Больова форма діабетичної невропатії та її лікування прегабаліном
DOI:
https://doi.org/10.24026/1818-1384.2(58).2017.105628Ключові слова:
діабетична невропатія, невропатичний біль, профілактика, терапія, прегабалінАнотація
Огляд присвячено проблемі больової діабетичної невропатії, розглянуто її поширеність серед хворих на цукровий діабет 1 та 2 типів, досягнення у вивченні етіопатогенезу, наявні в даний час можливості лікування. Найпоширенішою клінічною формою діабетичної невропатії є симетрична периферична невропатія (ДСПН), яка вражає близько 20% хворих на цукровий діабет 1 типу за тривалості захворювання 20 років та до 50% пацієнтів із цукровим діабетом 2 типу після 10 років прогресування захворювання. На даний час єдині доступні підходи до лікування ДСПН – це покращення контролю глікемії та терапія болю. Встановлено високі рівні доказів на підтримку застосування деяких антиконвульсантів (прегабалін, габапентин) та антидепресантів (дулоксетин, венлафаксин, амітриптилін) для лікування невропатичного болю. Комбінована терапія болю вивчена не достатньо, тому наразі керівництва рекомендують розпочинати лікування з монотерапії одним із препаратів першої лінії, титруючи його до досягнення терапевтичної дози за умови доброї переносимості.Посилання
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