Kusamalira Zizindikiro ndi Zovuta Zowonongeka
Gout ndi mtundu wa nyamakazi chifukwa cha kumanga ndi kutulutsa khungu la uric acid mu mgwirizano. Malinga ndi kuopsa kwa chiwembu, mankhwala angaphatikizepo mankhwala osokoneza bongo (OTC) odana ndi kutupa kuti athetse ululu, komanso kusintha kwa khalidwe (monga zakudya ndi zakumwa za mowa) kuti achepetse nthawi zambiri. Kugonjetsa kwachilendo kungapangitse mankhwala ovomerezeka kuti athe kuchepetsa kuchuluka kwa uric acid m'magazi.
Zothetsera Pakhomo ndi Moyo Wamoyo
Zizindikiro za kupweteka zimayamba chifukwa cha kuchuluka kwa uric acid , matenda otchedwa hyperuricemia . Pakapita nthawi, kumangako kungachititse kupanga uric acid makristasi mkati ndi kuzungulira mgwirizano, kumayambitsa mavuto aakulu komanso otha msinkhu opweteka ndi kutupa.
Momwemonso, chithandizo cha gout chiyenera kuganizira zinthu ziwiri: kuchepetsa uric acid ndi kuchepetsa gout ululu. Pali njira zingapo zothandizira kunyumba komanso kusintha kwa moyo komwe kungathandize.
Uphungu Wopweteka
Kugonjetsa gout nthawi zambiri kumatha masiku atatu mpaka 10. Kupweteka kumayambiriro kwa chiwonongeko (kawirikawiri maola 36 oyambirira) kudzakhala koipitsitsa.
Zina mwa njira zothandizira pakhomo:
- Phukusi lotentha kapena ozizira compress angapereke mpumulo wochuluka wa kuukira pang'ono. Onetsetsani kuti mukulunga phukusi lachitsulo mu thaulo lochepa kwambiri ndikugwiritsanso ntchito palimodzi kwa mphindi 15 kapena 20 yokha kuti muteteze chisanu. Mukhoza kuchita izi kangapo patsiku.
- Pumulani pamodzi. Popeza kuti chala chachikulu chimakhudzidwa, kweza phazi kuti lichepetse vutoli. Pewani mapazi anu mochuluka momwe mungathere, ndipo, ngati mukufuna kusuntha, gwiritsani ntchito ndodo.
Zowonjezera Zakudya
Chimodzi mwa zifukwa zazikulu za hyperuricemia ndi zakudya zomwe timadya. Zina zili ndi mitsempha yambiri yomwe imatchedwa purine yomwe, ikaphwasuka, imasandulika kukhala uric acid.
Zina zimakhala ndi zinthu zomwe zimapangitsa kuti asiye asidike mu impso.
Ngakhale palibe umboni woti zakudya zothandizira zakudya zingachepetse kapena kuopsa kwa chiwonongeko, muyenera kuyesetsa kupewa kupezetsa chikhalidwe chanu.
Kuti mukwaniritse izi, muyenera:
- Musamamwe mowa mwa mtundu uliwonse, makamaka mowa.
- Pewani zakudya zapamwamba-purine .
- Pewani zakumwa za fructose-zotsekemera zomwe zimawononga uric acid excretion.
- Imwani madzi ambiri kuti muchepetse mchere wa uric acid m'magazi anu.
Mankhwala a Over-the-Counter (OTC)
Mankhwala otchedwa OTC amagwiritsidwa ntchito mobwerezabwereza pofuna kuchepetsa kupweteka kumodzi ndi kutupa. Zina mwazochita:
- Mankhwala otsutsana ndi kutupa (nonsteroidal anti-inflammatory drugs (NSAIDs), monga Aleve (naproxen) ndi Advil (ibuprofen), amagwira ntchito potseka chithandizo cha enzyme ya COX m'njira yotchedwa analgesic (pain relieving) ndi anti-inflammatory.
- Tylenol (acetaminophen) ingagwiritsidwe ntchito pa milandu yowopsa. Ngakhale kuti alibe anti-inflammatory properties ya NSAIDs, ndizovuta kwambiri mankhwala a analgesic.
