Mapulani a mankhwala a Lupus akugwirizana ndi zosowa zanu ndipo angasinthe pakapita nthawi. Njira zambiri zothandizira matenda a lupus kwawonjezeka, kupereka madokotala chisankho choposa momwe angayendetsere matendawa atatha kupeza matendawa. Mankhwala opatsirana monga mankhwala osokoneza bongo komanso odana ndi zotupa, mwazinthu zina, angagwiritsidwe ntchito.
Ndikofunika kuti mugwire ntchito mwakhama ndi dokotala ndikugwira nawo ntchito yoyang'anira matenda anu, ndikuyambirananso ndondomeko yanu yothandizira nthawi zonse kuti muwone ngati n'zotheka.
Ngati lupus yapezeka, dokotala wanu adzakukonzerani chithandizo cha mankhwala malinga ndi msinkhu wanu, kugonana, thanzi, zizindikiro, ndi moyo wanu. Pofuna kukonza dongosolo lanu la mankhwala, dokotala wanu ali ndi zolinga zingapo:
- Kuchepetsa kutupa chifukwa cha matendawa
- Pewani kusamala kwa chitetezo cha mthupi chomwe chimayambitsa kutupa kwa minofu
- Pewani mapira ndi kuwachitira iwo akadzachitika
- Zizindikiro zolamulira
- Pezani mavuto
Malemba
Mankhwala a mankhwalawa ndi ofunika kwambiri pa kasamalidwe ka odwala ambiri omwe ali ndi lupus erythematosus (SLE), mtundu waukulu wa lupus. Pali mitundu yambiri ya mankhwala omwe alipo tsopano, yomwe yowonjezera mwayi wothandizira ndi zotsatira zabwino kwambiri za odwala.
Mankhwala a Lupus ayenera kuphatikizapo mankhwala ochepa ngati n'kotheka kwa nthawi yaying'ono.
Odwala ena samafunanso mankhwala, ndipo ena amawatenga kokha pokhapokha ngati akufunikira kapena kwafupikitsa, koma ambiri amafunikira mankhwala opatsirana nthawi zonse. Ngakhale zili zothandiza, palibe mankhwala osokoneza bongo. Mankhwala omwe amagwiritsidwa ntchito nthawi zambiri kuti athetse matenda a lupus ndi awa:
- Mankhwala otsutsana ndi kutupa (osaperoidal anti-inflammatory drugs (NSAIDs)
- Zilonda
- Corticosteroids
- Matenda a Immunosuppressives / mankhwala othandizira anti-rheumatic drugs (DMARD)
Ngati muli ndi vuto la lupus , mumatha kuchiritsidwa ndi matenda opatsirana pogonana komanso / kapena mankhwala ochepa a corticosteroids.
Ngati muli ndi matenda a lupus ochepa , dongosolo lanu la mankhwala likhoza kukhala ndi matenda a chiwembu komanso kanthawi kochepa kuti corticosteroid ichitike. Mungapindulenso ndi immunosuppressive.
Pachilombo chachikulu cha lupus chomwe chimaphatikizapo ziwalo zanu, mwinamwake mungafunikire kuchuluka kwa mankhwala a immunosuppressive. Mukhozanso kupatsidwa mankhwala okwanira a corticosteroid kwa kanthawi kochepetsetsa kutupa kwanu. Mofanana ndi lupus yofatsa komanso yochepa, mungathenso kupindula ndi matenda opatsirana pogonana.
Zokwanira zosiyanasiyana zomwe mungapeze komanso zovuta zamakonzedwe ka mankhwala zingakhale zodabwitsa komanso zosokoneza. Dokotala wanu atabwera ndi ndondomeko ya mankhwala, nkofunika kuti mumvetse bwino chifukwa chogwiritsa ntchito mankhwala, momwe zimagwirira ntchito, kuchuluka kwa momwe mukuyenera kutengeramo, pamene mukufunikira kutenga, komanso zotsatira zake zomwe zingatheke. khalani. Ngati simukutsimikiza, onetsetsani kuti mufunse.
Odwala ambiri amachita bwino mankhwala a lupus ndipo amakhala ndi zotsatira zochepa.
Ngati mutero, yesetsani kukhumudwa, kumbukirani kuti mankhwala ena osakaniza amakhalapo. Komanso, dziwitsani dokotala mwamsanga. Zingakhale zoopsa kusiya mwadzidzidzi kumwa mankhwala, ndipo musayime kapena kusintha mankhwala popanda kuyamba kulankhula ndi dokotala wanu.
