Matenda a shuga a polyneuropathy a m'munsi malekezero: momwe mungazindikire ndikuchiritsa?

Polyneuropathy ya malekezero enaake ndizovuta zina za shuga. Vutoli limakhudza minyewa yam'mimba kwambiri yomwe ili kutali ndi ubongo ndipo imatha kutsagana ndi ululu, kusayenda bwino kwamitsempha, ndikuchepetsa kwambiri moyo wa wodwalayo.

Kodi matenda ashuga a polyneuropathy a m'munsi amatsika

Matenda a shuga a polyneuropathy a m'munsi am'munsi amadziwika ndi kuwonongeka kwa minyewa yambiri yamitsempha yomwe imayendetsa ntchito ya phazi ndi chidwi chake - kupweteka, kutentha, tactile (tactile).

Maganizo: diabetesic vegetative polyneuritis ya m'munsi malekezero, a shuga a distal polyneuropathy, distal symmetric sensorimotor polyneuropathy.

Pathology imayamba ndikukwiyitsa kwa ulusi wamanjenje, pakapita nthawi, kufa kwawo kumachitika. Zotsatira zake, kuzindikira kwa chizindikiro chaubongo ndi chingwe cha msana kumasokonekera kumapazi, ndipo khungu ndi minofu imayamba. Zosintha izi zimatha kutsagana ndi kupweteka, kusintha kwa gait.

Mu diabetesic polyneuropathy yam'munsi malekezero, kuwonongeka kwa minyewa yamitsempha kumachitika

Zizindikiro zake zomwe zimapangitsa kuti wodwalayo akhale pachiwopsezo chokhala ndi matenda a diabetesic distal polyneuropathy:

nthawi yodwala matenda ashuga yoposa zaka zisanu,
retinal capillary zovuta
kunenepa
matenda oopsa
matenda a mtima
chibadwire
magawo a laborat: lipids (cholesterol, lipoproteins) yamagazi ndi mkodzo albumin.

Mtundu wa matenda ashuga sukukhudza zochitika za autonomic polyneuritis.

Zimayambitsa komanso zowopsa

Kutalika kwa shuga komwe kumatsalira m'magazi, kumapangitsa kukula kwa matenda a distal polyneuropathy motsutsana ndi maziko a matenda ashuga komanso kwambiri. Njira zopangira matendawa sizinafotokozedwe bwino, komabe, zimaganiziridwa kuti kufa kwa minyewa ya mitsempha kumayenderana kwambiri ndi njira zam'magazi zomwe zimayambika chifukwa chophwanya magwiridwe antchito a glucose wamba.

Chifukwa chake, chifukwa chachikulu chakukhazikitsidwa kwa distal polyneuritis ndi shuga mellitus, ndipo chofunikira kwambiri ndicho kuchuluka kwakukula kwamagazi (hyperglycemia).

Zowopsa zake zimaphatikizapo kusuta.

Zizindikiro za matenda a shuga a polyneuritis a diabetes

Mu gawo loyambirira (subclinical), matendawa sazunza wodwala. Nthawi yomweyo, kupenda kwamitsempha kumatha kuwonetsa zotsatirazi:

kuphwanya kwamphamvu khungu la phazi,
idachepetsa kwambiri tendon Reflex.

Matendawa akamakula, gawo lachipatala (lomwe limatsatiridwa ndi mawonekedwe akunja) limachitika.

Zizindikiro za gawo loyambirira:

kutsika kwa kutentha kwa khungu la phazi,
kumverera kwa "goosebumps",
Hypnothesia (hypersensitivity to light touch),
kukokana
ululu wamtundu wina ndi mphamvu.

Odwala omwe ali ndi matenda a diabetesic distal polyneuritis, zimachitika modabwitsa. - Komano, kusazindikira mphamvu zakunja, mbali inayo, ululu womwe sugwirizana ndi kukondoweza kwakunja.

Zizindikiro za matenda ashuga a polyneuropathy, monga lamulo, amayamba kuwonekera pokhapokha njira yachipatala itabweretsa kusintha kosasintha

Zowonongeka zina zam'mitsempha ya mitsempha zimatsagana ndi zizindikiro zotsatirazi:

Kuuma ndi kutopa kwa khungu la kumapazi,
kusintha kwa minofu
kumverera kwa "masokosi" pamiyendo,
kukonza masamba a mapazi, mapangidwe a "fupa" m'malo olumikizana ndi chala.
kusakhazikika,
phazi la phazi,
kumverera kwa "magolovu" m'manja.

Mu matenda a diabetes polyneuritis, mapazi onse nthawi zambiri amakhala nawo.

50-80% ya odwala ali ndi matenda osawawa (asymptomatic). Zikatero, zotupa zimatha kupezeka pamlingo wovuta - mawonekedwe a zilonda zam'mimba.

Kuzindikira ndi kuzindikira mosiyanitsa

Pozindikira matenda a autonomic polyneuritis, kuwunika kwamitsempha kumagwiritsidwa ntchito ndi zida zotsatirazi:

monofilament - kuyerekezera zamkati,
folokoyo - kuyesa kugwedeza mwamphamvu,
"Malangizo a Neuro" (singano yamitsempha) - yowunika momwe ululu ulili,
"Kutayipa" - kuwunika kutentha,
malleus - kuyesa tendon Reflex.

Kuphatikiza apo, kuyeserera kwa labotale magazi ndi mkodzo kumachitidwa kuti adziwe zomwe zingayike chiopsezo.

Diabetesic distal polyneuropathy imasiyanitsidwa makamaka ndi polyneuropathy yoyambitsidwa ndi zifukwa zina:

uchidakwa
matenda
matenda a chithokomiro
kuchepa kwa vitamini
matenda oncological
poyizoni
autoimmune pathologies.

Depal polyneuropathy yomwe idayamba chifukwa cha matenda ashuga nthawi zambiri sizotsatira zake.

Njira zazikulu zochizira matenda ashuga a distal polyneuropathy:

pathogenetic - kubwezeretsa kwa ntchito ya minyewa yamitsempha,
chizindikiro - kugwiritsidwa ntchito kwa mawonekedwe a matenda.

Chithandizo chotere sichimachotsa zomwe zimayambitsa matendawa, koma zimachepetsa mayendedwe ake, zimachepetsa zovuta, zimasintha mkhalidwe wamthupi komanso wodwala.

Mankhwalawa a shuga a distal polyneuropathy ndiwofatsa, kuphatikizapo:

mankhwala
physiotherapy ndi physiotherapy
zakudya mankhwala
mankhwala azitsamba.

Chithandizo chokwanira (kuphatikizapo mitundu ingapo) chimakhala ndi zotheka.

Palibe njira zamankhwala zomwe zimagwiritsidwa ntchito popanda kuvomerezedwa ndi dokotala: mankhwala ambiri amafunikira kusankha mosamala mlingo ndi kuyan'ana, ndipo zida ndi njira zingapo zimaphatikizidwa matenda ophatikizika.

Mankhwala

Kubwezeretsa ntchito ya minyewa ya minyewa (kusintha mayendedwe awo - kufalitsa zizindikiritso za mtima wamanjenje), ikani izi:

kukonzekera kokhala ndi mavitamini a gulu B (Milgamma) kapena mawonekedwe a vitamini B osungunuka okha₁ (Benfotiamine)
α-lipoic acid (Thiogamma, Thioctacid).

Chithandizo cha pathogenetic chikuchitika mu maphunziro ataliatali, zotsatira zake sizowoneka mwachangu.

Pofuna kuthetsa ululu ndi zovuta zokhudzana ndi kugona, kuda nkhawa, kukhumudwa, mankhwala otsatirawa:

antidepressants (amitriptyline, desipramine, paroxetine),
anticonvulsants (gabapentin, carbamazepine),
antiarrhythmic (mexiletine),
ma pinkiller ndi jakisoni (Tramadol), komanso ma gels ndi mafuta onunkhira (Capsaicin).

Mankhwala osagwirizana ndi antisteroidal anti-yotupa (Ibuprofen) amatha kutumikiridwa kumaphunziro aposachedwa, chifukwa kugwiritsa ntchito nthawi yayitali kumalumikizidwa ndi chiwopsezo chachikulu cha kuwonongeka kwa mucosa ya m'mimba.

Physiotherapy, kutikita minofu, kulimbitsa thupi

Kuchita masewera olimbitsa thupi, kutikita minofu ndi masewera olimbitsa thupi kumathandizira kutsitsa ululu ndikuthandizira minofu ya minyewa ndi minyewa, kupewa minyewa ya minofu, komanso kusintha kwa kutsekeka kwa mitsempha.

maginotherapy
phonophoresis,
electrophoresis
kuchiritsa matope.

Kutikita minofu imagwiritsidwa ntchito ponseponse komanso katemera.

Masewera olimbitsa thupi amakhala pakupanga miyendo tsiku ndi tsiku, kutambasula miyendo ndi manja anu, kusinthasintha ndikutambasulira zala zanu, kutembenuza cholowera m'chiuno mosiyanasiyana.

Zolemba zamagulu azakudya

Ndikulimbikitsidwa kupangitsa kuti zakudya zizikhala ndi micronutrients ndi mavitamini omwe amathandizira kuti mitsempha ipangidwe - potaziyamu, magnesium, mavitamini B.

nyemba, nandolo, mphodza,
ma Buckwheat groats
mbewu, mtedza,
chinangwa
tomato, nkhaka, parsley,
nsomba zam'nyanja.

Ngati palibe kuwonongeka kwa impso, maproteni a nyama (nyama, nkhuku, nsomba) sayenera kukhala ochepa: kuchepa kwawo kumawonjezera ntchito ya minyewa ya m'mimba.

Chithandizo cha matenda am'mimba komanso zovuta zomwe zingachitike

Chinsinsi chakuchita bwino kwa matenda ashuga a distal polyneuropathy ndikuchotsa chachikulu chomwe chikuwonongeka mu minyewa ya minyewa: makulidwe komanso kukhazikika kwa shuga wa magazi (glycemia). Popanda kukwaniritsa izi, mphamvu ya mankhwalawa yomwe cholinga chake ndi kubwezeretsa ntchito ya mitsempha ndiyochepa kwambiri.

Amapereka shuga ya magazi kwakanthawi kokwanira, mankhwalawa a polyneuropathy amapereka zotsatira zabwino, makamaka ngati amayamba munthawi yake. Poyambirira kwamatendawa, kusintha kwa ma pathological mu minyewa yamitsempha kumasinthiratu.

Nthawi zina chikhululukiro sichingatheke ngakhale ndi matenda a glycemia. Odwala, komanso iwo omwe pazifukwa zina sanalandire chithandizo chovuta, nthawi zambiri amakumana ndi zovuta zazikulu:

wodwala matenda ashuga
Charcot phazi.

Izi nthawi zambiri zimapanikizika ndi gangrene, zomwe zimaphatikizapo kudula phazi.

Matenda a shuga a polyneuropathy am'munsi am'mphepete popanda kupezeka amathandizidwa ndi matenda monga phazi la Charcot

Kupewa

Zochitika zomwe zimalepheretsa chitukuko cha matenda ashuga odziyimira pawokha:

kuwongolera moyenera shuga
kupatula,
kulimbitsa thupi.

Chofunikanso ndikofunikira kuphatikiza ntchito ndi kupumula - chinthu chofooka chifukwa chosagona mokwanira, kutopa, kupsinjika, ndizovuta kwambiri kukaniza matendawa.

Kupweteka kwa matenda ashuga a m'mimba ndi chithandizo chake - kanema

Matenda a shuga a polyneuropathy a m'munsi am'munsi amakhala ovuta kwambiri a matenda a shuga, omwe amaphatikizidwa ndi kuwonongeka kwaumoyo wa wodwalayo ndipo nthawi zambiri kumabweretsa kulumala. Kudziwona koyambirira ndi zovuta zovuta za matenda a zamitsempha zimachepetsa kuwonongeka kwa minyewa yamitsempha, ndipo nthawi zina zimakwaniritsa chikhululukiro chokhazikika.

Makina owononga

Kodi matenda ashuga a polyneuropathy ndi ati? Kulumikiza komwe kulumikizidwe pakati pa ziwalo zosiyanasiyana ndi ubongo ndi mitsempha. Kapangidwe kameneka kamaphatikizapo dongosolo lamkati lamanjenje (ubongo ndi msana), machitidwe aumwini ndi zotumphukira. Gawo lakumapeto limakhala ndi ulusi wamanjenje womwe umapita kumapeto, thunthu ndi mutu. Iyenso amatengapo mbali ziwiri: zamasamba komanso zina. Loyamba limagwira ntchito ziwalo zamkati, lachiwiri ndi la kuwongolera thupi. Ndi DP, magawo onsewa amakhudzidwa. Chifukwa chake, chipatalachi chimakhala ndi ululu waukulu ndipo chimatha kuwononga moyo wa munthu.

Shuga wokwera amawononga makhoma amitsempha yamagazi, ndipo ulusi wamanjenje sungalandire chakudya chokwanira ndi mpweya chifukwa cha kusokonezeka kwa magazi. Chifukwa chake, kagayidwe kamasokonekera pano, ischemia imachitika, ndipo izi sizichitika mwachangu. Zotsatira zake, kutsekeka kwa ma pulows kumachepetsedwa kapena kuyimitsidwa kwathunthu. Ngati kuwonongeka kwa ulusi wamanjenje kunapezeka koyambirira, ndiye kuti mitsempha imatha kubwezeretsedweratu.

Polyneuropathy nthawi zambiri imakhudza manja, koma miyendo ndi miyendo yaying'ono imavutika kwambiri.

Zomwe zimayambitsa, kumene, ndi hyperglycemia, ndipo zomwe zimayambitsa ngozi zili motere:

ukalamba
luso la matenda oopsa,
kusuta
atherosulinosis
nephropathy
matenda ashuga retinopathy.

Gulu la polyneuropathy mu shuga

Gawoli likuwonetsa kuti ndi madipatimenti a mitsempha yokhudzana ndi mitsempha omwe amathandizira nawo njirayi - yodziyimira pawokha komanso yofanana. M'malo omaliza, ulusi wamanjenje zowongolera komanso zamagalimoto zimakhudzidwa. Wosazindikira - wowonda komanso wandiweyani wokhala ndi ma diameter osiyanasiyana. Amatumiza kufotokozera kuchokera kuzowona kupita ku ubongo. Ma mota - amanyamula lamulo la ubongo kumagawo osiyanasiyana a thupi. Mwachitsanzo, munthu akakhudza malo otentha, ulusi wosachedwa kupweteka, patatha makumi a mphindikati, amapatsira zambiri ku izi. Ndipo gulu limadutsa ulusi wamagalimoto kuti muchotse dzanja. Simukuzindikira kuti izi zimachitika mofulumira bwanji, ndipo mulibe nthawi yoti muwotche. Mitundu ya polyneuropathy yodziwika bwino ndi iyi:

mphamvu - kutentha kwa thupi kwatayika kwathunthu,
misempha yama motor - mota imakhudzidwa ndipo kufooka kwa minofu kumawonekera,
sensorimotor - kuphatikiza kwapapitapo.

Mawonetsero azizindikiro

Zizindikiro zoyambirira za matenda ashuga polyneuropathy mu gawo lotukuka ndizo goosebumps ndi kupweteka kwa mwendo, komanso dzanzi. Ululu umawoneka pakupuma ndikuwuka kuchokera ku zala mpaka kumapazi. Pambuyo pake, zomverera zosasangalatsa zimayamba kukula usiku ndipo zimadziwika kuti zimayaka m'miyendo. Kutentha ndi kupwetekedwa mtima kumayamba kuchepa. Pazotsatira zamtsogolo, dziwani:

kupweteka pakupuma komanso kugwira ntchito mopambanitsa, popanda kuyimilira,
kusowa tulo chifukwa cha ululu, kuchuluka pakapsinjika ndikuchepa pakuyenda,
minofu ya miyendo imayamba kuyenda, zala ndi mapazi zimafooka,
miyendo imakhala yapinki kapena ofiira, mawanga amdima amatha kuwoneka.

Misomali pazala ndi yopunduka: imakhala yodontha kapena yopyapyala. Pa gawo lotsiriza, mawonekedwe a phazi limasinthanso: limakula kudutsa, flatfoot imachitika, cholowa chamchiwongo chimasinthanso - ichi ndi osteoarthropathy. Pankhaniyi, zimachitika pamunsi pamapazi zimasungidwa. Mukamayesedwa ndi katswiri wamitsempha, amachokera ku distal symmetric sensorimotor polyneuropathy ya matenda ashuga. Choyamba, ulusi wolimba kwambiri womwe umapita kumanja ndi kumapazi umakhudzidwa. Zotsirizazo zimakhudzidwa ndi manja. Izi ndizomwe zimatchedwa kuti "socks-gloves" syndrome.

Ndi kugonjetsedwa kwa ulusi wamanjenje wamkati, khungu limasandulika hypersensitive, ngakhale kuchokera pakukhudza pang'ono pamakhala kupweteka kwakuthwa (allodynia).

Koma nthawi yomweyo, zala za miyendo zimasiya kumva. Zizindikirozi zimatchedwa zabwino, zimadziwika pachiyambipo. Kenako ulusi wamanjenje yaying'ono umakhudzidwanso, pomwe kutentha kwa dzuwa kumatha, ndipo kumva ndi kutentha m'miyendo kumachitika. Ululu wam'mawa komanso dzanzi ndizovuta kwambiri usiku. Miyendo imakololedwa nthawi zonse, mapazi amatupa. Khungu limakhala louma kwambiri ndipo limang'amba kapena limakhalabe lonyowa. Zilonda, mabala ndi calluses nthawi zambiri zimawoneka pamapazi. Chifukwa cha kuwonongeka kwa ulusi wama motor, minofu imafooka ndikuwongolera, zala ndi mapazi ndizopunduka.

Popita nthawi, kufooka kwathunthu kwa minofu ndikutha kwa mphamvu ya tendon kumayamba. Zowonetsera zonse zofotokozedwa zimangopita patsogolo. Pamenepo anawonjezera visceral neuropathy, yomwe imayendera limodzi ndi kusagwira ntchito kwamkati mwa ziwalo. Mwachitsanzo, orthostatic hypotension imatha kuchitika ngati ziwiya sizingakhalebe ndi vuto la kuthamanga kwa magazi, pali zovuta za chikhodzodzo mu mawonekedwe a kwamikodzo, kusabala, komanso kubereka kwa azimayi, ndipo kudzimbidwa kumatha kuchitika.

Mitsempha yomwe imapereka mauthenga ku minofu ya fundus imakhudzidwa, makamaka kwa okalamba. Kenako amphaka, anisocoria amakula, malo amasokonezeka, etc. kupweteka kwadzidzidzi kwa chiwopsezo kumatha kuwonekera pamimba, chiwindi, ndi pharynx. Zizindikiro zoyipa zimawonekera: miyendo imakhala ngati imasweka, zimakhala zovuta kuyenda ndi manja ndi miyendo popanda kupweteka, dzanzi ndi kumva kugwedezeka kumakhala kosatha. Gait ndi yosakhazikika, munthu amakhala ali pafupi kugwa, chifukwa samamva ngati akupita patsogolo, ngati kuti akuyenda thonje. Izi zikuwonetsa kusasintha kwa zosinthazo.

DP imayendera limodzi ndi kupindika kwa minofu ya nkhope, eyelone, kumeza kumasokoneza, chizungulire chikuwonekera.

Kusintha kwamawu: Mawu akumaliza amizidwa, munthu sangatchule mawu ndi mawu opitilira 3.Ndiye kuti, mwa kuyankhula kwina, minyewa iliyonse imayamba kulephera pang'onopang'ono ndipo njirayi imayamba kuchokera kuzowona kupita ku ubongo.

Ndi matenda ashuga a polyneuropathy, Zizindikiro zimadutsa m'njira zingapo zachitukuko:

Subclinical - munthu alibe zodandaula, koma neuropathologist amatha kuwona kuchepa kwa ululu, kutentha ndi kugwedezeka kwamphamvu, kukulira kwa Refil.
Zachipatala - imatha kukhala yopweteka, yopweteka, amyotrophic. Mu mawonekedwe oyamba, ntchito zamkati, zotupa, zotupa, ma sciatic ndi ma optic zimakhala ndizovuta komanso kupweteka kwa thupi ndikuwonekera. Gawo lopanda vuto - Zizindikiro zoyipa zomwe tafotokozazi. Munthu samadzimva nsapato zodzaza, madzi otentha, kuvulala. Zowonongeka zimachitika, koma wodwala samamva izi. Zilonda m'miyendo zimapezeka mu 75% ya milandu.

Zotsatira za matendawa

Polyneuropathy mu shuga mellitus imatha kuyambitsa zovuta. Ndi kutayika kwa miyendo, munthu samamva kuwotcha, kudula, chimanga, kutupa. Zimatha ndikudula. Ndi kugonjetsedwa kwa ulusi wowonda kwambiri, pamakhala kupweteka kosalekeza: kuwombera, kugunda, kukoka, lakuthwa kapena lotupa. Miyendo imapweteka usiku, pakupuma. Ndi matenda a shuga, mavuto amasowa, koma zizindikiro zina zonse zimatsalira.

Choyipa chachikulu pokhudzana ndi zovuta ndi momwe shuga ikukwera komanso palibe ululu.

Chilala, dzanzi limadziwika nthawi zonse. Kusintha kwa phazi pamwambapa kumadziwika kuti ndi matenda a shuga. Lingaliro ili palimodzi limaphatikizira, kuwonjezera pa zomwe tafotokozazi, kupezeka kwa zilonda zam'mimba, purcin-necrotic njira, zotupa zamafupa. Vutoli la DP limachitika kawirikawiri ndi mtundu wachiwiri wa matenda ashuga - pafupifupi nthawi 10. Ndi phazi la matenda ashuga, mavuto ang'onoang'ono kumapazi amapezeka:

msomali wokhala ndi chotupa, kumera kwa msomali chifukwa chamatumbo am'munsi kuchokera ku nsapato zolimba,
fungus ya msomali (onychomycosis) ndi khungu la phazi,
chimanga, chimanga,
ming'alu ndi khungu lowuma zidendene - hyperkeratosis.

Maonekedwe a phazi asintha: limasunthika chifukwa cha phazi lathyathyathya, kufinya, fupa la chala limakulirakulira, zala zake zimakhala ngati nyundo, zopindika, kuzungulira molumikizana koyamba.

Kuzindikira matendawa

Ngakhale wodwalayo sawonetsa madandaulo a DP, sizitanthauza kusowa kwake. Pozindikira, njira zapadera zamagetsi zama electroneuromyography ndi kuyesa kumverera kwamaganizidwe zimachitika.

Electroneuromyography - kutsimikiza kwa mphamvu zamagetsi zamiyendo, kuphunzira kwa zosunthika pamodzi. Njira imeneyi imawerengedwa kuti ndi yophunzitsa, imatsimikiza mawebusayitidwe ndi kuwonongeka kwa zotumphukira zamisempha. Zisokonezo zam'maso zimapezekanso pamagalimoto.

Kuphatikiza apo, njira yamphamvu yomwe imagwirira ntchito imagwiritsidwa ntchito: kuwunika kuyankha kwa ubongo kuyipitsidwa ndi fayilo yamitsempha.

Dokotala amawunika wodwalayo, akumayang'anira mawonekedwe am'munsi, kutsika kwa mitsempha ya m'mapazi, kuthamanga kwa magazi kumiyendo ndi miyendo, ECG ndi ultrasound ya mtima. Kutsimikiza kwa cholesterol ndi lipoproteins ndikofunikira. Mwazi wamagazi ndi insulin yokwanira amatsimikiza. Dokotala wamitsempha amayang'anitsitsa matendawa akuwoneka ngati wamisala yachipala, tactile (wogwiritsa ntchito monofilament - chipangizo chokhala ndi chingwe chambiri cha usodzi, chomwe dokotala amasunthira pakhungu la wodwalayo) komanso kutentha kwa kutentha, kugwedezeka - kuyesedwa ndi foloko yakuwombera (iyenera chimodzimodzi pamiyendo yonse). PNP yowunika ndi kukhazikika kwa wodwala mu Romberg. Njira imodzi sazindikira.

Zotsatira zake, ngati wodwala ali ndi matenda ashuga, hypervolemia yayitali chifukwa cha hyperglycemia, zizindikiro za distal symmetric sensorimotor DP zam'munsi zam'munsi, komanso kusapezeka kwa ma neurology ena, ndiye izi zimapangitsa kuzindikira matenda ashuga a distal polyneuropathy.

Chithandizo cha polyneuropathy mu shuga

Mankhwalawa cholinga chake ndi kuchepetsa shuga m'magazi kuti akhale abwinobwino kapena oyandikira kwambiri momwe angathere, kubwezeretsa mapuloteni komanso mafuta a metabolism. Odwala ayenera kupatsidwa chakudya chochepa cha carb, ndipo ndi T2DM, zolimbitsa thupi. Mankhwala a insulin, mankhwala antidiabetes, ndi antioxidants ndi mankhwala.

Chithandizo cha polyneuropathy mu shuga mellitus chimaphatikizapo kuchotsedwa kwa ululu, kukonza ma microcirculation, kubwezeretsanso ma processor ndi zakudya zamitsempha yama mitsempha, kuwakwaniritsa ndi okosijeni, etc.

Kutumiza ululu mu matenda ashuga a polyneuropathy

Kukonzanso kwa kupweteka ngakhale kuzimiririka kwathunthu kwa vutoli kumatheka chifukwa cha shuga m'magazi. Kuchepetsa kuwawa ndi kuwawa, ma anticonvulsants ndi antiarrhythmic mankhwala amagwiritsidwa ntchito. Zikuwoneka kuti zakale zimakhala ndi zotsatila zina. Mafuta a Capsaicin nthawi zambiri amalembedwa, koma nthawi zambiri samalekeredwa bwino, chifukwa amayambitsa kutentha kwamphamvu. Zodzola Finalgon, Apizartron amagwiritsidwanso ntchito. Zizindikiro zamitsempha zimathandizidwanso bwino ndi lipoic acid.

Chithandizo cha matenda a shuga a polyneuropathy a m'munsi am'munsi sichokwanira popanda kugwiritsa ntchito asidi.

Imaletsa kudzikundikira kwa shuga mumitsempha ya mitsempha, imayendetsa ma enzymes m'maselo, omwe amathandizira kubwezeretsa mitsempha yowonongeka. Mwa njira zazikulu zamankhwala zingadziwike:

Thioctacid BV, Dialipon, Espa-Lipon, Berlition - lero ndiwofunikira mankhwala othandizira DP, nthawi yawo yoyang'anira imakhala pafupifupi miyezi itatu.
Mavitamini a B amayikidwa - amalepheretsa zovuta zomwe zimachitika chifukwa cha shuga m'maselo a mitsempha, ndikubwezeretsa kufalikira kwa zovuta kumapeto kwa mitsempha. Imwani mankhwala Milgamma Compositum kwa miyezi 1.5.
Kupititsa patsogolo kukwera kwa magazi, Neurostabil, Actovegin, Trental, Ginkgo biloba, Tanakan amapatsidwa miyezi itatu. Ndi kukokana m'miyendo, kukonzekera kwa magnesium kumagwiritsidwa ntchito.
Zotsatira za lipoic acid ku DP: amatenga nawo gawo pakusinthana kwa glucose ndi lipids ndipo salola cholesterol kuti ipangidwe, ndi cytoprotector, imakhazikitsa cell membranes ndikuwonjezera ntchito yawo ya antioxidant, imakhala ndi anti-yotupa komanso analgesic.