- Zojambula zamtundu wa capsaicin , zopangidwa kuchokera ku mankhwala omwe amapezeka mu tsabola, zakhala zikusonyezedwa kuti zimapereka chithandizo chochepa cha zizindikiro za gout. Zilipo zowonjezera mavitamini, lotions, ndi zolembera za transdermal ndipo zimapezeka mosavuta pa tsamba.
Malemba
Mankhwala osokoneza bongo amagwiritsidwa ntchito ngati zakudya ndi zamoyo zimapereka mpumulo komanso / kapena pali umboni wowonongeka. Mankhwala omwe amagwiritsidwa ntchito pochizira gout akhoza kusweka kwambiri kukhala mitundu iwiri: anti-inflammatory ndi uric acid-kuchepetsa.
Mankhwala Osokoneza Bongo
Mankhwala odana ndi zotupa omwe amagwiritsidwa ntchito pochizira gout angapangidwe nthawi zonse kapena amagwiritsidwa ntchito pofunika kuthetsa zizindikiro zovuta. Zina mwazochita:
- Colchicine ndi mankhwala odana ndi kutupa omwe amagwiritsidwa ntchito pochizira matenda a gout. Mankhwalawa amagwira ntchito potseka mavitamini opweteka omwe amachititsa kupanga mapuloteni a uric acid. Colchicine ingagwiritsidwe ntchito payekha koma imayikidwa motsatizana ndi mankhwala ochepetsa asidi a uric monga probenecid. Zotsatirapo zimaphatikizapo kutsegula m'mimba, khunyu, ndi ziwalo za m'mimba.
- Corticosteroids , yomwe imatengedwa pamlomo kapena mwa jekeseni, imapereka mpumulo wafupipafupi wa zizindikiro zovuta. Mankhwala amagwiritsira ntchito poyesa chitetezo cha m'thupi mwathunthu, choncho, sichikhoza kugwiritsidwa ntchito ngati njira yopitilira mankhwala. Mankhwala am'malamulo (kawirikawiri ndi mankhwala osokoneza bongo) angaperekedwe kwa masiku asanu. Mankhwala a corticosteroid amagwiritsidwa ntchito nthawi zambiri pamene pali umboni wa matenda a nyamakazi. Kugwiritsa ntchito mowa mopitirira muyeso kungapangitse kulemera, kuvulaza mosavuta, kufooketsa mafupa, mavuto a maso, kuthamanga kwa magazi, komanso kuopsa kwa matenda.
- Qutenza (capsaicin) 8.0 patch patch akhoza kupereka kupweteka zochepa kupweteka panthawi yoopsa. Zotsatira zoyipa zimaphatikizapo zomwe zimachitika pamasitomala, kuphatikizapo kuyaka, kutentha, kufiira, kutupa, ndi kuthamanga pang'ono.
Mankhwala Ochepetsa Mankhwala a Uric
Ngati njira zina zimachepetsa kuchepa kwa uric acid, madokotala nthawi zambiri amadwala mankhwala omwe angachepetse kuchuluka kwa hyperproduction ya uric acid kapena kuwonjezera exretion ya uric acid m'thupi.
Pakalipano pali mankhwala asanu omwe amavomerezedwa ndi US Food and Drug Administration pazinthu izi:
- Probenecid ndi mankhwala omwe amamwa tsiku ndi tsiku kuti athandize impso zanu kuchotsa uric acid. Ngakhale kuti zothandiza kuchepetsa zizindikiro, zimatha kutenga nthawi kuti mankhwalawo asagwire ntchito. Nthawi zina, zida zowonjezereka zingapitirire pa miyezi isanu ndi umodzi kapena yoyamba mpaka thupi likusintha kuchipatala.
Zotsatirapo zimaphatikizapo miyala ya impso , kunyoza, kupweteka, kupwetekedwa m'mimba, ndi kupweteka mutu. Pulogalamu yamakono yotchedwa ColBenemid imapezekanso yomwe ikuphatikiza probenecid ndi colchicine.
