Mankhwala Osteoarthritis
Anthu oposa 27 miliyoni ku US ali ndi osteoarthritis . Makamaka, molingana ndi Centers for Disease Control and Prevention (CDC), osteoarthritis imakhudza 13.9 peresenti ya anthu achikulire omwe ali ndi zaka 25 kapena kupitirira ndi 33.6 peresenti ya akulu 65 kapena kuposa. Ndi mtundu wambiri wa nyamakazi. Maondo , manja , mapazi , chiuno , ndi msana ndizo ziwalo zomwe zimakhudzidwa kwambiri ndi osteoarthritis.
Anthu omwe ali ndi matenda odwala matenda a mitsempha amafunikira mankhwala othandiza kuti athetse ululu umodzi, kuuma, kutupa, ndi zizindikiro zina.
Zolinga zina zothandizira zimaphatikizapo kuteteza kapena kukonza ntchito yogwirizana, kuchepetsa ubwana, ndi kukulitsa umoyo wa moyo.
Anthu omwe ali ndi matendawa nthawi zambiri amasokonezeka ndi njira zambiri zothandizira-komanso moona mtima, angafune kudumpha zomwe sizigwira ntchito ndi kuganizira zomwe zimachitika. Palibe njira imodzi kwa aliyense, koma ofufuza apanga malangizo othandizira kuchiza matenda a osteoarthritis.
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Kodi Kusiyanitsa Pakati pa Aphungu ndi Aleve Ndi Chiyani?
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Kugwiritsira ntchito Viscosupplement Hyalgan Kuchitira Knee Osteoarthritis
Pali mankhwala osagwiritsa ntchito mankhwala omwe samakhala opanga mankhwala osokoneza bongo, mankhwala osokoneza bongo, mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala, mapiritsi amtundu, mapangidwe a moyo, komanso opaleshoni.
Mu 2012, American College of Rheumatology (ACR), inafalitsa mankhwala osokoneza bongo komanso mankhwala osapereka mankhwala, chingwe, ndi mawondo. Gulu la akatswiri a zachipatala linapereka ndondomeko yabwino, ndondomeko yovomerezeka, kapena ndondomeko yopanda chithandizo chamankhwala. Kuti ziwoneke ngati ndondomeko yamphamvu, umboni wapamwamba unkafunika, komanso umboni umene umapindulitsa kwambiri potsata zoopsa zomwe zikugwirizana ndi chithandizo.
Malingaliro ovomerezeka anali ogwirizana ndi kusowa kwapamwamba khalidwe lapamwamba umboni kapena umboni umene sunali wosiyana poyerekeza phindu potsutsana ndi zoopsa. Ngati palibe ndondomeko yoperekedwa, pali deta yopanda malire kapena deta yosawerengeka yochokera kuchipatala.
Dzanja (Pharmacologic Treatment Options)
Palibe ndondomeko zamphamvu zomwe akatswiri omwe amagwirizana ndi ACR amapeza m'gululi. Akatswiriwa adalimbikitsa kugwiritsa ntchito njira imodzi kapena zingapo zotsatirazi:
- katswiri wamaseweraicin
- NSAIDs zamatsenga , kuphatikizapo trolamine salicylate
- NSAID zamlomo, kuphatikizapo COX-2 inhibitors
- Ultram (tramadol)
Katswiri wodziwa bwino ntchitoyi analimbikitsa kuti zotsatirazi zisagwiritsidwe ntchito:
- mankhwala ochiritsira
- mankhwala opangidwa ndi opioid analgesic
Komanso, analimbikitsa kuti anthu omwe ali ndi matenda a osteoarthritis omwe ali ndi zaka 75 kapena kupitirira ayenera kugwiritsa ntchito NSAID zakumutu m'malo mwa ma NSAID.
Dzanja (Osati Pharmacologic Treatment Options)
Panalibe umboni wochuluka wokwanira kupereka malangizo othandizira pa gulu la mankhwalawa, koma maumboni angapo ovomerezeka anapangidwa.