Mutha kuchiza popanda mankhwala. Mwa njira zosagwiritsa ntchito mankhwala zimatha kutchedwa kuti olimbitsa miyendo, kutikita minofu ndi physiotherapy. Ngati mukupeza vuto linalake phazi ndikupanga kukonza, simungathe kugwiritsa ntchito zida zofinya chifukwa amachedwetsa kuchiritsa (ayodini, wobiriwira wanzeru, mowa, potaziyamu lamanganidwe). Mutha kuthira furatsilin, chlorhexidine, dioxidine. Simungagwiritse ntchito cheze chifukwa chimangirira chilonda. Pazonse, kukonza kumakhala bwino kumanzere kwa akatswiri.

Panthawi yamavuto amitsempha yama miyendo, mankhwalawa amasuntha kapena balloon angioplasty amachitika.

M'matenda apamwamba, polyneuropathy amayenera kuthandizidwa ndi madokotala a opaleshoni: mu njira zotupa, zilonda zam'mimba, ma vaccesses, phlegmon, necondolaomy, kudzicheka komanso kuyika kwachuma zimachitika (mu 15-20% ya milandu). Extracorporeal shock wave therapy ndi njira yatsopano yothandizira. Itha kutchedwa chithandizo ndi kukula kwa zinthu, tsinde maselo chithandizo, njira plasma ndege, njira biomechanical.

Kuphatikiza pa chithandizo chachikulu, tikulimbikitsidwa:

Kuchita masewera olimbitsa thupi ndi njira yopanda mankhwala. Zochita zolimbitsa thupi zimachitidwa kwa mphindi 10, tsiku ndi tsiku (kusinthasintha-kutalika kwa zala, kusuntha chidendene ndi chala, chidendene, kuyika chidendene ndi chala pansi pansi, kusintha, ndi miyendo ya pini yopukutira, ndi zina). Izi zimasunga kamvekedwe ka minofu.
Magnetotherapy - imapangitsa kukoka kwam'mimba m'matipi, kumachepetsa kutupa, kumathandizanso kusinthika kwa mitsempha yowonongeka ndikuthandizanso kupweteka. Acupuncture amagwiritsidwanso ntchito pokonza magazi komanso kuchepetsa magazi.
Hyperbaric oxygenation - kukhudzana ndi thupi motsogozedwa ndi mpweya wambiri. Poterepa, magazi amadzaza ndi mpweya ndipo zimakhala zimakhala insulin.
Vazaprostan - amateteza mitsempha ya magazi kuundana wamagazi, kukulitsa mitsempha ya magazi ndikutchingira kuyika kwa cholesterol pamakoma awo.

Ponena za ma compress ndi mafuta onunkhira, ndikofunikira kudziwa kuti sizoyenera zilonda zam'mimba komanso zotupa m'm miyendo ndi mapazi omwe ali ndi matenda a shuga a polyneuropathy. Mafuta amachititsa kuti zikhale zovuta kuzungulira kwa chilondacho, ndipo amathanso kukhala sing'anga wama virus, kotero masiku ano amagwiritsa ntchito zopukutira zowonjezera (ndizowononga) kapena amagwiritsa ntchito masiponji a collagen kudzaza mabala.

Kuchiza ndi wowerengeka azitsamba

Ndi matenda ashuga polyneuropathy, mankhwalawa amatha kuchitika pogwiritsa ntchito mankhwala azitsamba, mankhwala azitsamba. Koma chida chilichonse chotere chiyenera kuvomerezedwa ndi adokotala. Kuchepetsa shuga m'magazi amatenga:

kulowetsedwa kwa masamba a laurel ndi nthanga za fenugreek,
kulowetsera
osakaniza zitsamba: Muzu wa burdock, chingwe, zopumira komanso masamba a birch,
kulimbitsa ulusi wamitsempha ndi michere - tchuthi la kefir, parsley ndi mbewu za mpendadzuwa,
pakuchita kutikita minofu ndi zomanga thupi kugwiritsa ntchito mafuta kuchokera ku wort ndi ginger wa St.
kusisita tincture wa rosemary pa viniga amapaka miyendo.

Zoyambitsa ndi Zoopsa

Zomwe zimayambitsa matenda ashuga polyneuropathy ndikuwonjezereka kwa shuga wamagazi komwe kumachitika mu shuga mellitus chifukwa cha kuchepa kwa insulin. Nthawi yomweyo, limagwirira kuwonongeka kwa ulusi wamanjenje mu izi ali multifactorial ndipo amayambitsidwa ndi njira zingapo za pathological. Udindo wotsogola umachitika ndi zinthu zingapo.

Matenda a metabolism mu minyewa yamanjenje. Kuperewera kwa insulini kumabweretsa kuti glucose kuchokera m'magazi simalowa m'maselo, omwe amawonetsedwa ndi hyperglycemia. Nthawi yomweyo, chakudya ichi ndi chomaliza komanso chimangokhala mphamvu yokhayo ya minofu yamitsempha. Kuperewera kwa mphamvu kumapangitsa kuti khungu lizipangika komanso kukhazikika kwa matenda ashuga a polyneuropathy.
Matenda a metabolic ambiri . Chifukwa cha kuchepa kwa glucose m'matipi, metabolic bypass pathways imaphatikizidwa kulipirira kuchepa kwa mphamvu. Izi zimapangitsa kuti pakhale matupi a ketone (chinthu chosemphana ndi mafuta) ndi zinthu zina zakupha zomwe zitha kuwononga minyewa yamitsempha.
Matenda a Ischemic. Mu shuga mellitus, chitukuko cha angiopathies (zotupa zam'mimba) zokhudzana ndi ma pathological mu khoma la mtima ndizodziwika. Izi zimachepetsa magazi kupita ndi ziwalo ndi ziwalo, makamaka pamlingo wa microcirculatory. Kuthamanga kwa magazi kumachulukitsa kuchuluka kwa kuchepa kwa mphamvu mu ulusi wamitsempha ndikuthandizira kuchepa kwawo.

Kuchepa kwa matenda ashuga a polyneuropathy kumakhala kokwanira kwambiri kwa odwala matenda ashuga, ndipo nthawi zambiri amakhala akumaphwanya zakudya ndikumamwa mankhwala a hypoglycemic. Nthawi zina, kusokonezeka kwa mitsempha ya zotumphukira kumatha kukhala chizindikiro choyamba chosakwanira kupanga insulin, koma nthawi zambiri neuropathy imachitika patapita zaka zambiri chitukuko cha matenda ashuga chikuchitika. Masinthidwe amachitidwe amanjenje amanjenje samatha kusintha.

Mitundu ya matenda

Matenda a diabetesic polyneuropathy amadziwika ndi mitundu yambiri yamankhwala, kutengera ndi momwe mitsempha ya gulu lomwe limakhudzidwira kwambiri. Pali kukambirana pokhudzana ndi gulu la asayansi.

Ndi chitukuko cha kuwonongeka kwa mitsempha, kusintha kwa ma pathological nthawi zambiri sikungasinthidwe, motero ndikofunikira kuti muchepetse kupitilira kwa vutoli.

Malinga ndi ofufuza ena, shuga yeniyeni ya polyneuropathy imayenera kuganiziridwa ngati imodzi mwazinthu zowonongeka zamagetsi mu shuga mellitus - distal symmetric sensorimotor neuropathy. Kuchokera pamalingaliro ano, mkhalidwe uli ndi zosiyana zotsatirazi zamaphunziro:

kuphwanya kwamtundu wamtundu wam'magazi komanso ma tendon reflexes (mwachitsanzo, Achilles). Uwu ndi mtundu wofatsa, chifukwa zaka zakhala zikuyenda popanda kupita patsogolo wowoneka,
kuwonongeka m'mitsempha yaumwini, kukhala ndi mawonekedwe owopsa kapena subacute. Nthawi zambiri zimakhudza mitsempha yamiyendo ya miyendo (zilonda, zamkati, mitsempha yapakati) ndi mutu (wamtundu, wamafupa, oculomotor),
kutupa ndi kuwonongeka kwa mitsempha yam'munsi, zikukhudza malo obisika. Amadziwika ndi kupweteka kwakukulu ndipo nthawi zambiri amakhala ovuta ndi zilonda zam'mapazi zamiyendo ndi miyendo, gangrene.

Lingaliro linanso ndilakuti mitundu yonse ya zowonongeka m'mitsempha ya m'matumbo a shuga imatchedwa diabetesic polyneuropathy. Pankhaniyi, symmetric sensorimotor neuropathy ndi autonomic neuropathy imasiyanitsidwa ndi iyo. Zotsirizirazi zimaphatikizira ana, mimbulu, thukuta, mitundu ya mtima - kutengera ndi dongosolo liti kapena chiwalo chomwe chimakhudzidwa kwambiri ndi matenda. Payokha, diabetesic neuropathic cachexia imasiyanitsidwa - vuto lalikulu lomwe limaphatikizapo onse sensorimotor ndi autonomic neuropathy kuphatikiza kuchepa kwakukulu kwa thupi.

