesis, utachepa matumbo, kuchepa kwa esophagus, hypoacidosis, dysbiosis yamatumbo, mapando omasuka, kapamba, dyskinesia wa biliary.
Urogenital Autonomic Neuropathy	Kuphwanya kwamikodzo, mkodzo Reflux. Mwa amuna, kusokonezeka kwa kugonana ndi kuchepa kwa mphamvu ya kupweteka kwa ma testicles, mwa akazi, kuphwanya kwachinsinsi komwe kumachitika mu nyini.
Ntchito ya ophunzira imalidi	Kusinthasintha kwa mwana kuti asinthe kuyatsa kumayendera pang'onopang'ono, zimakhala zovuta kuti wodwalayo asinthe poyang'ana mbali yake. Mdima, masomphenya amakhala ndi vuto lalikulu.
Kusokonekera Kwachisoni	Mukamadya, thukuta limachuluka. Nthawi yonseyi, hypo-kapena anhidrosis imawonedwa.
Matenda a Thermoregulation	Kutentha kumakhala kosintha kuyambira 37 mpaka 38
Matenda a shuga	Izi zimaphatikizapo kutopa, sexomotor polyneuropathy, matenda osakhazikika miyendo.

Kuwonongeka kwa mitsempha yozungulira

Matenda a diabetes a neuropathy amatha kuwonetsa kuwonongeka m'mitsempha yamtundu uliwonse m'thupi. Izi zikuwonetsa kuti mawonetsedwe azachipatala amasiyana siyana ndipo matendawo amafunika kumuyesa mozama.

Matendawa amatchuka chifukwa cha kuyambika kwake ndipo amadziwika ndi kupweteka kwamphamvu m'mitsempha komanso minofu ntchito (kufooka, paresis, ziwalo). Mwa zizindikiro zofala, ndizotheka kutcha mitsempha yam'mimba, diplopia, ululu wakuthwa m'munsi m'munsi kapena pachifuwa, pamimba. Odwala awo nthawi zambiri amasokonezeka ndi kupweteka kwa mtima kapena kugunda kwa kapamba, chifuwa cham'mimba.

Ndizosatheka kulosera zamtsogolo zauronomic neuropathy. Zizindikiro zimatha kutha ndikuwonongeka mosayembekezereka, popanda kuvulaza wodwala, kupatula kusapeza bwino kwambiri.

Kusiyanitsa kosiyanitsa kuyenera kuchitika ndi chidakwa chaukali kapena poizoni. Ndi chizindikiro cha ululu chomwe chimapezeka m'miyendo yakumtunda, ndikofunikira kupatula neuropathy ya radial kapena ulnar nerve. Chithandizo chikuyenera kuperekedwa molumikizana ndi endocrinologist ndi neuropathologist.

Njira Zodziwitsira

Gawo loyamba pakupanga chidziwitso cholondola ndikupeza anamnesis ndikuzindikira madandaulo onse odwala. Dotolo ayenera kufotokozera ngati wodwalayo amavutika kugwira zinthu zosiyanasiyana kwa nthawi yayitali, akuyenda ndikukwera masitepe, ngati wodwalayo wasamalira kusakhazikika, malingaliro osasangalatsa mumiyendo (kumva kugwa, kuwotcha, kukwawa). Komanso, wodwalayo amatha kuwona kuwonongeka kwa ziwalo za m'chiberekero (mavuto ndi chimbudzi kapena kukodza, kuphwanya kwa erection).

Gawo lotsatira pakupezeka kwa matenda a diabetesic neuropathy ndikuzindikira zamitundu yonse.

Kuzindikira kwamphamvu kumayang'aniridwa ndi foloko yomaliza maphunziro. Kuti muchite izi, ikani mwendo wake pakatikati pa chala chachikulucho ndikuyeza nthawi yomwe munthu agwedezeka. Kuzindikira kwamkati kumawunikidwa pongokhudza chilichonse pachikopa. Mphamvu yamatenthedwe amasunthidwa ndi chipangizo chomwe mumakhala mbali ziwiri: chitsulo ndi pulasitiki. Pokhudza khungu, wodwalayo ayenera kudziwa kutentha. Njirayi ikhoza kuphatikizidwa ndi yapita. Kumva kupweteka kumayang'aniridwa ndi singano yonyansa.

