Evaluation of the effectiveness of metabolic therapy in the treatment of diabetic polyneuropathies in patients with type 2 diabetes


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The aim of this study was to study the effectiveness of metabolic therapy in the treatment of polyneuropathy in patients with type 2 diabetes mellitus. The results of treatment of 110 patients with type 2 diabetes were analyzed. To study the efficacy and safety of metabolic drugs, patients were divided into 4 parallel groups: Group 1 (Control group), patients receiving only basic hypoglycemic therapy; group 2 (Cocarnit), patients who, in addition to basic hypoglycemic therapy, received a combined metabolic drug - "Cocarnit"; Group 3 (Cytoflavin), patients who, in addition to basic hypoglycemic therapy, received the combined metabolic drug "Cytoflavin"; group 4 (Thioctacid), patients who, in addition to basic hypoglycemic therapy, received the drug thioctic acid "Thioctacid". All patients were tested for TSS, NSS,NDS, SF-36, neurophysiological study - ENMG, as well as determination of VEGF in blood serum in dynamics in order to evaluate the effectiveness of metabolic therapy 24-48 hours before and after 36-40 days of therapy. According to the TSS and NSS scales, patients who received Cocarnit, Cytoflavin, and Thioctic acid had significantly higher confidence differences before and after therapy (p<0.001) than in the control group p=0.001. On the NDS scale, the "Thioctic acid" group has an advantage over two parallel groups of patients receiving metabolic drugs (p<0.001). The best indicators of changes in electroneurophysiological parameters were observed in the "Cocarnit" group: an increase in the distal (p=0.033) and proximal (p=0.034) amplitudes of nerve fiber contraction, as well as an improvement in the distal (p=0.05) and proximal (p=0.05) rates of excitation along the nerve. There were no significant changes in the level of vascular endothelial growth factor (VEGF) during therapy in any of the groups of patients, but there was a significant inverse relationship of this indicator with the experience of type 2 diabetes (r=-0.246; p=0.022), age of patients (r=-0.218; p=0.042) and LDL (r=-0.274; p=0.01).

Full Text

Restricted Access

About the authors

I. N Pashkova

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

assistant of the Department of pharmacology and pharmaceutical consulting with a postgraduate course

T. V Potupchik

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Ph.D. (Medical), Associate Professor, Department of pharmacology and pharmaceutical consulting with a postgraduate course

I. V Gackich

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Ph.D. (Medical), Associate Professor, Department of pharmacology and pharmaceutical consulting with a postgraduate course

M. M Petrova

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Dr.Sc. (Medical), Professor, first Vice-rector, Head of the Department of outpatient therapy and family medicine with a postgraduate course

O. F Veselova

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Associate Professor, Head of the Department of pharmacology and pharmaceutical consulting with a postgraduate course

A. N Narkevich

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Ph.D. (Medical), Associate Professor, Head of the Department of medical Cybernetics and Informatics

T. P Shalda

Federal state budgetary educational institution of higher education "Krasnoyarsk state medical University named after Professor V.F. Voino-Yasenetsky" of the Ministry of health of the Russian Federation

Senior Lecturer, Department of pharmacology and pharmaceutical consulting with a postgraduate course

