Kusiyanasiyana pakati pa PPIs ndi H2 Blockers for Kutentha

by Sharon Gillson; Yofotokozedwa ndi Emmy Ludwig, MD

Kuyerekeza Mitundu Yachiwiri Yambiri ya Mankhwala a GERD

Ngati mukupweteketsa mtima, mwinamwake mukudabwa za kusiyana pakati pa mankhwala apadera ochizira: proton pump inhibitors (PPIs) ndi H2 blockers. Zonsezi zimadula mpweya wa asidi. Iwo ndi osiyana, komabe, momwe amachitira zimenezi.

Ngakhale ma PPI atatsegula mapulotoni a proton mmimba, H2 blockers amagwira ntchito poletsa ma histamine receptors m'maselo opanga asidi m'mimba.

Phunzirani zambiri za kusiyana kwake, momwe angakuthandizireni kupweteka kwa mtima, ndi chifukwa chake dokotala angakulimbikitseni wina ndi mzake.

Nchiyani Chimachititsa Kuzimitsa Mphuno ndi Chofunika Choti Chichichitire?

Kupweteka kwa chifuwa kungayambitsidwe ndi matenda omwe amachititsa kuti matenda a reflux a gastroesophageal (GERD) ayambe . GERD imachitika pamene asidi ochokera m'mimba imabwerera mpaka kumtunda. Kawirikawiri m'mimba mwa asidi ndi zina zili m'mimba (ndi kunja kwa mimba) ndi valve yotchedwa low esophageal sphincter (LES). Koma zifukwa zambiri zingathe kufooketsa valavu kuphatikizapo:

Kudya zakudya zomwe zimayambitsa kupweteka kwa mtima , monga zakudya zowonongeka (mwachitsanzo, tomato ndi zipatso za zipatso), zakudya zokometsera zokometsera, kapena chokoleti
Kumwa mowa kapena caffeine
Kusuta fodya
Kukhala ndi matenda ena, monga shuga ndi mphumu
Kukhala ndi mphamvu yowonjezera pamimba mwako (mwachitsanzo, kunenepa kwambiri, kutenga mimba, kapena zovala zolimba)

Zosintha zamoyo - kusiya kusuta, kudula mowa ndi zakudya zomwe zimayambitsa kupweteka kwa thupi, ndi kutaya thupi - nthawi zambiri ndizo mzere woyamba wa chithandizo cha kupweteka kwa mtima.

Koma nthawi zina mankhwala ndi ofunikira, ndipo ndi pamene PPIs ndi H2 blockers zingathandize.

Proton Pump Inhibitors (PPIs)

Pulogalamu ya proton ndi molekyulu m'maselo ena am'mimba. Ndi "mapampu" acidi m'mimba. Zimatengera ion osasiyamu ya potaziyamu kuchokera mmimba ndikuiika ndi acidic hydrogen ion.

Iyi hydrogen ion ndi yomwe imapangitsa zinthu kukhala zovuta. Mwa kuika mavitamini ambiri a ma hydrogen m'mimba mwako, mpope umapangitsa kuti m'mimba mwako mukhale ovuta kwambiri. Koma poletsa kuchitapo kanthu kwa mpope (kulepheretsa), kutseka kwa asidi m'mimba kumayimitsidwa.

Proton pump inhibitors amagwiritsidwa ntchito pochizira matenda a Edzi, m'mimba komanso zilonda zam'mimba , matenda opatsirana komanso matenda a Zollinger-Ellison . Mankhwalawa angagwiritsidwe ntchito payekha kapena atengedwa pamodzi ndi antacids. Ma PPI onse ali ofanana ndi momwe amagwirira ntchito, ndipo palibe umboni umene umasonyeza kuti wina ndi wogwira mtima kuposa wina. Komabe, amasiyana ndi momwe amadwala ndi chiwindi komanso momwe amachitira ndi mankhwala ena. Kuwonjezera apo, zotsatira za ma PPI zingakhale nthawi yaitali kuposa zina ndipo zingatengedwe mobwerezabwereza.

Ma PPI ndi awa:

Aciphex (rabeprazole)
Nexium (esomeprazole)
Prevacid (lansoprazole)
Prilosec (omeprazole) : imapezekanso pa-over-the-counter monga Prilosec OTC
Protonix (pantoprazole)
Dexilant (Dexlansoprazole)

Mapulogalamu a PPIs amayamba kuchedwa pamene H2 blockers amayamba kugwira ntchito mkati mwa ola limodzi. Ma PPI amagwira ntchito kwa nthawi yaitali: ambiri mpaka maola 24, ndipo zotsatirazo zikhoza kukhala masiku atatu. H2, koma nthawi zambiri amagwira ntchito kwa maola 12 okha.

H2 Odziletsa

Maselo osokonezeka m'mimba mwanu amakulimbikitsani m'njira zosiyanasiyana kuti atulutse asidi.

Imodzi mwa izi zimayambitsa zokhazokha ndi histamine, yomwe imamangiriza mbiri ya histamine 2 pa selo ya parietal. Olemba H2, mofanana ndi dzina lawo, atseke malo awa omwe amalowetsamo ndipo potero athe kuchepetsa kupanga acid.

Ophwanya H2 ndi awa:

Kodi H2 Blockers Zimasiyana Bwanji ndi Proton Pump Inhibitors (PPIs)?

Ngakhale kuti onse awiri a H2 ndi proton pump inhibitors onse amapewa kutsekemera kwa m'mimba, pali njira zingapo zomwe mankhwalawa amasiyana:

Momwe amagwira ntchito: Amagwira ntchito pamagulu osiyanasiyana popanga mimba ya asidi. H2 blockers (histamine blockers) amachititsa chimodzi mwa zinthu zoyambirira zopangira acid. Proton pump inhibitors amalepheretsa njira yomaliza yopsereza asidi mmimba. Mwa kuyankhula kwina, asidi omwe apangidwa (omwe angachepetse chifukwa chophimba H2) amatetezedwa kuti asadzafike mmimba.

Kumene amagwira ntchito: Mankhwalawa onse amagwiritsidwa ntchito m'maselo a parietal, omwe ndi maselo opanga asidi m'mimba mwa m'mimba. H2 blockers amagwira ntchito poletsa ma recamorous histamine m'maselo a parietal kuti achepetse kuchuluka kwa asidi opangidwa (ngakhale pali zovuta zina kuti asidi ena apangidwebe). Proton pump inhibitors amagwira ntchito pomatsetsa mapulotoni a proton m'maselo amenewa ndi kuteteza asidi kuti asalowe m'mimba.
Zimagwira ntchito bwino: Proton pump inhibitors amachititsa kuti asidi azikhala oposa H2. Izi ndizo chifukwa pali zovuta zina, kuphatikizapo histamine 2, zomwe zimapangitsa kuti asidi ndi H2 zowonongeka zizitsutsa mbiri ya histamine 2.
Amagwira ntchito mofulumira: H2 blockers amayamba mofulumira, nthawi zambiri ntchito mkati ola limodzi kumwa mankhwala. Proton pump inhibitors, mosiyana, ali ndi nthawi yofulumira yochitapo kanthu.
Zimatenga nthawi yaitali bwanji: H2 blockers akhoza kugwira ntchito kwa maola 12 mutatha kumwa mankhwala. Proton pump inhibitors amatha kukhala nthawi yayitali. Ma PPI amatha maola 24, pamene ena akhoza kukhala ndi zotsatira zomwe zimatha masiku atatu.
Zotsatirapo: Chifukwa cha njira zosiyanasiyana zochitiramo ntchito, zotsatira za magulu awiri a mankhwala zimasiyana, ngakhale kuti mitundu yonse ya mankhwala nthawi zambiri imalekerera. Zotsatira zomwe zingatheke zimakhalanso zosiyana pakati pa mankhwala enieni m'gulu lililonse. Ndi ma H2 blockers, mutu wafala kwambiri. Proton pump inhibitors ali otetezeka kwambiri koma amagwirizanitsidwa (mu maphunziro ena koma osati onse) ndi chiopsezo chowonjezeka cha kuphulika kwa m'chiuno . Palinso zotsatira zina, ndipo nkofunika kukambirana ndi dokotala musanayambe kumwa mankhwalawa.

Kodi Zina Zomwe Akazi Odziletsa ndi Ma PPI Ayenera Kuchita?

Ndi bwino kudziwa kuti kuwonjezera pa kupweteketsa mtima (komanso makamaka, GERD), mankhwalawa amagwiritsidwa ntchito pochiza matenda a shuga ndi kuchepetsa zizindikiro za matenda a zilonda zam'mimba . Angagwiritsenso ntchito kuchiza matenda ena osokoneza ubongo omwe angapangitse mimba yambiri ya m'mimba.

Kusankha Pakati pa H2 Odziletsa ndi Proton Pump Inhibitors

Mutha kudabwa chifukwa chake dokotala wanu angasankhe mankhwalawa pa wina. Popeza proton pump inhibitors amachititsa kuti asidi ayambe kuponderezedwa, nthawi zambiri amafunikira zizindikiro zambiri.

Nthawi yoyamba kuchitapo kanthu ingathenso kudziwa mankhwala omwe adokotala angakulimbikitseni. Popeza kuti ma H2 akugwira ntchito mofulumira, amagwiritsidwa ntchito ngati munthu ali ndi zizindikiro zake. Chifukwa cha kuchitapo kanthu mwamsanga, mankhwalawa angagwiritsidwe ntchito kwa iwo omwe amangokhalapo kanthawi kochepa.

Popeza proton pump inhibitors amatenga nthawi yaitali kuti ayambe kugwira ntchito koma amakhala ndi zotsatira zowonjezereka, amagwiritsidwa ntchito nthawi zambiri kwa iwo omwe ali ndi zizindikiro zosatha za kupweteka kwa mtima kuti athetse zizindikiro.

Ngati mwapezeka posachedwapa ndi GERD, lankhulani ndi dokotala wanu za dongosolo la mankhwala. Ngati simungapeze chitonthozo ndi kusintha kwa moyo, mayesero a masabata asanu ndi atatu a PPI mankhwala angakonzedwe.

Ngati mukupitiriza kukhala ndi zizindikiro pambuyo poti mankhwala a PPI achotsedwa kapena ngati muli ndi mavuto ochokera kwa GERD wanu (monga matenda oopsa), kukonza (nthawi yayitali) mankhwala a PPI adzakonzedweratu. Nthawi zina H2-blocker, mmalo mwa PPI, akulimbikitsidwa kuti asamalidwe.

Mankhwalawa akutsutsana ndi Kugonjetsa Mankhwala Osokoneza Bongo

Mankhwala ambiri omwe amagwiritsidwa ntchito poyambitsa kupuma amapezeka ngati mankhwala komanso mankhwala owonjezera. Ngakhale mankhwalawa ali ofanana, mankhwala owonjezera amapezeka peresenti yochepa (kawiri theka la mlingo wa mankhwala).

Lankhulani ndi dokotala wanu kapena wamankhwala musanalowe m'malo mwa imodzi mwa izi. Komanso, zindikirani zotsatira zowonongeka za ma antiacids. Amatha kuchepetsa kuyamwa kwa mankhwala ena, kuphatikizapo mankhwala ena opweteka mtima.

Zithandizo Zina Zopweteketsa Mtima

Kuwonjezera pa H2 blockers ndi proton pump inhibitors, anthu ambiri amagwiritsanso ntchito mankhwala osokoneza bongo kuti athetse kupsinjika kwa mtima. Kumbukirani kuti pali kusiyana pakati pa antacids ndikum'fotokozera dokotala za mankhwala omwe angakhale abwino kwa inu. Kuwonjezera pa mankhwala ndi kusintha kwa moyo, anthu ena amafunikira chithandizo chamankhwala, monga opaleshoni ya hernia .

Pambuyo pa Mankhwala Otsitsimula

Ndi mankhwala onse omwe amachititsa kupweteka kwa mtima, timakonda kuiwala za kusintha kwa moyo zomwe zingathe kupweteka mtima . Ngati mukufuna mankhwala kuti muthe kupsinjika, onetsetsani kuti muwone ngati chimodzi mwa izi zingathe kusintha zizindikiro zanu:

Lekani kusuta. Kusuta fodya kumabweretsa kukhumudwa m'njira zingapo.
Yang'anani zakudya zanu. Dziwani bwino zakudya zomwe zimapweteketsa mtima kwambiri, komanso zakudya zomwe zimalekerera anthu omwe akudwala .
Pewani kumwa mowa. Kumwa kungayambitse kupweteka kwa anthu ena.

Mawu Ochokera

Ngati muli ndi mafunso okhudza mankhwala anu oyambitsa kupweteka, chonde lankhulani ndi dokotala wanu. Ndikofunika kuti mutenge mankhwala anu monga momwe mwafunira, kuphatikizapo kutsatira ndondomeko yoyenera komanso nthawi yodyera. Pamodzi ndi mankhwala, yang'anani njira zomwe mungasinthire kusintha kwa moyo wanu zomwe zingakuthandizenso kuchepetsa kupsa mtima.

> Zotsatira:

Katz PO, Gerson LB, Vela MF. Kuzindikira ndi Kusamalira Matenda a Reflux a Gastroesophageal. Am J Gastroenterol 2013; 108: 308-28.

> Scarpignato C, Gatta L, Zullo A, Blandizzi C. Proton Pulogalamu Yopindulitsa ndi yotetezeka Inhibitor Therapy mu Matenda Okhudzana ndi Acid-A Paper Powonjezereka Ubwino ndi Zowopsa Zowonongeka kwa Acid. BMC Medicine . Lofalitsidwa pa Intaneti 2016 Nov 9.

> Shin JM, Kim N. > Pharmacokinetics > ndi Pharmacodynamics ya Proton Pump Inhibitors. Journal of Neurogastroenterology ndi Motility . 2013; 19 (1): 25-35. do: 10.5056 / jnm.2013.19.1.25.

> Zhang Y, Qing L, B B, Liu R, Zuo-Jing L. Proton Pump Madzimadzi Oteteza Vuto ndi H2 Receptor Antagonists Thandizo la Kutsekemera Kwambiri M'mimba Pambuyo pa Endoscopy: A Meta-Analysis. World Journal of Gastroenterology . 2015. 21 (20): 6341-6351.