Magawo a matenda

Palibe njira zofotokozedwera bwino za matenda a matenda ashuga polyneuropathy. Komabe, matendawa ali ndi mawonekedwe omwe amapita patsogolo, kuchuluka kwa kuchuluka kwa zizindikiro kumadalira kuchuluka kwa hyperglycemia, mtundu wa neuropathy, moyo wa wodwalayo. Nthawi zambiri, matendawa atha kugawidwa magawo:

Mawonekedwe a Nonspecific neurogenic. Izi zimaphatikizira kuchepa kwa mphamvu, kumverera kwa "goosebumps" pakhungu, nthawi zina - kupweteka pamizere ya mitsempha komanso m'dera lawo lobisika. Matendawa amatha kupitilira zaka zambiri osapitilira mitundu yowopsa.
Kusokonezeka kwamagalimoto. Amatuluka pomwe ulusi wama motor umagwira mu pathological process, kuphatikizapo autonomic mantha system. Kupindika minofu, paresis imatha kukhazikika, ndipo nthawi zambiri - kukokana. Mitsempha yamagetsi yamagetsi ikakhudzidwa, kusokonezeka kwa malo ogona, kusinthasintha kwa ana, thukuta, ndi ntchito yamtima ndi kugaya chakudya kumachitika.
Zovuta za trophic. Zotsatira zoyipa kwambiri za matenda ashuga polyneuropathy zimayamba chifukwa cha kuphatikiza kwa matenda a patonomic innervation ndi zovuta zam'magazi. Amatha kukhala onse am'deralo (zilonda zam'mimba, zironda m'miyendo), komanso wamba m'chilengedwe (neuropathic cachexia).

Zotsatira zina zofala kwambiri za matenda ashuga polyneuropathy ndikugonjetsedwa kwa mbali ya 3 ndi ya 4 yamitsempha yama cranial yomwe imayendetsa kayendedwe ka ma eye. Izi zimayendera limodzi ndi kuwonongeka kowoneka bwino chifukwa cha kusokonezeka kwa malo okhala, kulumikizana, mawonekedwe a ana, ndi chitukuko cha anisocoria ndi strabismus. Nthawi zambiri, chithunzichi chimayamba mwa odwala omwe ali ndi matenda osokoneza bongo opitilira zaka 50, omwe adwala kalekale chifukwa cha zovuta zina.

Diabetesic polyneuropathy imadziwika ndi mitundu yambiri yowonetsera, chithunzi cha chipatala chimadalira mawonekedwe a pathology, kuchuluka kwake, komanso mtundu wa mitsempha ya mitsempha (mota, sensory, autonomic) yomwe idakhudzidwa kwambiri. Nthawi zambiri, mavuto amtunduwu (makamaka kutentha ndi kugwedezeka) amawonekera koyamba. Pambuyo pake, zovuta zamagalimoto (kufooka kwa minofu ya miyendo, paresis) zimatha kulowa nawo. Ngati mitsempha yamaso idakhudzidwa, anisocoria ndi strabismus zimachitika.

Matendawa ndi osachiritsika mwachilengedwe, mawonekedwe ake amawonjezeka pang'onopang'ono zaka zambiri, kukula kwake kumadalira kuchuluka kwa chithandizo cha matenda ashuga komanso kukhalabe ndi shuga.

Dongosolo la matenda ashuga polyneuropathy nthawi zambiri limakhala limodzi ndi zovuta kuzungulira kwamasamba, makamaka kumadera akumunsi. Poyamba, kutentha kwa khungu la kumapazi ndi miyendo yotsika kumachepera, kuphwanya khungu ndikotheka - peel, keratinization. Kuvulala ndi kuvulala kwamiyendo kumachiritsa nthawi yayitali.Pamene matenda akupita patsogolo, kupweteka kwambiri m'miyendo kumachitika (panthawi yopuma komanso panthawi yochita masewera olimbitsa thupi), zilonda zam'mimba zimayamba. Popita nthawi, necrosis yamtundu wa mapazi nthawi zambiri imayamba, yomwe imasandulika gangore.

Mavuto omwe angakhalepo komanso zotsatirapo zake

Kupita patsogolo kwa matenda a shuga a polyneuropathy kungayambitse kufooka kwa minofu ndi minyewa, komwe kumachepetsa kuyenda. Kuwonongeka kwa mitsempha ya cranial kumayambitsa ziwalo zamaso ndikuwonetsa masokonezo. Zovuta zam'magazi zomwe zimatsagana ndi polyneuropathy yam'mphepete nthawi zambiri imakhala yovuta ndi zilonda zam'mimba ndi gangrene, chomwe ndichizindikiro chakudula kwamiyendo.

Kuchepa kwa matenda ashuga a polyneuropathy kumakhala kokwanira kwambiri kwa odwala matenda ashuga, ndipo nthawi zambiri amakhala akumaphwanya zakudya ndikumamwa mankhwala a hypoglycemic.

Vuto lalikulu kwambiri la matenda ashuga polyneuropathy ndi neuropathic cachexia, limodzi ndi kuchepa kwa thupi, mavuto a sensorimotor ndi ma pathologies angapo amkati.

Vutoli limakhala losavomerezeka, chifukwa zovuta zake sizinasinthe. Komabe, kudziwika kwakanthawi kwamatenda a matenda limodzi ndi chithandizo choyenera kumatha kuchepetsa kuchepa kwake.

Kanema wochokera pa YouTube pamutu wankhani:

Diabetesic polyneuropathy (polyneuropathy) ndi chotupa cha zotumphukira zamagetsi, chomwe ndi chizindikiro (zovuta) cha matenda a shuga.

ICD-10	G 63.2, E10.4, E11.4, E12.4, E13.4, E14.4
ICD-9	250.6
Mesh	D003929
Medlineplus	000693

Zambiri

The zotumphukira mantha dongosolo tichipeza msana, cranial ndi ena mitsempha ndi plexuses. Ntchito yake yayikulu ndikulumikiza dongosolo lamanjenje ndi ziwalo za thupi. Dongosolo la zotumphukira limagawidwa kukhala somatic and autonomic (autonomous, visceral). The somatic imayendetsa kayendedwe ka minofu, ndipo wamasamba amatsogolera njira zofunika - kupuma, kugunda kwa mtima, kaphatikizidwe kazinthu zina ndi zina zotero.

Matenda a diabetesic polyneuropathy amakhudza maulalo onse awiriwa. Zimapezeka mu 75% ya anthu odwala matenda ashuga (mosasamala mtundu wake). Monga lamulo, mawonetseredwe oyamba a matenda amadzimadzi amadzimva okha zaka 15-25 atatha kukula kwa matendawa.

Matenda a diabetes polyneuropathy amapezeka chifukwa cha kuchuluka kwamphamvu kwa glucose. Pali njira ziwiri zazikulu zachitukuko:

Chifukwa cha kuchuluka kwa glucose, ma capillaries ozungulira minyewa yamitsempha amawonongeka. Magazi ake amayamba kuwipira, ndipo mitsempha imalandira mpweya wokwanira, mavitamini ndi michere. Njira yotumizira zamkati imachepetsa kapena kusiya kwathunthu.

Glucose amalumikizidwa mwachangu ndi mapuloteni, kuphatikizapo omwe ali gawo la michere yamitsempha. Zotsatira zake, momwe zimagwirira ntchito zimasokonekera, ndipo zinthu zowopsa za glycation zimadziunjikira m'thupi.

Matenda a shuga a polyneuropathy amatha kukhala limodzi ndi masikelo osiyanasiyana owonongeka kwamizeremizere. Kutengera izi, mitundu yambiri ndi magawo ake amasiyanitsidwa, iliyonse yomwe ili ndi mawonekedwe ake.

Zachidule. Wodwalayo samamva kusasangalala, koma pakuwunika, ma neuropathologist amamuwona kuchepa kwamphamvu kwa kupweteka, kugwedezeka, kutentha, komanso kufooketsa chidwi kwa Achilles.
Zamankhwala. Itha kudziwonetsa mumitundu ingapo - kupweteka, kupweteka, amyotrophic.
Mavuto

Zizindikiro zopweteka zam'mimba za polyneuropathy, momwe ntchito zamkati, zilonda, zodziwikiratu, zotupa, mitsempha yodutsika ndi kuwala:

kupweteka mthupi lonse, kukumbukira kukunjenjemera kapena kugwedezeka kwamagetsi,
kuphwanya zamkati
akumwetulira miyendo
allodynia - kupweteka kwapweteka ndi kukhudza pang'ono.

Mwanjira yopanda ululu, matenda ashuga a polyneuropathy am'munsi amatsika amapezeka (sensory neuropathy). Zikakhudza ulusi wamitsempha womwe umapita ku miyendo. Zizindikiro zake:

dzanzi ndi dzanzi,
kumva kulira
kusakhazikika poyenda.

Ndi kupita patsogolo kwa zizindikiro za matenda ashuga a polyneuropathy am'munsi, chidwi chake chimatha: wodwalayo samamva kulimba kwa nsapato ndi madzi otentha m'bafa, samazindikira kuvulala, ndi zina zotero.

Fomu la amyotrophic limadziwika ndi chotupa chachikulu cha mathero amitsempha. Zimaphatikizidwa ndi zowawa, dzanzi m'miyendo ndi kufooka kwa minofu.