Zilonda
Zilonda zamtunduwu zinayamba kupangidwa pa nthawi ya nkhondo yachiwiri ya padziko lonse chifukwa quinine, mankhwala odwala malungo, sankatha. Ochita kafukufuku anapeza kuti mankhwala a antitimalarial angagwiritsidwe ntchito pochizira kupweteka kwa pamodzi komwe kumachitika ndi nyamakazi . Ntchito yotsatira ikusonyeza kuti mankhwalawa ali othandiza kuthetsa vutoli:
- Lupus nyamakazi
- Kuphulika khungu
- Zilonda za m'mphuno
- Kutopa
- Fever
- Kutupa kwa mapuloteni
Mafupa, omwe amavomerezedwa ndi US Food and Drug Administration (FDA) kuti athetse lupus, amagwiritsidwa ntchito pofuna kuteteza moto pamene amachotsedwa mosalekeza, koma sagwiritsidwa ntchito kugwiritsira ntchito njira zowopsa kwambiri za lupus zomwe zimakhudza ziwalo. Zitha kukhala masabata kapena miyezi musanazindikire kuti mankhwalawa akuletsa zizindikiro za matenda.
Mitundu yamagetsi amphatikizapo:
- Plaquenil (hydroxychloroquine sulphate)
- Aralen (chloroquine)
Ngakhale kuti chloroquine imagwiritsidwanso ntchito, chifukwa cha chitetezo chabwino, hydroxychloroquine sulphate nthawi zambiri imakonda. Ntchito yotsutsa-yotupa ya mankhwala awa sikumveka bwino. Matendawa amachititsanso mapulogalamu anu kuchepetsa chiopsezo cha magazi ndi mapiritsi apansi a m'magazi.
Zotsatira zoyipa za matenda a mtima angaphatikizepo:
- Mimba imakhumudwitsidwa
- Kuwonongeka kwa retina wa diso (chosowa)
NSAIDs
Mankhwala otsutsana ndi kutupa (nonsteroidal anti-inflammatory drugs) (NSAIDs) amaphatikizapo gulu lalikulu komanso lachilengedwe la mankhwala omwe ali ndi zochepetsera kupweteka, zotsutsana ndi zotupa, ndi malungo. Kupweteka ndi kutupa ndizovuta kwambiri kwa odwala omwe ali ndi lupus, ndi NSAID nthawi zambiri amamwa mankhwala osankhidwa kwa odwala a lupus ochepa kapena osagwirizana nawo, ngakhale kuti sakuvomerezedwa ndi FDA kuti athetse lupus. Odwala omwe ali ndi ziwalo zogonana angadabwe kwambiri mankhwala osokoneza bongo komanso osakanikirana.
Ngakhale kuti NSAID zina, monga buprofen ndi naproxen, zimapezeka pa-counter, mankhwala a dokotala amafunika kwa ena. NSAID zingagwiritsidwe ntchito zokha kapena kuphatikiza ndi mitundu ina ya mankhwala kuti zithetse ululu, kutupa, ndi malungo. Ndikofunika kuti mutenge mankhwala awa pansi pa malangizo a dokotala. NSAID ikhoza kukhala yokhayo mankhwala omwe amafunika kuti athetsere pang'ono, koma matenda otheka kwambiri angafunike mankhwala ena.
Zotsatira zoyipa za NSAID zingaphatikizepo:
- Mimba imakhumudwitsidwa
- Kuthamangitsani
- Kutsekula m'mimba
- Kusungirako zamagetsi
Anthu ena amakhalanso ndi chiwindi, impso, mtima, kapena mavuto a ubongo pogwiritsira ntchito NSAID, zomwe zimapangitsa kukhala kofunika kwambiri kuti mukhale pafupi kwambiri ndi dokotala mukamamwa mankhwalawa.
Ngakhale kuti NSAID zonse zikuwoneka ngati zikugwira ntchito mofanana, sizinthu zonse zomwe zimakhudza munthu aliyense. Kuonjezera apo, odwala angapange bwino NSAID imodzi kwa nthawi ndiyeno chifukwa chosadziwika angayambe kupeza phindu lililonse. Kupititsa ku NSAID yosiyana kungapangitse zotsatira zoyenera. Muyenera kugwiritsa ntchito NSAID imodzi pa nthawi iliyonse.
Corticosteroids
Corticosteroids ndi mahomoni obisika ndi chigoba cha adrenal gland. Zosintha zamakomlekedwe ameneŵa zimagwiritsidwa ntchito mankhwalawa monga mankhwala osokoneza bongo. Mawu akuti "steroids" nthawi zambiri samamvetsetsedwa ndipo kusokonezeka kungabweretse pamene corticosteroids akulakwitsa anabolic steroid.
Corticosteroids yavomerezedwa ndi FDA pochiza lupus ndipo kawirikawiri imayendetsedwa pamlomo. Pa nthawi ya matenda aakulu, iwo akhoza kuperekedwa mkati mwa intravenously. Koma mukadakhazikika, maulamuliro ovomerezeka ayenera kubwereranso. Chifukwa chakuti ndi mankhwala osokoneza bongo, dokotala wanu adzafufuza mlingo wotsika kwambiri ndi phindu lalikulu kwambiri.
Odwala Lupus omwe ali ndi zizindikiro zosasintha kapena omwe sakuyembekezeredwa kuyankha ku NSAID kapena antimalarials akhoza kupatsidwa corticosteroid. Ngakhale kuti corticosteroids imakhala ndi zotsatira zoyipa kwambiri, zimathandiza kwambiri kuchepetsa kutupa, kuchepetsa kupwetekedwa kwa minofu ndi kuphatikizana ndi kutopa, komanso kuteteza chitetezo cha mthupi. Zilinso zothandiza pakulamulira ziwalo zazikulu zogwirizana ndi lupus.
Matendawa atalandira chithandizochi, nthawi zambiri mlingowu umaperekedwa kufikira mlingo wotsika kwambiri womwe umayendetsa matendawa. Muyenera kuyang'aniridwa mosamala panthawiyi kuti muwononge ululu, kupweteka, ndi kutopa kumene kungatheke pamene mlingo ukutsitsa.
Odwala ena angafunike corticosteroids pokhapokha panthawi ya matendawa; Anthu omwe ali ndi matenda oopsa kapena okhudza ziwalo zofunikira kwambiri angafunike chithandizo cham'tsogolo. Nthaŵi zina madokotala amapereka corticosteroid yochuluka kwambiri ndi mitsempha kwa nthawi yochepa (masiku), otchedwa bolus therapy kapena mankhwala opatsirana.
Pambuyo pa mankhwala a corticosteroid yaitali, mankhwalawa sayenera kuimitsidwa mwadzidzidzi. Kulamulira kwa corticosteroids kumapangitsa thupi lanu kukhala ndi mahomoni a adrenal kuti achepetse kapena kuimitsa, ndipo kusagonjetsa matenda kapena adrenal crisis (zomwe zingakhale zoopsa pamoyo) zingabwere ngati mankhwala atayimilira mwadzidzidzi. Kuchulukitsa mlingo kumathandiza kuti matenda anu adrenal ayambirenso ndi kuyambiranso kupanga mahomoni. Pamene mwakhala muli corticosteroids, zimakhala zovuta kwambiri kuchepetsa mlingo kapena kusiya ntchito yawo.
Corticosteroids yogwiritsira ntchito lupus ndi awa:
- Prednisone (Sterapred) - nthawi zambiri pofuna kuchiza lupus; onani zambiri pansipa
- Hydrocortisone (Cortef, Hydrocortone)
- Methylprednisolone (Medrol)
- Dexamethasone (Decadron)
Corticosteroids alipo monga:
- Zojambula zam'madzi kapena mafuta opangira mafuta
- Mapiritsi ovomerezeka
- Njira zamadzimadzi
- Maselo a Steroid (jekeseni wamkati kapena intravenous)
Zotsatira zazing'ono za corticosteroids zingaphatikizepo:
- Kuwonjezeka kwa maso (glaucoma)
- Kutupa
- Kuthamanga kwa magazi
- Kuwonjezeka kwa kudya
- Kulemera kwalemera
Zotsatira za nthawi yaitali za corticosteroids zingaphatikizepo:
- Zozizira
- Msuzi wamkulu wa shuga (shuga)
- Matenda
- Mafupa olefuka kapena owonongeka (osteoporosis ndi osteonecrosis)
- Nthawi yaitali kuti mabala azichiritsidwa
- Khungu lofewa ndi losavuta kuvulaza
- Sakanizani
Kawirikawiri, kuchuluka kwa mlingo ndi nthawi yayitali, zimakhala zoopsa komanso zoopsa kwambiri . Ngati mumagwiritsa ntchito corticosteroids, muyenera kuyankhula ndi dokotala wanu ponena za kutenga calcium yowonjezerapo ndi vitamini D kapena mankhwala kuti achepetse chiwopsezo cha matenda odwala matenda a m'mimba.