ACR chikhalidwe chimalimbikitsa kuti akatswiri azaumoyo (wothandizira payekha, wodwalayo, kapena wothandizira) ayenera:
- yang'anani luso la wodwalayo kuchita ntchito za tsiku ndi tsiku
- perekani malangizo mu njira zothandizira pamodzi
- perekani zipangizo zothandizira kuti zigwiritsidwe ntchito pazochita za tsiku ndi tsiku
- perekani malangizo othandizira kugwiritsa ntchito kutentha (ie, kutentha ndi kuzizira)
- Perekani ziphuphu kwa anthu omwe ali ndi trapeziometacarpal joint osteoarthritis (pansi pa thupi )
Hip (Pharmacologic Treatment Options)
Palibe ndondomeko zamphamvu zopangira njira zoyamba zamagetsi zothandizira opaoarthritis. Malingaliro ovomerezekawa akuphatikizapo kugwiritsa ntchito mankhwala awa:
- acetaminophen
- NSAID zamlomo
- tramadol
- jekeseni wa corticosteroid
Akatswiri amavomereza kuti zotsatirazi zotsatilazi siziyenera kugwiritsidwa ntchito pa hip osteoarthritis:
Palibe ndondomeko yomwe idaperekedwa ponena za kugwiritsa ntchito:
- NSAID zamatsenga
- jekeseni wa hyaluronate
- Cymbalta (duloxetine)
- mankhwala opangidwa ndi opioid analgesic
Hip (Osati Pharmacologic Treatment Options)
Akatswiri amalimbikitsa anthu omwe ali ndi hip osteoarthritis:
- kutenga nawo mbali pamtima kapena kumatsutsa zochitika pamtunda, kapena onse awiri
- kuthandizira kuchita masewera olimbitsa thupi
- kutaya thupi, ngati kunenepa kwambiri
Akatswiri amanena kuti anthu omwe ali ndi hip osteoarthritis:
- kuthandizira pulogalamu yodzikonda
- Landirani mankhwala othandizira (kusisita) pamodzi ndi masewero olimbitsa thupi
- kulandira thandizo la maganizo
- landirani malangizo okhudza kugwiritsa ntchito njira zowonjezera
- alandire ndikugwiritsa ntchito zothandizira kuyenda , monga n'kofunikira
Akatswiri sanapereke malingaliro okhudza njira zotsatirazi:
- kuchita masewera olimbitsa thupi, okha kapena kuphatikizapo zolimbikitsana
- tai chi
- mankhwala othandiza okha
Knee (Pharmacologic Treatment Options)
Palibe ndondomeko zopambana pa mankhwala oyamba a knee osteoarthritis. Akatswiri amavomereza kuti chimodzi mwa zotsatirazi chigwiritsidwe ntchito:
- acetaminophen
- NSAID zamlomo
- NSAID zamatsenga
- tramadol
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Kugwiritsa ntchito Orthovisc mu Viscosupplementation
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Malingaliro Ochiza Chithandizo cha Mankhwala Ogwira Mtima
- jekeseni wa corticosteroid
Akatswiri amavomereza kuti anthu omwe ali ndi mafupa a m'magazi OSAGWIRITSE ntchito:
- chondroitin sulfate
- glucosamine
- katswiri wamaseweraicin
Palibe malangizi othandizira kugwiritsa ntchito mankhwala a hyaluronates, duloxetine, kapena opioid analgesic.