Njira yovuta kwambiri ndi matenda ashuga a polyneuropathy, okhudza onse amanjenje komanso osabereka. Zizindikiro za mkhutu mkati mwa ziwalo zamkati zimawonjezeredwa kuzizindikiro zam'malingaliro ndi kupweteka, kuphatikizapo:

gastroparesis (kupitirira chakudya patsogolo), kutsegula m'mimba, kutsegula m'mimba,
chizungulire, kukomoka,
kugunda kwa mtima
kutayika kwa vuto la chikhodzodzo (kusayenda, kusakwanira),
kusowa kwa erectile mwa amuna, anorgasmia mwa akazi,
kusokonezeka pakulankhula, kumeza movutikira, ndi zina zotero.

Zotsatira za matenda ashuga polyneuropathy popanda chithandizo:

zilonda zam'mimba zosachiritsa (70-75% ya odwala),
Kusintha kwa mapazi,
kuwonongeka kwa mitsempha ya optic, kuyambitsa strabismus ndipo,
kuwoneka kwa malo amisala yodutsitsa, zomwe zimatsogolera kudula miyendo.

Zoyambitsa

Zotsatirazi zimathandizira kukulitsa kwa polyneuropathy mu matenda a shuga:

kuphwanya kudziyang'anira pawekha shuga,
nthawi yayitali yodwala matenda
kuthamanga kwa magazi
kukula kwakukulu
ukalamba
kukhalapo kwa zizolowezi zoipa (kusuta, kumwa mowa),
dyslipidemia,
chibadwa.

Zomwe zimachitika mu pathological njira zingapo zotupa zamitse mitsempha

Kutengera kuwuma kwa mawonetserowa, magawo otsatirawa owonongeka amasiyanitsidwa, pamaziko omwe chithandizo chofunikira cha polyneuropathy chatsimikiziridwa:

0 - palibe zowoneka
1 - njira ya asymptomatic yovuta,
1a - palibe zodandaula kuchokera kwa wodwala, koma kusintha kwa pathological kungathe kutsimikizika kale pogwiritsa ntchito mayeso ozindikira,
1b - palibe zodandaula, zosintha zitha kutsimikiziridwa osati kokha ndi mayeso apadera, komanso mwa kuyesa kwa mitsempha,
2 - gawo la mawonetseredwe azachipatala,
2a - Zizindikiro za zotupa zimawonekera palimodzi ndikuyesa koyesa,
2b - siteji 2a + kufooka kwa kusinthasintha kwa miyendo,
3 - polyneuropathy yovuta ndi kulumala.

Zizindikiro za matenda a shuga a polyneuropathy amadwala mwachindunji pamtundu ndi mawonekedwe a kukula kwake, komanso mankhwala omwe amagwiritsidwa ntchito.

Mavuto Osautsa

Makhalidwe amawonetsera zamatsenga. Amatha kutsimikiziridwa pokhapokha poyesedwa ndi matenda (subclinical form) kapena kukhala madandaulo a odwala (mawonekedwe azachipatala). Odwala amavutika ndi ululu. Ululu ukhoza kuwotcha, kuphika, kuwombera, kuwopseza. Maonekedwe ake amathanso kuyambitsidwa ndi zinthu zomwe sizimabweretsa chisangalalo mwa anthu athanzi.

Zofunika! Diabetesic polyneuropathy yokhala m'munsi yotsika imadziwika ndi mawonekedwe ofanana kuchokera kumbali ya mapazi ndi miyendo yotsika, popeza kumeneko ndiye kuti zombo zoyambira kumapeto zimavutika.

Wodwalayo amatha kudandaula kuti ali ndi dzanzi, akumva ngati kuti ndi tsekwe, mukumva kutentha, mphamvu yokhudzana ndi kuzizira, kutentha, kugwedezeka. Kusintha kwachilengedwe kumapitirira, ndipo kwaubweya kungakhale kulibe.

Monga lamulo, zosokoneza zazovuta ndizofanana. Ndi mawonekedwe a asymmetric pathology, ululu wammbuyo umayamba kuchokera m'chigawo cha pelvic ndikupita pansi. Izi zimaphatikizidwa ndi kuchepa kwa kuchuluka kwa dzanja lomwe lakhudzidwa, kuphwanya kuchuluka kwake mokhudzana ndi thupi lonse.

Kusokonezeka kwa chidwi cha kupweteka ndi chimodzi mwazinthu zowala kwambiri za polyneuropathy

Kuphatikiza matenda

Kukula kwa sensory-motor polyneuropathy nthawi zambiri kumakhala ndi koopsa. Anthu odwala matenda ashuga amadandaula za izi:

dzanzi
kupweteka kwachilengedwe
kuphwanya zamkati mpaka pakalibe kwathunthu,
kufooka kwa minofu
kusowa kwachilengedwe komanso maonekedwe a zam'tsogolo.
kukokana usiku m'munsi ndi kumtunda,
kusowa kwa kukhazikika poyenda.

Vuto lamafupipafupi la njira zophatikizika ndi kuwonongeka kwa makina ndi phazi la anthu odwala matenda ashuga - njira yodutsitsa madzi momwe lesion imagwirira ziwalo zonse, kuphatikizapo cartilage ndi mafupa. Zotsatira - kusinthika ndi chisokonezo cha gait.

Chofunikira ndiku kusiyanitsidwa kwa mawonekedwe a diabetesic sensorimotor ndi mowa wa polyneuropathy.

Kugonjetsedwa kwapaulendo

Maselo am'mitsempha am'kati mwa ziwalo zamkati amathanso kukhudzidwa. Zizindikiro zimatengera gawo kapena dongosolo lomwe lakhudzidwa. Pathology ya mtima ndi mitsempha ya magazi imawonetsedwa ndi orthostatic matenda oopsa, pulmonary edema, chidwi cha zolimbitsa thupi. Odwala amadandaula za kusinthasintha kwa mtima, kuchuluka kwa magazi, kufupika, kutsokomola. Kuperewera kwa chithandizo cha panthawi yake kumatha kupha.

Kusokonezeka kwa mitsempha ya mtima - chizindikiro cha matenda amtundu wodziyimira pawokha

Zowonongeka pamtunda wamatumbo zimawonetsedwa ndi paresis, kuchepa kwa mamvekedwe a nthambi zake, kuphwanya kwa microflora yachilendo, komanso matenda a Reflux. Odwala akuvutika kwambiri ndi kusanza, kutentha kwa mtima, kutsegula m'mimba, kuchepa thupi, kupweteka.

Genitourinary polyneuropathy imayendera limodzi ndi ma atony a chikhodzodzo, kusinthanso mkodzo Reflux, matenda opatsirana pogonana, matenda opatsirana amatha kuikidwa. Ululu umawoneka m'munsi kumbuyo ndipo pamwamba pa pubis, kukodza kumachitika pafupipafupi, kutsatana ndi kupweteka komanso kutentha, kutentha kwa thupi kumakwera, kutuluka kwamitsempha kuchokera kumaliseche ndi urethra kumawonekera.

kuphwanya kwa thukuta njira (kuchuluka kapena kufupika mpaka kufinya kwathunthu kwa thukuta)
zamatsenga zojambula (zojambulazo zimachepera m'mimba mwake, kupendekera kwakanthawi kochepa kumachepa, makamaka madzulo),
adrenal polyneuropathy ilibe mawonekedwe owonetsera.

Zochizira

Pochizira matenda ashuga a polyneuropathy, chofunika ndi kukonza shuga. Izi zimachitika ndi endocrinologist, yemwe amawunika mitundu ya mankhwala a insulin komanso kugwiritsa ntchito mankhwala ochepetsa shuga. Ngati ndi kotheka, ndalamazo zimasinthidwa ndi anthu ogwira ntchito kwambiri kapena mankhwala owonjezera amalembera.

Kuwongolera zakudya kumachitika, njira zofunikira zolimbitsa thupi zimasankhidwa. Dokotalayo amapereka malangizo amomwe angapangire kuthamanga kwa magazi ndi kulemera kwa thupi pamilingo yovomerezeka.

Magulu otsatirawa a mankhwala amalembedwa:

Zotupa za alpha lipoic acid ndi mankhwala osankha. Amatha kuchotsa cholesterol owonjezera, kuyimitsa zoopsa zakunja kwa chiwindi ndi mitsempha yamagazi. Oimira - Berlition, Lipoic acid, Thiogamm. Njira ya mankhwala osachepera miyezi iwiri.
Mavitamini a B - kusintha magwiridwe antchito am'kati ndi potumphukira kwamanjenje, kumathandizira kuti matendawa azitha kufalitsa matenda a neuromuscular impulses (Pyridoxine, cyanocobalamin, Thiamine).
Ma antidepressants - amagwiritsidwa ntchito pochepetsa mawonetsedwe owawa (amitriptyline, nortriptyline). Kutumizidwa yaying'ono Mlingo, pang'onopang'ono kukwaniritsa zofunika achire kwenikweni.
Aldose reductase inhibitors - mbali zabwino pamankhwala pogwiritsa ntchito gululi adawonetsedwa, koma sanakwaniritse ziyembekezo zawo zonse. Gwiritsani ntchito molingalira kwa dokotala wopezekapo (Olrestatin, Izodibut, Tolrestat).
Ma anesthetics am'deralo - amagwiritsidwa ntchito pochepetsa ululu pamayendedwe a ntchito. Zotsatira zimawonekera pambuyo pa mphindi 10-15.
Anticonvulsants - Carbamazepine, Finitoin. Gululi lifunika kusankha mosamala. Yambani ndi milingo yaying'ono, ndikukulira kwa milungu ingapo.

