Kukuthandizani Kuti Muzisamalira Chifuwa cha Matenda a Nyamakazi
Mankhwala ndizofunikira kwambiri pa chithandizo chamankhwala cha nyamakazi ya nyamakazi . Mukangodziwa kuti muli ndi matenda a nyamakazi , dokotala wanu amalangiza ndi kupereka mankhwala.
Pali mankhwala ochepa omwe amagwiritsidwa ntchito popanga nyamakazi ya mafupa omwe amagawidwa kukhala mankhwala osokoneza bongo malinga ndi momwe amagwirira ntchito. Ndikofunika kuti mumvetse zomwe mungasankhe, komanso kumvetsetsa chifukwa chake mankhwala ena adasankhidwa.
Mwa kuyankhula kwina, kodi mankhwalawa akuchita chiyani mu thupi?
Ngati njira yeniyeni ya chithandizo simukuwoneka ngati yogwira ntchito patapita nthawi, ndizochizolowezi kuti dokotala wanu asinthe kusintha kwa regimen yanu. Tiyeni tione mankhwala a nyamakazi. Mutha kulembedwa chimodzi kapena zingapo zotsatirazi.
NSAIDs
NSAIDs (mankhwala osagwiritsidwa ntchito ndi mankhwala osapsa mphamvu) amapewa COX 1 ndi COX 2 (maselo a cyclooxygenase) popanga prostaglandin , mahomoni omwe amachititsa kuti kutupa m'thupi. Pali maSASA angapo omwe mungasankhe. NSAID zambiri zomwe zimatchulidwa ndi Motrin (ibuprofen) , Naprosyn (naproxen) , Mobic (meloxicam) , ndi Voltaren (diclofenac) . Celebrex (celecoxib) ndiyo yokha ya COX-2 yokhayokha yomwe imapezeka ku US Komanso, Advil (ibuprofen) ndi Aleve (naproxen) alipo pa mphamvu yowonjezera.
NSAID zakhudzana ndi chiopsezo chowonjezeka cha matenda a mtima kapena kupwetekedwa mtima, motero adatsimikiziranso kuti mankhwalawa ayenera kutengedwa pa mlingo wotsikirapo kwambiri ndipo nthawi yayitali ingatheke.
Komanso, musayambe kutenga mankhwala oposa NSAID panthawi imodzi. Werengani malemba mosamala ngati NSAID zingakhale zigawo za mankhwala osiyanasiyana pa chifuwa, kuzizira, kupweteka, kugona, ndi kupwetekedwa m'mimba.
Analgesics
Mankhwala osokoneza bongo amagwira ntchito mwa kuchepetsa ululu. Acetaminophen ndi mankhwala otchuka opweteka kwambiri; kwenikweni ndi mankhwala okhawo a analgesic omwe amapezeka pa tsambalo.
Iyenso, ikhoza kugwiritsidwa ntchito pazinthu zosiyanasiyana, choncho nkofunika kuwerenga malemba ndi kuzindikira zotsatira za acetaminophen.
Mankhwala amphamvu kwambiri amapezeka ndi mankhwala okhaokha. Amatchedwa opioids kapena mankhwala osokoneza bongo. Opioids amachititsa dongosolo loyamba la mitsempha kuti lisamadziwitse zowawa. Mankhwala opioid amabwera ndi chiopsezo chodalira, koma ngati amagwiritsidwa ntchito moyenera komanso mosamala zokhudzana ndi zotsatirapo ndi zovuta, mankhwalawa akhoza kupweteka kwambiri kwa anthu omwe ali ndi nyamakazi. Mu 2016, Centers for Disease Control and Prevention (CDC) inamasula malangizo olemba opioids . Mankhwala otchedwa Hydrocodone / acetaminophen (brand Norco) ndi Tramadol (chizindikiro cha Ultram) ndi awiri omwe amawotcha opioid analgesics. Zina zimaphatikizapo oxycodone ndi MSContin.
Corticosteroids
Corticosteroids , yomwe imatchedwanso glucocorticoids kapena steroids, imatsanzira zotsatira za hormone cortisol m'thupi ndipo zimathandiza kuti chitetezo cha mthupi chitengeke. Corticosteroids alipo mitundu yambiri kuphatikizapo mapiritsi, jekeseni wa jekeseni, madontho, ndi mapulitsi a pamwamba.
Corticosteroids ndi mankhwala odana ndi yotupa. Ngakhale kuti mphamvu zawo zingawoneke mozizwitsa, zimakhala ndi zotsatira zoopsa, osati zoopsa zomwe zimawopsa kwambiri.
Kuti achepetse chiopsezo chotere, corticosteroids iyenera kutengedwa pa mlingo wotsikirapo kwambiri ndipo nthawi yayitali ingatheke.
Anthu ena omwe ali ndi matenda a nyamakazi amalembera mlingo wochepa wa corticosteroid monga gawo la mankhwala awo ozoloŵera. Ena amangogwiritsa ntchito corticosteroids kuti athetse chifuwa cha nyamakazi. Anthu omwe atenga corticosteroid kwa nthawi yayitali amatha kupeza zizindikiro zotsalira ngati atasiya mankhwala popanda kugwiritsira ntchito. Prednisone ndi methylprednisolone ndizofala pamlomo wa corticosteroids. Triamcinolone ndi jekeseni wotchuka ndi kirimu.
