Chothandizira Chotsimikiziranso Kuwonjezera Chithandizo cha Chithokomiro
Chinthu chimodzi chodalirika chopezeka mu phunziro la matenda a chithokomiro ndiko kumvetsetsa mgwirizano pakati pa mtundu wotchuka wotchedwa diabetes wa mankhwala a metformin (dzina la mtundu wa glucophage) ndi chithokomiro.
Metformin imagwiritsidwa ntchito pochiza mtundu wa shuga 2 ndi insulini kukana. Pali chiyanjano chodziwika bwino pakati pa insulini yotsutsa -kuposa yeniyeni ya insulini, yomwe ili ndi mapiritsi apamwamba a m'magazi omwe amasonyeza kuti insulini sichithetsa kuchepetsa shuga ya magazi-osati khungu lamatenda akuluakulu (goiter), koma kuchulukitsa kwa mitsempha ya chithokomiro ndi khansa ya chithokomiro.
Chochititsa chidwi, kufufuza kwatsopano kumene kunafalitsidwa mu Journal of Endocrinology kwapeza kuti odwala omwe amachiritsidwa ndi metformin ali ndi kachilombo kakang'ono ka chithokomiro ndi kuchepetsa mlingo wa TSH, komanso amachepetsanso zoopsa za goiter, khansa ya chithokomiro, ndi khansa ya chithokomiro.
About Metformin
Metformin, yomwe imagulitsidwa pansi pa dzina la glucophage, imatengedwa kuti ndi mankhwala oyamba omwe amagwiritsidwa ntchito pochiza mtundu wa shuga , makamaka odwala omwe ali olemera kwambiri . Metformin ndi chiwindi chachikulu , kutanthauza kuti imachepetsa chiwindi cha chiwindi, ndipo imapangitsa kuti thupi lanu likhale lodziwika bwino ndi insulini. United States inayamba kugwiritsa ntchito metformin mu 1995, ndipo metformin tsopano ndiyo mankhwala osokonezeka kwambiri omwe amagwiritsidwa ntchito kwambiri kwa mtundu wa shuga 2 padziko lonse lapansi. Ku United States, mtengo wa mankhwala a metformin umachokera pa $ 5 mpaka $ 25 pamwezi.
Metformin ndi Thyroid
Phunziro lalikulu lomwe linalembedwa mu Journal of Endocrinology linayang'ana mgwirizano pakati pa metformin ndi ntchito ya chithokomiro ndi kufotokoza mwachidule zotsatira zofunikira za metformin zomwe zimakhudza chithandizo cha chithokomiro mtsogolomu.
Mwachindunji, phunzirolo linalongosola pazowunikira zingapo zofunika:
- Metformin ndi khansa ya chithokomiro: Zofukufuku zambirimbiri zikusonyeza kuti metformin imachepetsa kuchuluka kwa khansa ya chithokomiro, ndipo ili ndi zomwe zimadziwika kuti ntchito yotsutsa. Metformin inachepetsa kwambiri mphamvu ya insulini kuti ikhale ndi mphamvu zosiyanasiyana za maselo a chithokomiro, komanso maselo a khansa ya chithokomiro, kuphatikizapo maselo a khansa ya chithokomiro . Metformin imalepheretsanso kukula ndipo imaletsa metastase mu kansa ya chithokomiro . Metformin ikuwoneka kuti imasokoneza njira zazikulu zozindikiritsira zomwe zimalimbikitsa kukula kumeneko.
- Metformin ndi Mankhwala a Chithokomiro: Metformin imakhalanso ndi zovuta zotsutsana ndi tizilombo toyambitsa matenda, kuchepetsa kukula kwawo kapena kuchepetsa kukula kwake. Phunziroli linalongosola za kafukufuku amene anapeza kuti odwala omwe ali ndi kachilombo koyambitsa matenda a chithokomiro otetezeka ndi insulini amatsutsa, mankhwala omwe ali ndi metformin amachititsa kuchepetsa kukula kwa mitsempha, komanso kuchepa kwa magulu a TSH. Kufufuza kwatsopano kwa amayi omwe ali ndi insulin kukana ndi mitsempha ya chithokomiro anapeza kuti kudula kwakukulu kwambiri mu kukula kwa nodule kwa odwala omwe amachitira ndi metformin ndi levothyroxine, poyerekeza ndi mankhwala omwe amatengedwa okha.
- Matenda a Metformin ndi TSH Odwala Matenda a Chithokomiro: Mankhwala a Metformin anali ogwirizana ndi kuchepa kwa TSH, kutanthauza kuti akhoza kuthandizira pazithandizo zamakono za odwala khansa ya chithokomiro yomwe cholinga chake ndi kupondereza tizilombo ta TSH kuti tipewe kukana khansara. Metformin ikhoza kukhala yothandiza kwambiri, chifukwa ikuwoneka kuti imaletsa mazinga a TSH, popanda kuchititsa hyperthyroidism.