Zotupa za alpha-lipoic (thioctic) acid - mankhwala osokoneza bongo kuti apangitse magazi kuti athetse matenda osokoneza bongo

Zithandizo za anthu

Ndikotheka kuchitira odwala matenda ashuga polyneuropathy osati ndi mankhwala amwambo, komanso njira zosiyanasiyana ndi infusions okonzedwa kunyumba.

Lalirani mapesi akhonde okonzedwa kale. Wodwala akuyenera kuwathina kwa mphindi zosachepera 7-10 patsiku.

Mizu yophwanyika ya burdock ndi masamba a blueberry amasakanikirana. 3 tbsp zotsatira zosakaniza zimathiridwa ndi lita imodzi ya madzi otentha ndikuwumirira kwa maola osachepera 8. Kenako ikani moto ndikuwotha kwa maola atatu ena. Msuzi utatha, uyenera kusefedwa. Imwani kuchuluka kwa madzi omwe mumalandira masana.

Kapu ya oats imathiridwa ndi madzi okwanira 1 litre. Kuumirira kwa maola 10, ndiye kuti muyenera kuwiritsa kusakaniza kwa mphindi zosachepera 40. Chotsani pachitofu ndi kutumiza kumalo otentha. Pambuyo umasefedwa ndikuwamwa mu kapu ya theka la ola musanadye.

Kumbukirani kuti ndizosatheka kuchotsa polyneuropathy ndi wowerengeka azitsamba popanda mankhwala amchikhalidwe ndikuwongolera shuga. Koma kuphatikiza kwa zinthu izi kumatha kubweretsa zotsatira zabwino za matenda.

Matenda a shuga a polyneuropathy ndi matenda oopsa, limodzi ndi kuwonongeka kwa magawo a zotumphukira zamagetsi. Matendawa ndi zovuta za matenda ashuga, zizindikilo zake zoyambirira zimapezeka zaka zingapo atazindikira kuti ali ndi matenda ashuga. Amayenda pang'onopang'ono, poyamba distal kenako mbali zoyipa zamagetsi zimagwira nawo njira yothandizira matenda.

Polyneuropathy imapezeka mu 70% ya odwala matenda ashuga ndipo, monga lamulo, ali kale pamlingo wotere pamene chithandizo chamankhwala nthawi zambiri chimakhala chosagwirizana. Chithandizo chosafunikira chimatsogolera ku mawonekedwe opweteka kwambiri, ntchito imatayika. Pali chiopsezo cha kufa. Ganizirani momwe mungachitire polyneuropathy mu shuga.

Amayambitsa, pathogenesis ya polyneuropathy

Chifukwa chachikulu chomwe chimayambitsa makina a neuropathy ndikuwonjezera kuchuluka kwa shuga m'magazi. Zotsatira zake ndikuwonjezereka kwa kuchuluka kwa njira za oxidative. Ma radicals aulere amadziunjikira m'thupi, omwe amawononga ma neurons, akusokoneza ntchito zawo.

Shuga wambiri amatsogolera ku activation ya autoimmune njira zomwe zimawononga minofu yamitsempha. Kukhazikika kwa glucose kumayambitsa kusokonezeka mu osmolarity a intracellular space, minyewa yamitsempha yotupa, mawonekedwe apakati pa maselo amasokonezeka. Kukula kwa maselo amanjenje am'mitsempha kumachepetsedwa. Nthawi zonse hyperglycemia imachepetsa kuchuluka kwa mphamvu ya kagayidwe, kulimbikitsidwa kwa conduction kumakulirakulira. Mapeto a maselo amitsempha amatsata hypoxia (kufa ndi njala ya oxygen).

Zomwe zimayambitsa kukula kwa neuropathy:

Matenda a shuga
Ukalamba
Kupezeka kwa zizolowezi zoipa,
Intoxication ndi mankhwala, mankhwala.

Pathology imatha kukhala motsutsana ndi maziko a matenda oyenda bwino:

Chiwopsezo cha polyneuropathy chikuwonjezereka mu odwala matenda ashuga ndi ochepa matenda oopsa, kunenepa kwambiri, hyperlipidemia.

Mankhwala azitsamba

Kuphatikiza pa njira zochizira zomwe adokotala adapereka, mutha kuthandizidwa ndimankhwala achikhalidwe. Mankhwala azitsamba amathandizira kuchepetsa kukula kwa zizindikiro.

Sinthani misinkhu ya shuga pogwiritsa ntchito decoction, yomwe imaphatikizapo:

Peppermint - 30 g
Stigmas chimanga - 60 g,
Galega (mbuzi) - 100 g,
Nyemba Sash - 100 g.

Thirani 6 tebulo. l Sungani 1 lita imodzi ya madzi otentha ndikuyika moto wochepa kwa mphindi 5. Musanagwiritse ntchito, sefesa msuzi ndi kudya musanadye. Mlingo umodzi ndi 100 ml.

Kuti mupeze ma neuroni ndi michere, imwani tsiku lililonse. Mufunika:

Kefir - 1 tbsp.,
Mbewu za Mpendadzuwa - 2 tebulo. l.,
Parsley - kulawa.

Sendani ndikudula mbewu za mpendadzuwa, kuwonjezera pa kefir. Onjezani amadyera ndi kusakaniza. Imwani tambala 1 tsa / tsiku theka la ola musanadye kadzutsa (pamimba yopanda kanthu).

Clove (zonunkhira) imakhala ndi antioxidant yabwino. Kukonzekera kulowetsedwa muyenera:

Matenda a shuga a polyneuropathy ndi amodzi mwa zovuta zomwe zimayendera shuga. Vutoli limachitika chifukwa cha kuwonongeka kwa minyewa ya thupi ndi ma pathological agents opangidwa pophwanya carbohydrate metabolism.

Ziwerengero zokhudzana ndi matenda osokoneza bongo a shuga zimawonetsa kuti mawonekedwe a zovuta nthawi zambiri amapezeka zaka 15-20 kuchokera pachiwonetsero cha matenda. Matendawa atakula, nthawi yayitali imayenera kudutsa, chifukwa matenda ashuga amayamba pang'onopang'ono.

Kukula kwa matenda ashuga a polyneuropathy ku Moscow odwala ali pafupifupi 50-60%. Vutoli limadziwika ndi mitundu iwiri ya matenda ashuga 1 ndi yachiwiri. Chithandizo cha matendawa chikulimbikitsidwa m'makliniki apadera, manambala a foni ndi adilesi yomwe imapezeka patsamba.

Kuzindikiritsidwa kwa matenda ashuga a polyneuropathy akuphatikizidwa ndi gulu la matenda padziko lonse lapansi - ICD. Mavuto omwe ali m'dongosolo amapatsidwa nambala ya G63.2.

Mphamvu yamanjenje yaumunthu imakhala ndi gawo lapakati, lomwe limayimiridwa ndi ubongo ndi msana, komanso ulusi wamanjenje womwe umachokera kwa iwo, womwe umapanga gawo lamanjenje lamitsempha. Mulinso mitundu iwiri yayikulu ya mitsempha:

Zingwe zam'mimba za Somatic ndizomwe zimapangitsa kuti minofu yolimba ikhale. Mitundu yotereyi imapereka mayendedwe aulere aumunthu.

Dongosolo la autonomic limapereka mitengo ikuluikulu yamitsempha yomwe imapita ku ziwalo zonse zamkati. Imawongolera magwiridwe anthawi:

Tizilombo toyamwa
Mitsempha yamagazi
Njira yothandizira
Matumbo a urinary, etc.

Dongosolo lamanjenje la autonomic limagwira ntchito palokha, ndiye kuti, silimvera zokonda za munthu.

Dongosolo la matenda ashuga polyneuropathy limafikira ku mitsempha yonse yapadera yomwe ndi gawo limodzi la machitidwe a ziwonetsero zodziyimira payokha. Zizindikiro zomwe zingachitike mwa munthu zimadalira malo omwe awonongeka.

Pofuna kusokoneza mitsempha yamatenda, ntchito zamafupa zimachepa. Kunja, izi zimawonetsedwa ndi kupweteka kwambiri m'miyendo ndi malo ena momwe minofu ikuluikulu imakhala (chamimba chosindikizira, kumbuyo).

Kuwonongeka kwa mitsempha yomwe imapanga dongosolo laumwini la autonomic kumayambitsa kusokoneza ziwalo zamkati. Njirayi ndiyowopsa kwa thupi la munthu, chifukwa imabweretsa chitukuko cha ziwalo ndi machitidwe a thupi.

Kusintha kwa magwiridwe antchito amanjenje mu shuga kumachitika chifukwa cha kuchuluka kwa shuga m'magazi. Ndi gawo lokhazikika la shuga, kagayidwe mu minofu ndi maselo amasokonezeka. Glucose amachoka m'magazi ndikukhazikika m'malo osiyanasiyana, kuphatikizira kwamanjenje.