Ngati matenda okhudzana ndi matenda a diabetic neuropathy akukayikira, ndikofunikira kuchita njira zowonjezera zowerengera: electromyography, ultrasound, CT.

Mankhwala othandizira

Ndi neuropathy ya chiyambi cha matenda ashuga, njira yoyamba yothandizira ndikutsitsa shuga kuti ikhale yambiri. Kusungabe kuchuluka kwa glycemia ndiyo njira yokhayo yoletsa kuyambika kwa matenda ashuga a m'mimba kapena kuchedwetsa kukula kwake.

Dokotalayo amapereka mankhwala othandizira, omwe cholinga chake ndi kupewetsa kupweteka, kubwezeretsa minyewa yowonongeka, komanso kukonza minyewa. Wodwala ayenera kumvetsetsa kuti iyi ndi njira yayitali yomwe imafunikira kulimbikira komanso nthawi yayitali.

Kukonzekera kwa alpha-lipoic acid ndi lipophilic antioxidant, komwe kumachepetsa kukula kwa zopitilira muyeso mumitsempha ndikusintha mtundu wawo. Komanso, mankhwalawa amathandizira kutsitsa cholesterol ndikuwongolera mkhalidwe wamakhoma wamitsempha. Mukamamwa mankhwalawa, kupweteka, kutupa, paresthesia kumayamba kutchulidwa.

Pachikhalidwe, odwala omwe ali ndi matenda ashuga a mtima amapatsidwa mavitamini a B.

Kuti muchepetse kupweteka, mutha kugwiritsa ntchito ma analgesics ndi ma antidepressants atatu.

Njira zopanda mankhwala zochizira matenda a neuropathy zimaphatikizapo njira zakuthupi zomwe zimayang'ana kubwezeretsa ntchito za minofu ya minofu (electrophoresis, kukondoweza kwa magetsi a percutaneous, acupuncture ndi ena).

Njira yothandizira wodwala aliyense ndi payekhapayekha ndipo imafunikira chisamaliro chapadera.

Zomwe zimayambitsa odwala matenda ashuga

Magazi a munthu wodwala matenda ashuga amakhala ndi shuga osakhazikika. Pakakhala yotsika, ma neuron amakhala ndi njala.

Ngati shuga wambiri amawonedwa, acidization ya maselo imachitika. Kuphatikiza apo, shuga ochulukirapo amathandizira kuti fructose ndi sorbidol zichulukane, ndiye chifukwa chake maselo sangathe kuyamwa madzi ndi mchere.

Chifukwa chake pali edema ya mitsempha mathero. Chithunzicho chikuchulukirachulukira ndi matenda oopsa. Popeza minofu ya mitsempha imayatsidwa ndi ma capillaries ambiri ang'onoang'ono, kuthamanga kwa magazi kumawapangitsa kukokana, ndipo ma neurons amamwalira.

Madotolo amakhulupirira kuti cholakwa pakukula kwa DN chiri ndi jini losinthidwa mwapadera. Ndiamene amapanga ma neurons hypersensitive kuti azitha kuchuluka kwa glucose.

Zizindikiro za matenda a shuga a polyneuropathy a m'munsi am'munsi

Pankhani ya kuwonongeka kwa zotumphukira DN, siginatology sikuwoneka nthawi yomweyo, koma pakatha miyezi ingapo.

Chowonadi ndi chakuti pali mitundu yambiri yamanjenje mu thupi. Ndipo ena a iwo akamwalira, ma neuron athanzi amagwira ntchito yawo kwakanthawi.

Poyamba, mikono ndi miyendo zimavutika, chifukwa ulusi wamanjenje m'malo awa ndi wautali, ndipo umakonda kupweteka kwambiri.

Kodi mawonekedwe otumphukira amawonetsedwa bwanji?

Mitsempha yachifundo ikamwalira, minyewa yam'maso imadziwika.