Mtambo (Osati Pharmacologic Treatment Options)
Akatswiri amalimbikitsa zotsatilazi za mankhwala osamalidwa ndi mankhwala omwe ali ndi mafupa a m'magazi:
- kutenga nawo mbali pochita masewera olimbitsa thupi kapena kukana zochitika zochitika pa nthaka, kapena onse awiri
- kuthandizira kuchita masewera olimbitsa thupi
- kutaya thupi, ngati kunenepa kwambiri
Akatswiri amanena kuti anthu omwe ali ndi mafupa a m'magazi:
- kuthandizira pulogalamu yodzikonda
- Landirani mankhwala othandizira pamodzi ndi masewera olimbitsa thupi
- kulandira thandizo la maganizo
- gwiritsani ntchito zojambula zojambulidwa
- valani pakati pa insoles insoles (ngati matendawa ndi ofiira odwalaostearthritis)
- valani pang'onopang'ono yokhazikika pamagulu ophatikizidwa insoles (ngati matendawa ndi apakati pa chipinda cha osteoarthritis)
- landirani malangizo okhudza kugwiritsa ntchito njira zowonjezera
- Landirani ndikugwiritsa ntchito zothandizira kuyenda, ngati zikuwonetsedwa
- atenge nawo pulogalamu ya tai
Palibe ndondomeko yoperekedwa kwa:
- kuchita masewera olimbitsa thupi, okha kapena kuphatikizapo kulimbitsa thupi
- kuvala insoles zakumapeto
- kulandira mankhwala okhaokha
- kuvala maondo
- pogwiritsa ntchito zojambula zojambula zam'tsogolo
Panalinso njira ziwiri zochiritsira zomwe zinakhazikitsidwa pokhapokha kwa anthu omwe ali ndi mafupa a m'magazi omwe ali ndi vuto lopweteka kwambiri komanso omwe amafunikila opaleshoni yotsalira maondo koma sakufuna kapena sangathe kuchita izi:
- zochitika zachitsulo zachi Chinese
- kutulutsa magetsi
Kuchiza kwa Zina Zina
Ngakhale mapazi ndi msana, komanso ziwalo zina, sizinaphatikizidwepo ndi ndondomeko zachipatala kuchokera ku American College of Rheumatology, mfundo zambiri zimagwiritsidwa ntchito kwa othandizidwa alionse-makamaka mankhwala othandizira. Osteoarthritis wa msana umachitika pamene kuwonongeka kwa ma diski pakati pa vertebrae. Anthu ambiri omwe ali ndi vuto la disc discenerative safuna opaleshoni ndipo amathandizidwa ndi mankhwala oyenera. Ngati zowonongeka sizilephera, komabe opaleshoni ingaphatikizepo laminectomy, discectomy kapena spinal fusion .
Mofanana ndi ziwalo zina, chithandizo cha phazi la osteoarthritis chimapangitsa mpumulo wa zizindikiro. Kuvala orthotique kapena zothandizira phazi zingakhale zothandiza. Kutaya thupi ngati kunenepa kwambiri kumathandiza kulimbitsa thupi. Ngati njira zothandizira mankhwala osasamala zimalepheretsa kuyankha moyenera, opaleshoni ikhoza kuganiziridwa ngati njira yomaliza. Arthroscopy , arthrodesis (fusion), kapena arthroplasty (kuphatikizira mmalo) ingaganizidwe, malingana ndi chophatikizidwa chomwe chili pamapazi kapena minofu. Cholinga cha opaleshoni yamapazi ndichotsetsa ululu ndikupangitsani ntchito yogwirizana.
Mawu Ochokera
Bungwe la American College of Rheumatology limalimbikitsa kuti chithandizo cha dzanja, chiuno, ndi maondo a mafupa amachokera pa umboni umene unalipo kupyolera mu 2010. Akatswiriwa anaphatikizapo madokotala, othandizira, odwala, akatswiri a rheumatologists , opaleshoni ya mafupa, komanso opaleshoni ndi othandizira ogwira ntchito. Pulogalamuyi inapangitsa kuti anthu aziwona bwinobwino umboni.
Malangizidwewa ndi ofunikira chifukwa pali njira zambiri zamankhwala zothandizira osteoarthritis-ndi malingaliro okhudza kumene angayambire. Anthu ambiri omwe amapezeka kuti ali ndi osteoarthritis amagwiritsa ntchito mankhwala osokoneza bongo komanso osagwiritsa ntchito mankhwala.
wakupatsani bukuli chifukwa ndi losavuta kumvetsa ndipo limakulolani kuti mukambirane zomwe mungachite poyambitsa matenda ndi dokotala wanu. Ngati yankho lanu liri lokwanira, mutha kuona zosavuta zanu zina. Ndipo, pofuna chithandizo chamankhwala, pali zowonjezereka kuti mudziwe zambiri.
> Zotsatira:
> Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 Malangizo Ogwiritsiridwa ntchito kwa Nonpharmacologic ndi Pharmacologic Therapies mu Osteoarthritis ya Dzanja, Hip, ndi Knee. Matenda a Nyamakazi ndi Kafukufuku . 2012; Vol. 64 No. 4, masamba 465-474.
> Kalunian KC. Poyamba Pharmacologic Therapy ya Osteoarthritis. Zaposachedwa. Idasinthidwa pa Meyi 19, 2016.
> Moskowitz RW, et al. Matenda a Osteoarthritis - Kuzindikira ndi Udokotala / Kupanga Opaleshoni. Kope lachinayi. LWW.