Kuwonongeka kwa mitsempha ya mitsempha kumayambitsa kusokonezeka kwa kutayika kwa ziwalo zosiyanasiyana. Chofunikira kwambiri pakukula kwa njira ya pathological ndi chinthu chinanso - kuperewera kwa mpweya wa okosijeni (hypoxia). Posemphana ndi kagayidwe kake ka munthu wodwala matenda a shuga, kuthamanga kwa magazi kudzera m'matumbo kumachepa. Zotsatira zake, mitsempha ya mitsempha siyilandira mpweya wokwanira, zomwe zimapangitsa kuchepa kwa ntchito yawo.

Chithunzi cha matenda

Zizindikiro za polyneuropathy nthawi zambiri zimafikira kumapeto. Nthawi zina, kusintha kwa ma pathological kumachitika m'mitsempha yamanja.

Kutengera gawo la chitukuko cha njirayi ndi kuuma kwa zizindikiro zamankhwala, magawo akulu a matenda a shuga a polyneuropathy amawasiyanitsa. Izi zikuphatikiza:

Gawo loyesera
Gawo lazachipatala
Gawo la zovuta.

Gawo la kusintha kopita patsogolo limadziwika ndi kusakhalapo kwathunthu kwa madandaulo mwa wodwala. Zizindikiro zoyambirira za kuwonongeka kwa minyewa ya mitsempha zimachitika - kumva kwanyumba kumatha. Choyamba, malingaliro a kugwedezeka, kusintha kwa kutentha ndi kupweteka kumasokonekera.

Pakadali zizindikiro za matenda, wodwalayo ali ndi chithunzi cha matenda. Matenda opweteka kwambiri amawonongeka, omwe amatha kukhala gawo lililonse la thupi. Kukula kwa kupweteka kumasiyanasiyana kuyambira kofatsa mpaka kowonjezereka, kuphatikiza ndi kuchepa kwa chidwi. Zizindikiro zina zamatendawa ndi monga:

Kuchuluka kwa miyendo
Kuwonongeka kwakukulu
Ululu wamphamvu usiku womwe umatha kuchoka kudera lina kupita kwina.
Kumvetsetsa
Khungu loyaka.

Payokha, ndikofunikira kutchula mitundu inayake ya matenda ashuga a polyneuropathy. Chithunzi cha chipatala cha mawonekedwe osapweteka chikuwonetsedwa ndi mawonekedwe amanjenje - dzanzi la miyendo ndi kumva kugunda kwa manjenje. Amyotrophic polyneuropathy, kuwonjezera pa kuchepa kwa chidwi, imadziwika ndi mawonekedwe a kufooka kwa minofu komanso kuchepa kofananira ndi ntchito yamagalimoto a anthu.

Njira ya matendawa imatha kutsagana ndi kuwonekera kwa zizindikiro zosakhala zachidziwikire. Izi zikuphatikiza:

Mutu
Zingwe
Chizungulire
Kuchepetsa mphamvu
Kutsegula m'mimba ndi mseru
Kuchepetsa kwamitseko
Kutha kumva ndi kuwona,
Amayi amakhala ndi anorgasmia,
Kuphwanya kachitidwe ka mawu.

Gawo lotsatira pakukula kwa matendawa ndi gawo la zovuta. Ndi kupita patsogolo kwa matenda ashuga a polyneuropathy, zotsatira zoyipa za kuwonongeka kwa mitsempha zimayamba. Pakadali pano, wodwalayo ali ndi gulu la "zoipa" za matendawa, zomwe zimaphatikizapo:

Kudzera
Kwambiri miyendo ndi mikono,
Kuyenda mosavuta mukamayenda, limodzi ndi ululu waukulu,
"Imfa" ya pakhungu.

Kupezeka kwa zizindikirozi kukuwonetsa kudalirika komwe kumachitika wodwalayo. Popita nthawi, zilonda zam'mimba zimayamba kupanga miyendo ya wodwalayo, ndikuwononga kukhulupirika kwa khungu.

Ndi kupita patsogolo kwa njirayi, zizindikirizo zimakulirakulira, zomwe zingayambitse kuphwanya kwathunthu ntchito za m'munsi. Njira yonyalanyazidwa imabweretsa chiwopsezo pamoyo wa wodwalayo, chifukwa chake, pamapeto pake, wodwalayo angafunenso kudulidwa chiwalo.

Kuchiza matenda

Zochizira matenda ashuga polyneuropathy, amagwiritsa ntchito mankhwala osiyanasiyana, omwe cholinga chake ndicholetsa kukopa kwa matenda omwe amathandizira kukula kwa matendawa.

Chofunikira pa mankhwalawa ndimatenda a shuga m'magazi. Popeza polyneuropathy ndi zovuta za matenda a shuga, chinthu choyamba chodzetsa wodwalayo ndicho kusintha matendawa. Wodwala ayenera kuonana ndi endocrinologist yemwe angasankhe kuchuluka kwa insulin. Izi zimathandizira msanga shuga m'magazi a wodwala.

Chithandizo cha matenda a shuga a shuga a m'magazi zimaphatikizapo kugwiritsa ntchito mankhwala omwe amapangitsa kuti wodwalayo asinthe. Dokotalayo amapereka mankhwala otsatirawa:

Vitamini amaphatikizira, makamaka mavitamini B, kubwezeretsa magwiridwe antchito a minyewa yamitsempha,
Kukonzekera kwa antioxidant (mavitamini a magulu C ndi E),
Othandizira zoletsa
Actovegin,
Maantibayotiki pakakhala matenda opatsirana ofala,
Opaleshoni kuti muchepetse zizindikiro zazikulu.

Pogwiritsa ntchito mankhwalawa pafupipafupi kuphatikizidwa ndi mankhwalawo, mkhalidwe wa wodwalayo umayamba kuyenda bwino, kuwuma kwa zizindikiro kumachepa. Kuti muchite izi mwachangu, ndikulimbikitsidwa kuphatikiza ndalama zomwe zalembedwedwa ndi wina ndi mnzake, chifukwa izi zimakhudza mwachangu zinthu zingapo zomwe zimayambitsa kukula kwa matendawa. Chifukwa cha izi, chithandizo chamankhwala chikhala chothandiza kwambiri.

Chofunika kwambiri pakuchira komanso kukonza wodwala pambuyo pa matenda ashuga a polyneuropathy ndi njira zopanda mankhwala. Njira zotsatirazi zimaperekedwa kwa wodwala:

Chithandizo cha physiotherapy
Chithandizo cha zilonda zapakhungu ndi zolakwika pam malekezero ndi antiseptics kupewa matenda oyanjana,
Kugwiritsa ntchito ma insoles apadera,
Mapazi am'munsi ndi mwendo
Kuwotchera malekezero akumunsi ndi masokosi ofunda (nkoletsedwa kugwiritsa ntchito mapiritsi otenthetsera ndi malo osambira chifukwa cha izi),
Kuchita masewera olimbitsa thupi kuti mubwezeretsenso minofu.

Masewera olimbitsa thupi omwe ali ndi diabetesic polyneuropathy yokhala m'munsi yotsika imaphatikizapo kuchita masewera olimbitsa thupi, omwe amatha kuchitidwa pakukhala.

Mukachira matenda, njira zachikhalidwe zachikhalidwe zimatha kugwiritsidwa ntchito. Izi zikuphatikiza:

Madeti
Clay
Zodzikongoletsera zazitsamba (calendula, muzu wa burdck),
Uchi ndi mandimu
Mkaka wa mbuzi
Nutmeg
Mummy.

Njira zina sizingagwiritsidwe ntchito m'malo mwa mankhwala, chifukwa izi zingayambitse zovuta za matendawa. Tsatirani malangizo a dokotala. Njira zina zamankhwala pamenepa zitha kugwiritsidwa ntchito kuti muchepetse zizindikiro za matendawa.

Zotsogola ndi kupewa

Kukula kwa munthu wodwala matenda ashuga polyneuropathy a malekezero kumatengera gawo lomwe zovuta zomwe zidadziwika. Ngati matendawa apezeka pamalo oyamba, ndiye kuti kuchira kwathunthu kumatha. Ngati matenda opititsa patsogolo matenda omwe amapezeka ndi zovuta zazikulu atapezeka, matulukidwe ake siabwino.

Kupewa matenda kumathandiza kwambiri odwala omwe ali ndi matenda ashuga. Ayenera kutsatira malangizo a adokotala, adye moyenera, amwe mankhwala nthawi. Ndikofunikira kuti mukhale ndi moyo wathanzi, kusiya zizolowezi zoyipa ndikuwongolera kunenepa kwambiri.

Chifukwa chake, matenda ashuga a polyneuropathy a malekezero ndi vuto lalikulu la matenda ashuga. Ngati mukukayikira nthendayi, muyenera kupeza nambala yafoni ndi adokotala a mbiri kuti mupange nthawi yokumana naye.

Timayesetsa kukupatsani chidziwitso chofunikira komanso chothandiza kwa inu ndi thanzi lanu. Zinthu zomwe zili patsamba lino ndizachidziwitso ndipo cholinga chake ndi kuphunzitsa. Alendo otsamba sayenera kuwagwiritsa ntchito ngati malangizo azachipatala. Kudziwa dokotala komanso kusankha njira zamankhwala ndikungokhala dokotala! Sikuti tili ndi vuto lililonse chifukwa chogwiritsa ntchito zidziwitso zomwe zalembedwa patsamba lino