Mawonetseredwe otsatirawa ndi mawonekedwe amachitidwe am'mimba:

• Hypersensitivity kwa zilizonse zoyipa. Wodwalayo akumva zotupa pakhungu lake, akuwotcha kapena ululu wowopsa womwe umachitika ngakhale ndi kukhudza pang'ono,
• kutsitsa pang'ono kulowa pansi, ndipo nthawi zina kutayika kwathunthu. Munthu amene akhudza chinthu amamva "kudutsa pagulu". Cholinga: chizindikiritso chochokera ku ma receptor sichimafika mu ma neurons a ubongo,
• zolakwika kwa okhumudwitsa. Chifukwa chake, poyankha kuwala, wodwalayo amayamba kumva kukoma mkamwa kapena mkokomo m'makutu. Chifukwa: kukwiya kwa gawo limodzi la thunthu la mitsempha kumayendetsa ma receptor ena ambiri (kulawa kapena mawu).

Ngati mitsempha yamagalimoto ivutika, motor neuropathy imachitika.

Chizindikiro cha motor neuropathy chimayamba pang'onopang'ono ndipo nthawi zambiri chimadziwonetsa usiku kapena nthawi yopuma:

• kusakhazikika kwa udindo ("miyendo thonje"),
• kulumikizidwa bwino (zotsatira za kuwonongeka kwa ma neurons aubongo),
• mafupa amasiya kuyenda, amatupa, zimakhala zovuta kuwongola,
• mphamvu ya minofu imachepetsedwa kwambiri. Chifukwa: matenda a shuga amasokoneza magazi ndi kusungika. Atrophy ya minofu imachitika pakapita nthawi.

Zizindikiro za mawonekedwe odziyimira pawokha

Pankhani ya mawonekedwe odziyimira pawokha, mitsempha ya autonomic NS imavutika. Pafupifupi machitidwe onse amthupi amakhudzidwa:

• m'mimba: kutentha kwadzuwa ndi kupindika, kudzimbidwa kosatha
• maso: masomphenya amachepa
• khungu limasintha (chifukwa cha kusachita thukuta thukuta). Poyamba, thukuta limawonedwa (nthawi zambiri usiku). Chifukwa cha makuponi ochulukitsidwa, khungu limasanduka lofiira. Tsitsi losasangalatsa limawonekera. Pambuyo pake, tiziwalo thukuta timachepetsa ntchito zawo, khungu limadzuka. Ntchito yake yoteteza imafooka, ndipo kuwonongeka kulikonse kwa nthawi yayitali sikuchira,
• ziwalo zamkati: kukodza kosakwanira komanso kosakwanira, kusabala,
• ntchito yamtima wasweka: arrhasmia, pafupipafupi kukoka. Chifukwa chotsika pang'onopang'ono mphamvu ya mtima, ngakhale vuto la mtima limatuluka popanda kumva kuwawa.

Zotsogola ndi kupewa

Kuzindikira koyambirira kwa matenda ashuga a m'matumbo (onse kuphatikizika ndi kudziyimira pawokha) ndiye njira yofunika kwambiri yopezera chiyembekezo komanso kusintha kwa moyo wa odwala. Magawo oyamba a matenda ashuga a m'mimba amatha kusinthidwa ndikulipirira chindapusa cha matenda ashuga. Kupanikizika kwa matenda ashuga a m'mimba kumabweretsa chiwopsezo chachikulu cha kubanika kwa mtima kosafunikira, mtima wamisala, komanso kudula kosapweteka kwa m'munsi.

Pofuna kupewa matenda ashuga a m'mimba, kuwunika pafupipafupi kuchuluka kwa shuga m'magazi, kukonza mankhwalawa panthawi yake, kuwunika pafupipafupi ndi katswiri wa matenda ashuga ndi akatswiri ena ndikofunikira.

Kodi misempha imagwira ntchito bwanji

Kuti timvetsetse za matendawa, tiyeni tikumbukire momwe maselo amanjenje amagwirira ntchito. Amakhala ndi maselo amitsempha - ma neurons. Amakhala ndi mitundu ndi mitundu iwiri ya ma process: ma axon atali ndi dendrites yayifupi.

Anatomically olekanitsa chapakati ndi zotumphukira mantha dongosolo. Mu chapakati Lowani muubongo ndi chingwe cha msana, titha kunena kuti amapangidwa ndi matupi a minyewa. Peripheral dongosolo lamitsempha - awa ndi mitsempha yopanga ma cell a mitsempha. Amabalalitsa thupi kudzera mu ubongo ndi msana.

