HD imakhala ndi zizindikiro zambiri zomwe zingayambe, zina zomwe zingatheke bwino ndi mankhwala komanso njira zopanda mankhwala. Musanayambe kuchipatala, zizindikilo ngati mbali ya matendawa zingathandizenso kulimbana nazo ndi kutenga mbali yambiri payekha kapena kusamalidwa kwa membala.
Mitundu ya Zizindikiro
Monga chikhalidwe cha ubongo, Huntington imayambitsa zizindikiro zomwe zimagwera mu gawo limodzi mwa magawo atatu: kusintha kwa thupi / kusintha, kusintha kwa chidziwitso, ndi kusintha kwa maganizo / khalidwe.
HD ndi chimodzi mwa zifukwa zambiri zomwe zimayambitsa matenda a 'dementia' .
Zizindikiro nthawi zambiri zimakhala pakati pa zaka 30 ndi 50. Komabe, anthu ena omwe ali aang'ono kusiyana ndi zaka 20 amapanga mtundu wa matenda a Huntington omwe amatchedwa matenda a achinyamata a Huntington.
Kusintha kwa thupi
Chizindikiro chimodzi cha HD ndi chorea. Chorea amatanthauza kutaya mphamvu zowononga kayendetsedwe ka thupi. Zimapangitsa kusuntha komwe kuli kosadziwika, kosavuta, ndipo mwadzidzidzi. Kusuntha uku kawirikawiri kumachitika m'thupi lapamwamba ndipo kumakhala mikono, pamwamba, thunthu, mutu, khosi, ndi nkhope. Zitha kuchitika m'milingo. Chorea alipo pafupifupi 90 peresenti ya anthu omwe ali ndi HD ndipo ndi chimodzi mwa zizindikiro zomwe nthawi zambiri zimakhudzidwa ndi mankhwala.
Zizindikiro zina za HD zimaphatikizapo kuchepa ndi kuyankhula, kusowa mgwirizano, kuwonongeka kwa kumeza chakudya ndi zakumwa ndipo, motero, kutayika kwakukulu. Chifukwa cha zizindikirozi, chiopsezo chogwa chikukula kwambiri kwa anthu omwe ali ndi HD, koma kugwira ntchito ndi akatswiri kungathandize kuchepetsa chiopsezo.
Kusintha kwachidziwitso
HD ndi chifukwa cha kusintha kwa ubongo, kotero n'zomveka kuti luso la kulingalira limakhudzidwa. Ngakhale kukumbukira kungakhudzidwe, mbali zina za kuzindikira zimakhudzanso. Izi zikuphatikizapo osowa akuluakulu ogwira ntchito (monga kukonzekera ndi kupanga zisankho), kusalongosoka bwino, kusazindikira, kusaweruzika komanso kusowa kuzindikira zomwe mumachita.
Kulephera kusokoneza kumatha kukhalanso. Mwachitsanzo, ngati muli ndi HD, mukhoza kuchita chinthu chomwe simungamve kuti n'choyenera chifukwa chakuti mukulephera kulamulira.
Kusintha kwa Maganizo ndi Khalidwe
Zizindikiro za HD zimaphatikizapo kusintha kwambiri ndi khalidwe. Mutha kumverera kupsa mtima kwakukulu ndi kukwiya, pamodzi ndi kusasinthika kosasinthika kumasinthasintha. Mawu amtunduwu amatha kukhalapo. Ndipotu, kafukufuku wina amatha kunena kuti 22 peresenti mpaka 66 peresenti ya anthu omwe ali ndi HD adzawonetsa nkhanza, nthawi zambiri kumayambiriro kwa matendawa.
Mofanana ndi mitundu ina ya chiwopsezo cha maganizo , kusowa chidwi kumakhala kofala mu HD. Kusokonezeka maganizo (komwe kumafanana ndi kusasamala koma kawirikawiri kumaphatikizapo kumvetsa chisoni ndi kusowa chiyembekezo) kungakhale kofunika kwambiri ndipo ndikulingalira mwamphamvu kuganiza kapena kudziganizira kudzipha. Kafukufuku amasonyeza kuti ali ndi chiopsezo chachikulu chodzipha kudzikweza kwa omwe amakhala ndi HD, ndi maphunziro ena omwe akusonyeza kukhalapo kwa kudzipha pa 19 peresenti ya ophunzira.
Kawirikawiri nkhawa zimaphatikizapo kuvutika maganizo. Kafukufuku wasonyeza kuti palipakati pa 34 mpaka 61 peresenti ya anthu omwe ali ndi nkhawa ya HD.
Kulimbikira , kumene iwe umakhala "wokhazikika" pa mawu, kuganiza kapena kuchita, si zachilendo.
Izi zingagwirizane ndi zovuta ndi zopondereza ndipo zimapangitsa kuti zikhale zovuta kuti mupite kuntchito yatsopano. Zingayambitsenso makhalidwe oipa omwe amachititsa ena kukhala ovuta kudziwa momwe angagwiritsire ntchito nthawi ndi munthu yemwe ali ndi HD.
Chithandizo Chachidule
Ngakhale kuti palibe mankhwala omwe alipo pa HD panthawiyi, pali mankhwala ochepa komanso njira zovomerezeka zomwe zingathandize kuthetsa zizindikiro zina kwa nthawi. Kumbukirani kuti musagwiritse ntchito mankhwala ovomerezeka kapena othandizira popanda kufufuza ndi dokotala wanu, monga ena angakhale ndi zotsatira zolakwika kapena mankhwala osokoneza bongo ndi mankhwala ena.
Popeza palibe chithandizo, cholinga cha chithandizo mu HD ndichokulitsa umoyo wa moyo ndikupitiriza kugwira ntchito kwa nthawi yaitali.
Mankhwala
Xenazine (tetrabenazine)
Xenazine adavomerezedwa mu 2008 ndi US Food and Drug Administration (FDA) kuti adziwe chorea mu HD. Zasonyezedwa kuti zithandize kuchepetsa kayendetsedwe kadzidzidzi ndipo kaŵirikaŵiri zimawoneka ngati njira yodziwika bwino komanso yothandiza yotengera HD.
Xenazine amachititsa chenjezo lokhudza kugwiritsidwa ntchito kwa anthu omwe ali ndi vutoli chifukwa zikuwoneka kuti akuwonjezera kuvutika maganizo ndi kudzipha. Zotsatirapo zingaphatikizeponso kugona ndi kugona.
Austedo ( deutetrabenazine )
Austedo inavomerezedwa ndi FDA mu 2017. Iyenso adalamulidwa kuti azitsatira kayendetsedwe kake (chorea) mu matenda a Huntington.
Austedo ndi mankhwala ofanana ndi Xenazine koma mphamvu yake imakhala yaitali. Chifukwa chake, Austedo kawirikawiri imalamulidwa kuti iwatengedwe kamodzi kapena kawiri patsiku, pamene Xenazine nthawi zambiri amalembedwa katatu tsiku lililonse.
Austedo wakhala akuwonetsa bwino pofuna kuchepetsa zizindikiro za chorea, koma monga Xenazine, mankhwalawa akubwera ndi chenjezo lamphamvu lomwe siliyenera kugwiritsidwa ntchito kwa anthu omwe ali ndi HD omwe akukumana ndi kuvutika maganizo kapena kudzipha, chifukwa zingathe kuwonjezera malingaliro awo.
Mankhwala a Antipsychotic
Mankhwala oletsa antipsychotic, omwe amatchulidwa kuti ndi opaleshoni, nthawi zina amatumizidwa kuti azichita chorea. Izi ndizogwiritsira ntchito mankhwala osokoneza bongo, kutanthauza kuti a FDA sanavomereze mankhwala awa makamaka chifukwa chaichi; Komabe, ena mwa iwo asonyeza ubwino wina m'dera lino.
Zotsatira za kafukufuku zimasiyana, koma antipychotic antipychotic zomwe zimagwiritsidwa ntchito kuti zithetse HD zikuphatikizapo Zyprexa (olanzapine), Risperdal (risperidone), ndi Seroquel (quetiapine). Mankhwala akale monga Haldol (haloperidol) ndi Clozaril (clozapine) amalembedwa koma amakhala ndi zotsatira zoopsa za kutentha ndi dyskinesia, zomwe zimayambitsa kayendetsedwe kenakake kopanda chidwi ndipo motero zingakhale zopanda phindu.
Kuwonjezera apo, mankhwala ena opatsirana kwambiri monga Abilify (aripiprazole) asonyeza njira yothandiza kuchepetsa zizindikiro za kuvutika maganizo mu HD, komanso kukulitsa kuzindikira.
Antipsychotics amagwiritsidwanso ntchito nthawi zina ndi cholinga chochepetsera makhalidwe oipa (monga chiwawa) chomwe chingathe kukhala mu HD; Komabe, pali zotsatira zambiri zomwe zingagwiritsidwe ntchito ndi antipsychotics, choncho chenjezo ndiloyenera.
Symmetrel
Kafukufuku wokhudzana ndi mphamvu ya Symmetrel (amantadine) yasonyeza zotsatira zotsutsana. Symmetrel ndi mankhwala oletsa tizilombo toyambitsa matenda omwe amagwiritsidwa ntchito pofuna kuthana ndi zoopsa zomwe nthawi zina zimachitika m'thupi la Parkinson , choncho cholinga chake mu HD ndi chizindikiro cha chorea. Zikuwoneka zothandiza kwa anthu ena omwe ali ndi HD.
SSRIs
Kusankha mankhwala osokoneza bongo otchedwa serotonin reuptake inhibitor (SSRI) amatchulidwa nthawi zina kuti athetse vuto la kuvutika maganizo komanso zovuta ndi zovuta zomwe nthawi zina zimakhalapo ndi anthu omwe ali ndi HD. Mofanana ndi mankhwala ena, mphamvu zimasiyanasiyana.
Makhalidwe Otetezeka
Zomwe zimakhazikika monga Depakote (divalproex) zingagwiritsidwe ntchito potengera kusiyana kwakukulu kwa maganizo omwe angayende limodzi ndi HD, kuphatikizapo chiwawa, chilakolako, ndi zizindikiro zowonongeka.
Mankhwala Ena
Poyankha zizindikiro zosiyanasiyana zomwe wodwalayo amawafotokozera dokotala, mankhwala ena amatha kulamulidwa kuti athetse vutoli. Mwachitsanzo, ngati kusowa tulo ndi nkhawa ndizofunikira kwambiri mu HD, dokotala nthawi zambiri amapereka mankhwala oti awathandize. Choncho, ndi kofunika kuti mutsegule ndi gulu lanu lachipatala ndikuwauzeni za chirichonse chomwe chikukuvutitsani. Angakhale ndi njira yomwe idzakuthandizani kusintha.
Njira zopanda mankhwala
Popeza kuti mankhwalawa akungoyesa kuthetsa zizindikiro zina za HD, njira zina zosagwiritsira ntchito mankhwala ndizovomerezeka.
Kulankhula ndi Chilankhulo cha Chilankhulo
Wotanthauzira mawu ndi chinenero angagwiritse ntchito ndi inu kuthandizira poyankhula zosowa zanu ndi zokonda zanu. Zochita zina zingakuthandizeni kulimbitsa lilime lanu ndi minofu yanu kuti mukhalebe ogwira ntchito nthawi yaitali.
Othandizira amalankhu angathenso kulingalira luso lanu lakumeza ndikudziwitsani kuti zida kapena zotani zomwe zingakuthandizeni kwambiri. Izi zikhoza kukhala zofunikira chifukwa, pamene matendawa akupita, zingakhale zovuta kumeza chakudya kapena madzi popanda kugwedeza.
Thandizo la Thupi ndi Ntchito
Thandizo la thupi ndi chithandizo cha ntchito zingakuthandizeni m'njira zingapo. M'madera oyambirira a HD, mankhwala opatsirana angathandize kusintha ndi kusunga mphamvu ndi ntchito. Pamene HD ikupita, zipangizo zikhoza kulamulidwa ndikugwirizana ndi zosowa zanu, ndipo pulogalamu ya kunyumba ingapangidwe kuti yowonjezera thanzi labwino.
Katswiri wogwira ntchito angagwire ntchito nanu pozindikira njira yabwino yopangira ntchito za tsiku ndi tsiku , monga kuyeretsa ndi kuvala. Ogwira ntchito zachipatala angathenso kuzindikira zochitika zamaganizo , ndi cholinga chokhala ndi chidziwitso chanu.
Achipatala angagwirenso ntchito ndi osamalira anu pamene matendawa akupita kuti awathandize kudziwa momwe angasamalire bwino.
Kuchita Zachilengedwe
Zochita zolimbitsa thupi zakhala zikugwirizana kwambiri ndi luso lokhazikika-kapena ngakhale luso lomvetsa bwino mu matenda ambiri omwe amachititsa kuti munthu adwale matenda a maganizo, ndipo izi zimakhala zowonjezereka mu HD. Kafukufuku wasonyeza kuti masewera olimbitsa thupi ali otsogolera zogwiritsira ntchito zowonongeka komanso zochitika zogwirira ntchito tsiku ndi tsiku.
Psychotherapy / Counseling Support
Kuyankhula ndi wogwira ntchito zachipatala kapena katswiri wa zamaganizo angakhale ofunika kwambiri mukasintha kusintha komwe HD imabweretsa ndikupeza njira zanu zokuthandizira. Kulankhulana kungathandizenso abambo kapena abwenzi, komanso ana ndi mabanja.
HD imabweretsa kusintha kwakukulu pa msinkhu wanu wogwira ntchito, ndipo ikhoza kukweza nkhawa m'banja mwawo omwe ali pangozi ya kukhala ndi HD kuyambira pamene imabadwa kwa ana. Wothandizira angakuthandizeni inu ndi banja lanu kugwirizanitsa kusintha komwe kumachitika, chiopsezo cha chibadwa cha HD, ndi kukugwirizanitsani ndi chuma mumudzi wanu komanso kunyumba kwanu.
Njira Zochiritsira
Njira zinanso zimathandizanso anthu omwe ali ndi HD. Mwachitsanzo, nyimbo , zojambulajambula, ndi mankhwala osewera zimagwiritsidwa ntchito. Ngakhale kuti sangasinthe zizindikiro za HD, akhoza kuthana ndi moyo wabwino ndikukhala ndi moyo wabwino.
Mapulogalamu a Dietitian
Kudya chakudya chopatsa thanzi n'kofunika kwa tonsefe, ndipo makamaka pamene mukulimbana ndi HD. Kuonetsetsa kuti thupi lanu likupeza zakudya zabwino zomwe zingakonde kungakuthandizeni kukhalabe ndi mphamvu. Izi zikhoza kukhala zovuta, makamaka pamene HD ikupita, kotero mukhoza kupindula ndi thandizo la zakudya zolembedwera.
Mawu Ochokera
Chofunika kwambiri, anthu omwe ali ndi HD ndi mabanja awo ali ndi chiopsezo chokhala paokha. Dziwani kuti pali zothandizira komanso zothandizira zomwe zilipo kuti zikulimbikitseni ndikuthandizani kudziwa zotsatirazi. Ngati simukudziwa chomwe mungachite kapena mukusowa chithandizo, Huntington's Disease Society of America ili ndi machaputala komanso magulu othandizira pa intaneti omwe angakulimbikitseni, yankhani mafunso anu kapena kuyenda ndi inu kapena kungomvetsera pamene mukukhala ndi HD.
> Zotsatira:
> Arora, G. (2015). Kugonjetsa Magulu a Matenda a Huntington. http://hdsa.org/wp-content/uploads/2015/07/Managing-Aggression-in-HD_Garima-Arora_ver005.pdf
> Coppen, E. ndi Roos, R. (2016). Njira zamakono zamakono zothandizira maulendo kuti achepetse Chorea mu Matenda a Huntington. Mankhwala osokoneza bongo , 77 (1), pp.29-46. 10.1007 / s40265-016-0670-4
> Dale, M. ndi van Duijn, E. (2015). Nkhawa mu Matenda a Huntington. Magazini ya Journal of Neuropsychiatry ndi Clinical Neurosciences , 27 (4), pp.262-271.
> Wallace M, Downing N, Lourens S, et al. Kodi Pali Mgwirizano wa Ntchito Yogonana ndi Buku la Ubongo, Makhalidwe, ndi Ntchito Tsiku ndi Tsiku? Mgwirizano Wopangika M'magulu a Matenda Oyamba a Huntington ndi Oyambirira. Mipikisano ya PLoS . 2016; 8.
> Wetzel HH, Gehl CR, Dellefave L, et al. Cholinga chofuna kudzipha mu Huntington matenda: Udindo wa comorbidity. Kafukufuku wamaganizo . 2011; 188 (3): 372-376. lembani: 10.1016 / j.psychres.2011.05.006.