References

  1. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Под ред. И.И. Дедова, М.В. Шестаковой, А.Ю. Майорова. М. 2019.
  2. Вёрткин А.Л., Кнорринг Г.Ю., Магомедова А.Ю. Сахарный диабет и диабетическая нейропатия: продолжаем разговор. Амбулаторный прием. 2016; 3(6): 8-13.
  3. Воробьева О.В. Тиоктовая (альфа-липоевая) кислота -спектр клинического применения. Журнал неврологии и психиатрии им. С.С. Корсакова. 2011; 10:86-90.
  4. Гацких И.В., Брикман И.Н., Газенкампф К.А., Петрова М.М., Веселова О.Ф., Шалда Т.П., Наркевич А.Н, Потупчик Т.В. Динамика неврологических нарушений на фоне комбинированной терапии у больных сахарным диабетом 2-го типа. Журнал неврологи и психиатрии им. С.С. Корсакова. 2018; 6:31-36. doi: 10.17116/jnevro20181186131
  5. Гацких И.В., Петрова ММ., Веселова О.Ф., Шалда Т.П., Наркевич А.Н, Брикман И.Н. Анализ когнитивного статуса у пациентов с сахарным диабетом 2 типа. Сахарный диабет. 2017; 20(6):434-440. D01:10.14341/DM7926
  6. Девликамова Ф.И. Применение препарата кокарнит при лечении пациентов с диабетической полинейропатией. Журнал неврологии и психиатрии им. С.С. Корсакова, 2016; 11:64-68.DOLIO.17116/jnevro201611611164-68
  7. Каракулова Ю.В., Филимонова Т.А. Мониторинг клинико-нейрофизиологических показателей при диабетической полинейропатии в процессе метаболической терапии. Доктор.ру. 2017; 1:25-29.
  8. Клинические рекомендации по неврологии Европейской федерации неврологических сообществ. Под ред. Gilhus N.E., Barnes М.Р., Brainin М. Научн. редактор русского издания Никитин С.С. М.; 2012.
  9. Коненков В.И., Бородин Ю.И., Любарский М.С. Лимфология. Российская акад. мед. наук, Сибирское отделение, Научно-исследовательский институт клинической и экспериментальной лимфологии. Новосибирск: Манускрипт, 2012.
  10. Мичурова М.С., Калашников В.Ю., Смирнова О.М., Кононенко И.В., Иванова О.Н. Роль эндотелиальных прогениторных клеток в развитии осложнений сахарного диабета. Сахарный диабет. 2015; 1:24-32. doi: 10.14341/DM2015124-32
  11. Мкртумян А.М., Маркова Т.Н., Подачина С.В. Возможность применения препарата Кокарнит при лечении диабетической полинейропатии. Эндокринология. 2016; 4:6-10.
  12. Музь В.А., Зубкова С.Т., Самсон А.Я. Возможности Цитофлавина в лечении липоидного некробиоза у подростков, больных сахарным диабетом. Диабет и сердце. 2012; 2:82-85.
  13. Пашкова И.Н., Потупчик Т.В., Петрова М.М., Веселова О. Ф., Гацких ИВ. Комплексная терапия полинейропатии у больных сахарным диабетом типа 2. Врач. 2018; 9:37-43. DOI: https://doi.org/10.29296/25877305-2018-09-08
  14. Рачин А.П., Шаров М.Н. Сравнительное открытое рандомизированное исследование по оценке эффективности и безопасности применения препарата кокарнит при боли в спине у пациентов, страдающих диабетической полиневропатией. Русский медицинский журнал. 2017;9:586-90.
  15. Ховасова Н.О., Наумов А.В., Магомедова А.Ю. Верткин А.Л., Носова А.В. Диабетическая нейропатия: что должен знать терапевт поликлиники. Амбулаторный прием. 2016; 2:60-63.
  16. Lerman O.Z., Galiano R.D., Armour М., Levine J.P., Gurtner G.C. Cellular dysfunction in the diabetic fibroblast: impairment in migration, vascular endothelial growth factor production, and response to hypoxia. Am. J. Pathol. 2003; 162(1): 303-312.
  17. Maric-Bilkan C., Flynn E.R., Chade A.R. Microvascular disease precedes the decline in renal function in the streptozotocin-induced diabetic rat. Am. J. Physiol. Renal Physiol. 2012; 3:308-315. http://dx.d0i.0rg/l 0.1152/ajprenal.00421.2011.
  18. Shenouda Sh. М., Widlansky M.E., Chen K. et al. Altered Mitochondrial Dynamics Contributes to Endothelial Dysfunction in Diabetes Mellitus. Circulation, 2011; 4:444-453. http://dx.doi.Org/10.l 161/CIRCULATIONAHA.l 10.014506.
  19. Ziegler D. Современные принципы ведения больных с диабетической полинейропатией. Нервно-мышечные болезни. 2012; 2:7-19. https://doi.org/10.17650/2222-8721-2012-0-2-7-19.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2020 Russkiy Vrach Publishing House

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies