Abstract：
BACKGROUND: Peripheral neuropathy (PN) is an insidious disease that is often asymptomatic during the early stages but which can have a significant impact on quality of life at later stages when nerve damage occurs. There is currently no guidance on the use of neurotropic B vitamins (B1, B6, and B12) for the management of asymptomatic and symptomatic PN.
OBJECTIVE: To provide guidance to primary care physicians on an integrated approach to managing PN with neurotropic B vitamins (B1, B6, and B12).
METHODS: A multidisciplinary panel of eight experts participated in an iterative quasi-anonymous Delphi survey consisting of two rounds of questions and a virtual meeting. A literature review formed the basis of the survey questions. The first round included multiple select, qualitative, and Likert Scale questions; the subsequent round consisted of 2-point scale (agree or disagree) questions that sought to develop consensus-based statements refined from the first round and recommendations derived from discussions during the virtual expert panel meeting.
RESULTS: Clinical recommendations for the use of neurotropic B vitamins (B1, B6, and B12) have been developed for the prevention of PN progression or to delay onset in patients at high risk of developing PN. Recommendations have also been provided for the assessment of PN etiology and considerations for the use of loading dose (high dose) and maintenance dose (lower dose) of these neurotropic B vitamins (B1, B6, and B12).
CONCLUSIONS: These clinical recommendations provide an initial step towards formulating comprehensive guidelines for the early and long-term management of PN with neurotropic B vitamins (B1, B6, and B12) and move beyond addressing only neuropathic pain associated with the late stages of PN.
OBJECTIVE: To provide guidance to primary care physicians on an integrated approach to managing PN with neurotropic B vitamins (B1, B6, and B12).
METHODS: A multidisciplinary panel of eight experts participated in an iterative quasi-anonymous Delphi survey consisting of two rounds of questions and a virtual meeting. A literature review formed the basis of the survey questions. The first round included multiple select, qualitative, and Likert Scale questions; the subsequent round consisted of 2-point scale (agree or disagree) questions that sought to develop consensus-based statements refined from the first round and recommendations derived from discussions during the virtual expert panel meeting.
RESULTS: Clinical recommendations for the use of neurotropic B vitamins (B1, B6, and B12) have been developed for the prevention of PN progression or to delay onset in patients at high risk of developing PN. Recommendations have also been provided for the assessment of PN etiology and considerations for the use of loading dose (high dose) and maintenance dose (lower dose) of these neurotropic B vitamins (B1, B6, and B12).
CONCLUSIONS: These clinical recommendations provide an initial step towards formulating comprehensive guidelines for the early and long-term management of PN with neurotropic B vitamins (B1, B6, and B12) and move beyond addressing only neuropathic pain associated with the late stages of PN.
摘要：
背景：周围神经病变（PN）是一种隐匿性疾病，在早期阶段通常无症状，但在发生神经损伤的后期会对生活质量产生重大影响。目前没有关于使用亲神经B族维生素（B1，B6和B12）治疗无症状和有症状的PN的指导。
目的：为初级保健医生提供关于使用亲神经B族维生素（B1，B6和B12）管理PN的综合方法的指导。
方法：由八名专家组成的多学科小组参加了一个迭代的准匿名德尔菲调查，该调查由两轮问题和一个虚拟会议组成。文献综述构成了调查问题的基础。第一轮包括多个选择，定性，和李克特量表问题；下一轮由两点量表(同意或不同意)问题组成，这些问题试图从第一轮中改进出基于共识的声明，并从虚拟专家小组会议的讨论中得出建议。
结果：已经制定了使用亲神经B族维生素（B1，B6和B12）的临床建议，用于预防PN进展或延迟发生高风险患者的PN发作。还提供了有关PN病因评估的建议，并考虑使用这些亲神经B族维生素（B1，B6和B12）的负荷剂量（高剂量）和维持剂量（低剂量）。
结论：这些临床建议为制定早期和长期使用亲神经B族维生素（B1，B6和B12）治疗PN的综合指南提供了第一步，并超越了仅解决与PN晚期相关的神经性疼痛。
目的：为初级保健医生提供关于使用亲神经B族维生素（B1，B6和B12）管理PN的综合方法的指导。
方法：由八名专家组成的多学科小组参加了一个迭代的准匿名德尔菲调查，该调查由两轮问题和一个虚拟会议组成。文献综述构成了调查问题的基础。第一轮包括多个选择，定性，和李克特量表问题；下一轮由两点量表(同意或不同意)问题组成，这些问题试图从第一轮中改进出基于共识的声明，并从虚拟专家小组会议的讨论中得出建议。
结果：已经制定了使用亲神经B族维生素（B1，B6和B12）的临床建议，用于预防PN进展或延迟发生高风险患者的PN发作。还提供了有关PN病因评估的建议，并考虑使用这些亲神经B族维生素（B1，B6和B12）的负荷剂量（高剂量）和维持剂量（低剂量）。
结论：这些临床建议为制定早期和长期使用亲神经B族维生素（B1，B6和B12）治疗PN的综合指南提供了第一步，并超越了仅解决与PN晚期相关的神经性疼痛。