Pali magawikidwe amanjenje mkati amodzi ndi zamasamba. Timasamalira mosamala NS mosamala. Amatsogolera ntchito yamafupa. Koma dongosolo lodziyang'anira pawokha limayang'anira ntchito ya glands, komanso ziwalo zamkati ndipo sizitengera zomwe tikufuna.

Mitsempha iyi imakhala ndi masauzande angapo owonda - njira zama cell amitsempha yokutidwa ndi myelin sheath ndi minofu wolumikizana endoneuria. Kuti muchite bwino chizimba, ulusi umasonkhanitsidwa m'mingolo yopyapyala yolumikizidwa ndi mtolo wa zotulutsa zolumikizika - perineuria. Mitsempha yama mitsempha ndi mitsempha imapita kwa perineuria, yomwe imapereka zakudya zamitsempha. Mizere yolumikizana imakutidwa ndikukutidwa ndi chipolopolo chamkati mwa epineuria. Ntchito yake ndikuteteza mitsempha kuti isawonongeke. Kapangidwe kameneka kamachedwa thunthu la mitsempha.

Mitsempha - pali mitundu itatu:

• Mitsempha yachisoni. Zopanda chidwi (ogwirizana) maselo amitsempha. Ali ndi maselo olandila mbali imodzi. Chifukwa cha zomwe, timatha kumva, kuwona, kumva kutentha, kupanikizika, kugwedezeka, kupweteka, kusiyanitsa kukoma ndi kununkhira. Mukadziwika ndi receptor, minyewa imayamba. Kudzera m'mitsempha, ngati ngati ndi waya, imaperekedwa ku ubongo ndikakonzedwa pamenepo. Titha kuganiza kuti ndi ubongo womwe timawona, kumva ndi kumva kupweteka.
• Mitsempha yamagalimoto wopangidwa ndi ulusi wama motor. Kuchokera kuubongo, lamulo lotulutsa limaperekedwa kudzera mu mitsempha kupita ku minofu yathu yonse ndi ziwalo zonse. Ndipo amamvera mokhulupirika ndi kupumula.
• Mitsempha yosakanikirana kuphatikiza ulusi wam'maselo am'mimba komanso amanjenje am'mimba ndipo amatha kuchita zonse ziwiri.

Sekondi iliyonse, dongosolo lathu lamanjenje limapereka thupi ndikugwirizanitsa ziwalo zonse. Chifukwa chake, kugonjetsedwa kulikonse kumabweretsa zotsatira zoyipa zomwe zimakhala zowopsa thanzi.

Zomwe zimachitika ndi dongosolo lamanjenje mu shuga

Mu shuga mellitus, kuchuluka kwa shuga m'magazi sikakhazikika. Ikamagwa, maselo amitsempha amanjala. Ndipo pakakhala shuga wambiri, zimayambitsa mapangidwe a free radicals. Zinthu izi zimapukusa maselo ndipo zimayambitsa kukhumudwa kwa mpweya. Miyezi yambiri yamkamwa imayendera limodzi ndi kudzikundikira kwa sorbitol ndi fructose mu minofu. Zakudya zamtunduwu zimasokoneza mayamwidwe amadzi ndi mchere m'maselo, zomwe zimapangitsa kuti mitsempha yotupa izitutira.

Ngati munthu nawonso ali ndi kukakamizidwa kowonjezereka, ndiye kuti pali kuphipha kwa ma capillaries ang'onoang'ono omwe amadyetsa thunthu la mitsempha. Zotsatira zake, maselo amakhala ndi njala ya oxygen ndikufa.

M'zaka zaposachedwa, akukhulupirira kuti jini losinthika, lomwe limabadwa, limagwira ntchito yayikulu pakukula kwa matenda a shuga. Zimapangitsa kuti ma neurons azikhala tcheru kwambiri ndi zovuta zam'magazi azambiri. Machitidwe a neurons atrophy ndipo sangathe kupereka chizindikiro. Mchombo wa axon myelin umawonongekanso, womwe umapangidwa kuti uzisiyanitsa ndi minyewa ya mitsempha ndikuletsa kuti zomwe zimapangitsa zisabalalike.