- Uloric (febuxostat) ndi m'kamwa xanthine oxidase inhibitor (XOI) yomwe imachepetsa thupi kupanga uric acid. Kutengedwa tsiku ndi tsiku, Uloric ikhoza kuchepetsa kuzunzika koopsa komanso kawirikawiri. Zowonongeka ndizofala pamene poyamba ayamba kumwa mankhwala. Ngakhale zitakhalapo, muyenera kupitiriza kumwa mankhwala monga momwe akufunira.
Zotsatira zoyipa zimaphatikizapo kunyowa, kupweteka pamodzi, ndi kupweteka kwa minofu. Musatenge Uloric ngati mukugwiritsa ntchito azathioprine (yogwiritsira ntchito mankhwala a nyamakazi) kapena mercaptopurine (ogwiritsira ntchito lymphoma, matenda a Crohn, kapena ulcerative colitis). - Zyloprim (allopurinol) ndi mankhwala ena osokoneza bongo a XOI. Mofanana ndi Uloric, zizindikiro zamoto zikhoza kuchitika pakulandila msanga. Pofuna kupewa izi, mankhwalawa amatchulidwa pazitsulo zochepa ndipo pang'onopang'ono anawonjezeka.
Zotsatira zake zimakhala zochepa kwambiri kuposa mankhwala ena ochepetsa asidi a uric acid ndipo angaphatikizepo kupweteka ndi kupwetekedwa m'mimba. Matenda a m'mimba nthawi zambiri amatuluka pamene thupi lanu limasintha kwa mankhwala. - Zurampic ( lesinurad ) ndi mankhwala osokoneza bongo omwe amachititsa zotsatira za XOIs pamene XOI yokha yokwanira. Zingatengedwe pamodzi ndi Uloric kapena Zyloprim koma ziyenera kugwiritsidwa ntchito mosamala ngati zingakulepheretseni mtima wanu. Muyeneranso kukhala osungunuka bwino kuti mupewe miyala ya impso.
Zotsatira zoyipa zimaphatikizapo kupweteka mutu, kutentha thupi, kupweteka kwa minofu, kupweteka pamodzi, ndi acid reflux. Lesinurad imapezekanso ndi allopurinol m'kabokosi koti Duzallo. - Krystexxa (pegloticase) ndi mankhwala atsopano opangidwa ndi mankhwala omwe amaperekedwa kudzera mu kulowetsa mkati mwa mitsempha ndipo amagwiritsidwa ntchito pokhapokha mankhwala ena atalephera. Krystexxa amagwira ntchito potembenuza asidi ya uric kukhala chinthu chotchedwa allantoin chomwe chimachotsedwa mosavuta m'thupi. Zimaperekedwa milungu iwiri iliyonse kuchipatala ndipo kotero zimasungiratu milandu yoopsa kwambiri.
Zotsatira zoyipa zimaphatikizapo zochitika zazing'ono zazing'ono, nseru, kupweteka, kupweteka, kupweteka, kupweteka pachifuwa, ndi kusanza. Nthawi zambiri, zimakhala zoopsa kwambiri.
Mankhwala ena othandizira angagwiritsidwe ntchito pa mankhwala a gout, kuphatikizapo Cozaar (losartan), mankhwala osokoneza bongo, ndi Tricor (fenofibrate), mankhwala osokoneza bongo. Zonsezi zingathandize kuchepetsa mphamvu ya seramu uric acid.
> Zotsatira:
> Anaud, P. ndi Bley, K. "Mutu wa capsaicin wam'mutu wothandizira kupweteka: njira zothandizira ndi njira zatsopano zogwiritsira ntchito kapisaicin 8%." Br J Anaesth. 2011; 107 (4): 490-502. DOI: 10.1093 / bja / aer260.
> Hanani, B; Matheson, E. ndi Wilke, T. "Kuzindikira, Kuchiza, ndi Kuteteza Gout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. ndi Barden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. DOI: 10.1016 / S0140-6736 (09) 60883-7.