Abstract
To examine the dysregulation of the autonomic nervous system and manifestations of pain syndrome in patients with rheumatoid arthritis combined with diabetes mellitus and the possibility of their correction in patients who receive complex therapy including neurotropic vitamins (neuromultivitis). One hundred and forty-six patients with rheumatoid disease were examined including 59 patients with diabetes mellitus. When testing for the presence of neuropathic pain syndrome using the diagnostic questionnaire of neuropathic pain (DN4), a greater prevalence of these features was revealed, with a high correlation with the duration of rheumatoid arthritis (r=0,56) and duration of diabetes mellitus (r=0,82). A positive effect of combined therapy with neuromultivitis on the daily rhythm of arterial pressure with its normalization and correction of autonomic disorders was noted. There were a more pronounced decrease in the frequency and severity of parasympathetic and sympathetic failure, as well as an improvement in the adaptation of the peripheral vascular system to orthostatic changes. Improvement of quality of life is, to some extent, due to the more pronounced positive effect of combined therapy with neuromultivitis on such autonomic disorders as palpitations, heart rhythm disturbances, manifestations of lipotymic disorders and even panic attacks.
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