##糖尿病患者的“沉默杀手”：DPNP治疗困境待解
糖尿病性周围神经病理性疼痛（DPNP）是糖尿病的严重并发症之一，随着糖尿病发病率和患病率的逐年攀升，DPNP已成为全球医疗领域的关注焦点。
DPNP的症状表现多样，疼痛程度也随着病程进展而加剧，给患者带来极大的痛苦。目前，药物治疗是DPNP最基础、最常用的手段，但由于药物选择有限、疗效不佳、安全性等问题，DPNP的治疗困境依然存在。
**早期诊断至关重要，但现状不容乐观**
“DPNP是一种隐匿性疾病，早期症状不易察觉。”首都医科大学附属北京朝阳医院内分泌科王广教授指出，2型糖尿病患者在病程早期基本不会出现微血管病变和神经病变，但随着病程延长，会逐渐出现微血管损伤和周围神经病变，直到已经出现了损伤，而一旦出现神经病变基本上不可逆。
“超过70%的DPNP患者存在中至重度持续疼痛，导致失眠、生活质量降低、情绪障碍等。”王广教授补充道，目前国内对于DPNP这类慢性疼痛的管理依然面临着巨大的挑战，早期诊断对患者尤为重要，一旦确诊就需要进行疾病管理并使用药物缓解疼痛，减轻对生活的影响。
**第三代钙离子通道调节剂带来新希望**
今年6月，第三代钙离子通道调节剂德力静获国家药监局批准，用于治疗成人DPNP。北京大学第一医院内分泌科郭晓蕙教授表示，第三代钙离子通道调节剂的上市对于DPNP患者来说是一道新的治疗曙光，临床研究结果证实了其对于患者的疼痛缓解具有显著改善，且明显改善了患者对疼痛的整体印象、睡眠、患者生活质量等。
**未来展望：多学科协作，构建完善的DPNP管理体系**
尽管新药的出现为DPNP患者带来了新的希望，但要彻底打破治疗困境，还需要多学科协作，构建完善的DPNP管理体系。
专家建议，加强对DPNP的早期筛查和诊断，提高医护人员对DPNP的认识，并积极开展患者教育，帮助患者了解DPNP的危害和治疗方法，积极参与治疗，提高生活质量。
此外，还需要加强对DPNP基础研究，开发更有效、更安全的治疗药物，探索新的治疗方法，为DPNP患者带来更多福音。
英语如下：
##The Silent Killer for Diabetics: Deciphering the Treatment Dilemma ofDiabetic Neuropathic Pain
**Keywords:** Diabetes, Neuropathic Pain, Dilemma
## The Silent Killer for Diabetics: Deciphering the Treatment Dilemma of Diabetic Neuropathic Pain
Diabetic peripheral neuropathic pain (DPNP)is a serious complication of diabetes. As the incidence and prevalence of diabetes rise year by year, DPNP has become a global focus in the medical field.
DPNP symptoms vary, and pain intensity increases with disease progression, causing significant suffering for patients. Currently, drug therapy is the most basic and commonly used approach for DPNP. However, due to limited drug options, suboptimal efficacy, andsafety concerns, the treatment dilemma of DPNP persists.
**Early diagnosis is crucial, but the current situation is not optimistic.**
“DPNP is a hidden disease, and early symptoms are difficult to detect,” said Professor Wang Guang,from the Department of Endocrinology at Beijing Chaoyang Hospital, affiliated with Capital Medical University. “Type 2 diabetes patients generally do not experience microvascular or neurological complications in the early stages of the disease. However, as the disease progresses, microvascular damage and peripheral neuropathy gradually occur. By the time damage is detected, itis often irreversible. Once neuropathy occurs, it is largely irreversible.”
“Over 70% of DPNP patients experience moderate to severe persistent pain, leading to insomnia, reduced quality of life, and emotional disorders,” added Professor Wang. “Currently, the management of chronic pain like DPNP in China still faces significantchallenges. Early diagnosis is crucial for patients. Once diagnosed, disease management and pain relief medications should be used to minimize the impact on their lives.”
**Third-generation calcium channel modulators bring new hope.**
In June this year, the third-generation calcium channel modulator, DeriJing, was approved by theNational Medical Products Administration for the treatment of adult DPNP. Professor Guo Xiaohui, from the Department of Endocrinology at Peking University First Hospital, stated that the launch of the third-generation calcium channel modulator is a new ray of hope for DPNP patients. Clinical research results have confirmed its significant improvement in pain relief forpatients, and it has significantly improved patients’ overall impression of pain, sleep, and quality of life.
**Future Outlook: Multidisciplinary Collaboration to Build a Comprehensive DPNP Management System**
While the emergence of new drugs brings new hope for DPNP patients, breaking through the treatment dilemma completely requires multidisciplinary collaboration tobuild a comprehensive DPNP management system.
Experts recommend strengthening early screening and diagnosis of DPNP, raising awareness of DPNP among healthcare professionals, and actively engaging in patient education. This will help patients understand the risks and treatment methods of DPNP, actively participate in treatment, and improve their quality of life.
Furthermore, there is a need to strengthen basic research on DPNP, develop more effective and safer therapeutic drugs, and explore new treatment methods to bring more benefits to DPNP patients.
【来源】http://www.chinanews.com/life/2024/08-22/10273284.shtml
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