DMARD
Mankhwala odana ndi nthendayi ( DMARD ) ndi mankhwala osokoneza bongo omwe amachititsa kuchepetsa matenda kupititsa patsogolo komanso kuchepetsa kuwonongeka.
Pali miyambo ya DMARD, zoyamba komanso zoyambirira. Palinso ma DMARD a biologic-omwe amayamba kuwonekera mu 1998. Ndipo posachedwapa, kachigawo kena ka DMARD komwe kamadziwika kuti ndi mankhwala ochepa a molekyulu.
Mwa miyambo ya DMARD, methotrexate ndi imene imaperekedwa. Zimatengedwa kuti ndi mankhwala oyenera a nyamakazi. Zina zamtundu wa DMARD zimaphatikizapo Arava (malo otsika) , Plaquenil (hydroxycholorquine) , ndi Azulfidine (sulfasalazine) . Golide ndi Imuran (azathioprine) zilipo koma sizinayanenedwe kaamba ka nyamakazi. Zachilengedwe za DMARD zimakhudza chitetezo cha mthupi , choncho zimakhala zovuta kulimbana ndi matendawa ndipo mwinamwake chiopsezo chowonjezereka chokhala ndi khansa zina. Muyenera kusamala zotsatira zowonjezera ndi machenjezo okhudzana ndi DMARD. Kawirikawiri, kuyesedwa kwa magazi nthawi ndi nthawi kumalamulidwa kuti ayang'ane ntchito ya chiwindi ndi malipoti a magazi.
DMARD zamoyo
Mankhwala a zamoyo , omwe amatchedwanso Biologic DMARDs kapena Biologic Response Modifiers, ndi mankhwala omwe adapangidwa kuti athetse kapena kuchepetsa kutupa komwe kumawononga ziwalo. Zamoyo zamoyo zimayendetsa mamolekyu pa maselo a chitetezo cha mthupi ndi zinthu zomwe zimagwiritsidwa ntchito palimodzi zomwe zimayambitsa kutupa ndi kuwonongeka.
Pali mitundu yambiri ya biologics, aliyense ali ndi cholinga chake. Zolinga zikuphatikizapo chotupa cha necrosis factor (TNF) , interleukins (IL-1, IL-6, IL-12, ndi IL-23), maselo B, ndi maselo T. Mankhwala a biologic ndi okwera mtengo, koma thandizo lachuma likupezeka kwa anthu omwe ali oyenerera. Mankhwalawa amaperekedwa ndi kulowetsedwa kapena jekeseni. Chifukwa cha zotsatira za biologics pa chitetezo cha mthupi, zotsatira zina zosavuta ndi zoopsa zimatheka.
Majekesti Ochepa a Ma Molekyulu Amakonzedwa
Gulu la mankhwala osokoneza bongo kwambiri la nyamakazi ya "rheumatoid rhythmic" "limayang'aniridwa ndi makompyuta aang'ono a DMARD" omwe amachititsa kusokoneza magetsi. Mwa kusokoneza zizindikiro zenizeni za maselo osakanikirana, n'zotheka kusankha maselo enaake, kuphatikizapo mapuloteni apamwamba, kusonyeza mapuloteni, ndi kusindikiza mapuloteni a nyukiliya. Pochita zimenezo, khalidwe la maselo omwe amaloledwa akhoza kuthandizidwa kapena kuthandizidwa.
Cholinga chachikulu cha ochita kafukufuku, pofuna kuchiza matenda omwe amachititsa kuti munthu azidwala matendawa, amphatikizapo kinasi, yogwirizana ndi Janus, phosphodiesterase-4, Bruton's tyrosine kinase, ndi phosphatidylinositol-3 kinase. Mayesero aumunthu amafunika kuti athe kudziwa zomwe zingatheke. JAK (Janus kinase) inhibitors ndi opambana kwambiri ndipo imodzi ndi FDA -vomerezedwa, Xeljanz (tofacitinib).
Mawu Ochokera
Anthu ena omwe ali ndi nyamakazi amawopsyeza mankhwala, makamaka chifukwa cha zotsatira zake, zina zomwe zingakhale zovuta. Ndikofunika kwambiri kufufuza ubwino ndi ngozi za mankhwala ndi dokotala wanu.
Ganizirani zomwe mukuchita panopa ndikusankha zolinga zamankhwala ndi dokotala wanu. Mwinamwake, inu mudzapatsidwa zina mwazomwe mungapeze zomwe zafotokozedwa pamwambapa. Sungani diary ya chizindikiro pambuyo poyambitsa mankhwala kuti muwone ngati akukuyenderani bwino. Dziwani zokhudzana ndi zotsatira zake ndipo perekani zodabwitsa kwa dokotala wanu.
> Zotsatira:
> Nyamakazi Masiku Ano. Njira Yothandizira Mankhwala Osokoneza Bongo 2016. Yofalitsidwa ndi Arthritis Foundation.
> Kelly, V. ndi Genovese, M. Novel ang'onoang'ono akuchipatala m'thupi la nyamakazi. Rheumatology (Oxford) (2013) 52 (7): 1155-1162.
> Kelley's Textbook of Rheumatology. Kusindikiza kwachisanu ndi chinayi. Elsevier.