- Matenda a Metformin ndi Chithokomiro mu mtundu wa 2 Odwala matenda a shuga: Pali kuchuluka kwa chiwerengero cha matenda a shuga a mtundu wa 2 odwala matenda a shuga. Metformin imagwirizanitsidwa ndi kuchepa kwa chiwopsezo chotchedwa hormone (TSH) odwala matenda a shuga. Odwala matenda a shuga a mtundu wa 2 omwe ali ndi khansa ya chithokomiro, mankhwala ndi metformin amathandizidwa ndi chiwopsezo chokwanira komanso kupulumuka kwa anthu odwala matenda a shuga omwe ali ndi kansa ya chithokomiro, komanso zotsatira zabwino kwambiri za odwala matenda a shuga omwe ali ndi khansa yosiyana kwambiri ndi maselo a mitsempha. Akatswiri ofufuza amanena kuti metformin imatulutsa zotsatira za mahomoni a chithokomiro pachitsipa chopuma.
Mfundo Zowunika
Kafukufuku wasonyeza kuti kuyamwa kwa levothyroxine sikusintha mwa kutenga metformin, choncho ndibwino kutenga mankhwala awiriwa panthawi imodzi.
Komabe, vuto ndilo chifukwa metformin ikhoza kuchepetsa TSH popanda kuthana ndi ma T4 kapena T3, zomwe sizikuwonetsa chithokomiro chenicheni cha mtundu wa anthu odwala matenda a shuga ndi hypothyroidism omwe amatenga onse a metformin ndi levothyroxine. Zingathenso kuthetsa kuponderezedwa kwa mtundu wa anthu odwala matenda a shuga omwe ali ndi matenda a khansa ya chithokomiro komanso omwe safuna kuti maselo a TSH asokonezeke, koma apamwamba kwambiri amazungulira mavitamini a T4 ndi T3 kuti asatenge khansa.
Malinga ndi ochita kafukufukuwo:
Mlingo wa TSH wovutika maganizo umapereka chitsimikizo chonyenga kapena ukhoza kuyambitsa mankhwala, kapena otchedwa endocrinologists akhoza kuchepetsa mlingo wa [levothyroxine] ndi mlingo wa TSH wochepa kwambiri. Achipatala ayenera kuganizira zotsatira za metformin pamene amamasulira chithokomiro kuti asatenge mankhwala oyenera kapena kusintha kwa mlingo wa [levothyroxine].
Kuchepetsa mlingo kungayambitse matenda a hypothyroidism kubwerera chifukwa, ngakhale kuti ndi otsika TSH, sipangakhale kokwanira kutulutsa mahomoni a chithokomiro kuti athetse zizindikiro za hypothyroid.
Kuonjezerapo, atatha opaleshoni kuchotsa mkaka kuti athetse khansa ya chithokomiro, odwala ambiri amaikidwa mankhwala opatsirana, kuteteza chiwerengero cha TSH kwambiri ndi mahomoni a chithokomiro kuti athetse khansa yowonongeka. Kwa mtundu wa anthu odwala matenda a shuga omwe ali ndi khansara ya chithokomiro, ndipo ali ndi kachilombo koyambitsa matenda a chithokomiro kuti achotse chingwe, TSH yotsika kwambiri chifukwa cha metformin mankhwala ingasonyeze kufunika kwa kuchepetsa mlingo wa levothyroxine. Koma kuchepa kwa mlingo, komabe, sikungathe kuperewera pamasom'manja.
Mawu ochokera
Zotsatira zatsopano zosangalatsa zikusonyeza kuti pangakhale ntchito zingapo za metformin m'magulu angapo:
- Dokotala wa shuga 2 yemwe ali ndi matenda a chithokomiro
- Dokotala wa shuga 2 yemwe alibe matenda a chithokomiro
- Anthu omwe ali ndi hypothyroidism omwe ali ndi insulin kukana, matenda amadzimadzi, ndi / kapena kunenepa kwambiri
- Matenda a kansa ya chithokomiro pa mankhwala a TSH-suppressive
Pa nthawiyi, akatswiri amalimbikitsa maphunziro ambiri ochipatala kuti awonetse bwino kugwiritsa ntchito metformin monga chithandizo cha matenda a chithokomiro komanso kukhazikitsa njira zothandizira mankhwala.
Ngati muli hypothyroid, ndipo muli ndi insulin kukana, koma simunatenge metformin, zingakhale zabwino kuti mukambirane ndi dokotala wanu ponena za kuwonjezera pa pulogalamu yanu ya mankhwala. Metformin imaonedwa kuti ndi mankhwala osokoneza bongo omwe ali ndi zotsatira zochepa, ndipo imaperekedwa kwa matenda opatsirana / matenda a shuga / insulin kukana, ndipo amaletsa kusintha kwa mtundu wa 2 shuga. Zotsatira zatsopanozi zikusonyeza kuti zingakhalenso ndi zotetezera pa chithokomiro chanu.
> Zotsatira:
> Distiller LA, et al. "Mtundu wa shuga 2 ndi matenda a hypothyroidism: mankhwala omwe amatha kukhala ndi metformin." Diabet Med 31 172-175. 2012.
> Xianghui M et al. "Ndemanga: Metformin ndi matenda a chithokomiro." Journal of Endocrinology. Kufalitsa pa intaneti, pa 14 February 2017. Chidule / Full PDF