Zizindikiro za matenda ashuga a shuga

Zizindikiro za matenda a shuga a shuga zimatengera gawo liti lamanjenje lomwe limayambukiridwa ndi matendawa. Munkhaniyi, tikungowerenga zowonongeka zamtundu wamanjenje. Ngakhale matenda ashuga amakhudza kugwira ntchito kwa dongosolo lamkati lamanjenje, makamaka khansa ya m'magazi. Vutoli limatchedwa diabetesic encephalopathy.

Ndi kuwonongeka kwamitsempha yamafupa, zizindikiro zimawonekera patatha miyezi yochepa. Izi ndichifukwa choti pamakhala mitsempha yambiri mthupi; poyamba, mitsempha yathanzi imagwira ntchito za omwe adawonongeka. Manja ndi miyendo ndizomwe zimayamba kuvutika, chifukwa pa fiber yayitali ya mitsempha imakhala malo ochulukirapo owonongeka.

Sensory neuropathy

Ichi ndi chotupa chamanjenje zam'malingaliro, chomwe chimawonetsedwa ndi zomverera zosokoneza symmetrically pamiyendo yonse, mikono kapena mbali za nkhope.

1. Hypersensitivity to irritants (hyperesthesia)
   Imawonekera ngati kumverera kwakukwawa, kugunda, kuwotcha kapena kusalala, kupweteka kwakapweteka kwakanthawi. Chomwe chimapangitsa izi ndi kusokonezeka m'mitsempha, komwe kumayambitsa kusaoneka kokwanira kuchokera zolandirira khungu kupita ku ubongo.
2. Kuyankha kosakwanira kwa omwe akukwiyitsa
   • Poyankha pakukwiya kulikonse pakhungu (striking, kumva,), kupweteka kumatha kuchitika. Chifukwa chake, munthu amadzuka ululu chifukwa cha kukhudza kwa bulangeti.
   • Poyankha chomukwiyitsa kamodzi, monga kuwala, kumverera kambiri: tinnitus, kusowa mkamwa ndi kununkhiza. Mu thunthu la mitsempha, "kudzipatula" kumasokonekera ndipo kupendekera komwe kumachitika m'maso kumafikira ku ma receptor ena (olfactory, gustatory, auditory).
3. Kuchepa kapena kuwonongeka kwathunthu kwa chidwi
   Mawonetsero oyamba amachitika pamapazi ndi m'manja, izi zimatchedwa "socks and gloves syndrome." Munthuyu akuwoneka kuti akumva chinthucho m'manja ndipo samayenda opanda nsapato, koma m'masokosi amkaka. Kuvulala kambiri mbali zosiyanasiyana za mitsempha kumalepheretsa chizindikirocho ku zolandirira kulowa mu ubongo.

Matenda a neuropathy

Ichi ndi chilonda cha mitsempha yamagalimoto yomwe imafikitsa ubongo kumalamulo. Zizindikiro zimayamba kukula pang'onopang'ono, zimakhazikika pakupuma komanso usiku.

1. Kutayika kokhazikika poyenda
   Kuchepa kwa chidwi chotsogola kumabweretsa kuti miyendo imakhala "cottony", minyewa siyimvera ndipo pang'onopang'ono imayamba kuyenda.
2. Kuperewera koyendetsa kayendedwe
   Izi ndizotsatira zowonongeka m'mitsempha ya cranial, yomwe imafikitsa deta kuubongo kuchokera ku ziwiya za vestibular, zomwe zimayang'anira malo amthupi m'malo.
3. Popeza sayenda mafupa okhaokha, amatupa ndi kulemala
   Kuphatikizika kwa zala ndi manja ndikoyamba kukhudzidwa. Manja, poyamba zimakhala zovuta kuwongola zala zazing'onopo, kenako zala zotsala. Kusinthasintha kwa shuga kumasokoneza ma microcirculation ndi metabolism m'malumikizidwe ndi mafupa, zomwe zimayambitsa kutupa ndi kuchuluka.
4. Kufooka minofu ndi kuchepa mphamvu m'manja ndi kumapazi
   Kuti minye igwire bwino ntchito, imafunikira magazi mozungulira komanso kubereka. Ndi matenda ashuga, zonsezi zimaphwanyidwa. Minofu imakhala yofooka, ndipo munthu amasiya kumva mayendedwe awo. Pa magawo oyamba a matendawa, minyewa imatupa, ndipo pamapeto pake imachepetsa voliyumu ndi atrophy.

Autonomic neuropathy

Ndi mtundu uwu wa neuropathy, mitsempha ya autonomic mantha system, yomwe imayang'anira ntchito ya ziwalo zamkati, imasokonezeka. Zotsatira zake, mamembala amalandila malamulo osokoneza, ndipo kupezeka kwa mpweya ndi michere kumachepa.

1. Matenda am'mimba
   • kuphwanya kwa kumeza
   • ma sphincters am'mimba amakhala omasuka, omwe amayambitsa kupindika pafupipafupi, kutentha kwa mtima,
   • cham'mimba chotsitsa,
   • Matumbo am'mimba amachepa - kudzimbidwa kosatha kumachitika,
   • zimachitika kuti matumbo amayenda mofulumira, ndiye kutsegula m'mimba kumachitika mpaka 20 patsiku, nthawi zambiri usiku. Koma nthawi yomweyo, munthu sataya thupi, chifukwa chakudya chimakhala ndi nthawi yoti chimidwe.
   Ntchito ya m'mimba imangoyenera kusinthira NS, ndipo kusokonezeka m'mitsempha kumayambitsa vuto mu chimbudzi.
   
2. Kusokonezeka kwa ziwalo za m'chifuwa
   • kusabala. Kukopa kumapitilira, koma kudzaza kwa mbolo ndi magazi kwambiri kumakulirakulira. Izi zimachitika chifukwa chophwanya malo okhala mkati ndi m'mimba.
   • kamvekedwe ka chikhodzodzo. Minofu ya chikhodzodzo sichilandira chizindikiritso ndipo imatambasulidwa. Kukodza kumakhala kochepa (nthawi 1-2 patsiku) komanso pang'onopang'ono. Chikhodzodzo sichikhala chopanda kanthu. Mitsempha imakhalamo nthawi zonse ndipo izi zimapangitsa kuti mabakiteriya azichulukane mkati mwake komanso kukula kwa cystitis.
     
3. Matenda a Mtima
   • kukomoka mtima,
   • kusinthasintha kwa mtima - arrhythmia,
   • kufooka kwakukulu poyesa kudzuka, komwe kumalumikizidwa ndi kuchepa kwa kuthamanga kwa magazi pamalo owongoka,
   • kuchepa kwa chidwi cha kupweteka kwa mtima, ngakhale kugunda kwa mtima sikupweteka.
   Kugwira ntchito moyenera kwa mtima kumadalira kayendedwe ka mitsempha ya autonomic. Ena a iwo amafulumizitsa ntchito ya mtima ndi nkhawa zowonjezereka, pomwe ena amachepetsa pafupipafupi mphamvu, ndikupatsanso mtima. Ndi matenda ashuga a m'mimba, kusala bwino kumasokonezeka, ndipo mtima umagwira molakwika. Motere, chiopsezo chodwala mtima kwambiri chikuwonjezeka kwambiri.
   
4. Kusintha khungu
   Ntchito ya thukuta lotupa imasokonekera. Poyamba, thukuta kwambiri limawonekera, makamaka pakati theka la thupi usiku. Nkhope ndi mapazi ake zimathukuta kwambiri. Kukula kwa ma capillaries osunthira kumapangitsa kuti khungu lifike pakhungu komanso kusokonekera pamasaya.
   Popita nthawi, thukuta limatulutsa thukuta losakwanira chifukwa cha kuphipha, ndipo khungu limakhala louma. Amawerengeka, pomwe mitundu yambiri ya melanin imakhala yokhazikika komanso yamtunda yopanda.
   Ntchito yoteteza khungu imasokonekera, ndipo izi zimapangitsa kuti ma purrotrauma aziwoneka ngati otupa. Izi zimatha kudzetsa chilonda ndikuduladula miyendo.
   
5. Zowonongeka
   Kuwonongeka kwa mitsempha kumayambitsa kusokonekera kwa mwana. Izi zimawonetsedwa ndi kuwonongeka kwa mawonekedwe, makamaka mumdima.