Zambiri pa Prednisone
Prednisone ndi corticosteroid imene madokotala amapereka, yokha kapena yogwiritsa ntchito mankhwala ena, koma nthawi zambiri amagwiritsidwa ntchito monga mankhwala amphindi. Ndizothandiza kwambiri pakuthana ndi lupus ndi zizindikiro zomwe zimayambitsa matenda nthawi zambiri. Anthu omwe ali ndi matenda ochepa a lupus sangagwiritse ntchito mankhwalawa.
Lumikizani dokotala wanu ngati mukukulapo zizindikiro zotsatirazi zomwe sizimachoka kapena zimakhala zovuta pamene mutenga prednisone:
- Mutu
- Chizungulire
- Kuvuta kugona kapena kugona tulo
- Chimwemwe chosayenera
- Kusintha kwakukulu m'malingaliro
- Kusintha kwa umunthu
- Maso owopsya
- Zikodzo
- Khungu lofewa, lopanda kanthu
- Zofiira zofiira kapena zofiirira kapena mizere pansi pa khungu
- Kuchepetsa machiritso a mabala ndi makutu
- Kuwonjezeka kwa tsitsi la tsitsi
- Kusintha kwa momwe mafuta amafalikira kuzungulira thupi
- Kutopa kwambiri
- Mitsempha yofooka
- Nthawi ya kusamba kapena yosafika
- Kuchepetsa chikhumbo chakugonana
- Kuthamangitsani
- Kuwonjezeka thukuta
Lembani dokotala wanu mwamsanga mukakumana ndi zizindikiro zotsatirazi mutatenga prednisone:
- Mavuto a masomphenya
- Kupweteka kwa maso, kupukusa kwala, kapena kuvundula
- Pakhosi, malungo, kuzizira, chifuwa, kapena zizindikiro zina za matenda
- Kugonjetsa
- Kusokonezeka maganizo
- Kutaya kukhudzana ndi chenicheni
- Kusokonezeka
- Kusokoneza minofu kapena kumangiriza
- Kugwedeza manja omwe simungathe kuwaletsa
- Kunjenjemera, kuwotcha kapena kuyimba pamaso, mikono, miyendo, mapazi, kapena manja
- Zimakhumudwa m'mimba
- Kuthamanga
- Lightheadedness
- Kuphatikizika kwa mtima
- Phindu ladzidzidzi mwadzidzidzi
- Kutupa kapena ululu mmimba
- Kuvuta kupuma
- Rash
- Mikoko
- Kuyabwa
Immunosuppressives / DMARDs (Matenda-Kusintha Mankhwala Osakanikirana ndi Matenda)
Mankhwala a Immunosuppressives ndi ma ARV ena omwe amagwiritsidwa ntchito ndi "off-label" (kutanthauza kuti sakuvomerezedwa ndi FDA kuti apeze lupus) chifukwa cha matenda aakulu a lupus momwe ziwalo zazikulu monga impso Zimakhudzidwa kapena zimakhala ndi kutupa kwa minofu kapenanso matenda osakwanira. Mankhwala a Immunosuppressives angagwiritsidwenso ntchito kuchepetsa kapena nthawi zina kuthetsa kusowa kwa corticosteroids, potero kukulepheretsani ku zotsatira zosavulaza za mankhwala a corticosteroid. Immunosuppressives amaletsa chitetezo chanu chachitetezo cha mthupi m'njira zosiyanasiyana.
Immunosuppressives ndi DMARD akhoza kukhala ndi zotsatira zoopsa kwambiri. Komabe, zotsatira zoyipa zimadalira mlingo womwe mukuwutenga ndipo nthawi zambiri zimasinthidwa mwa kuchepetsa mlingo kapena kuimitsa mankhwala pansi pa uphungu wa dokotala. Mankhwalawa angaperekedwe pakamwa kapena mwa kulowetsedwa (kutayira mankhwala mu mitsempha yanu kudzera mu chubu kakang'ono).
Pali ngozi zambiri zogwirizana ndi kugwiritsa ntchito immunosuppressives ndi DMARD. Izi zikuphatikizapo:
- Kugonjetsa
- Kuwonjezeredwa kwa matenda
- Kuchulukitsa mafupa a mafupa
- Kukula kwa malignancies
Mankhwala osiyanasiyana okhudzana ndi matenda osokoneza bongo komanso mankhwala ena othandizira matendawa amapezeka kuti athetse lupus. Zonsezi zikugwiritsidwa ntchito ku gulu la mankhwala omwe amagwiritsidwa ntchito ngati njira yachiwiri yodziwombera ndi lupus ndi mitundu ina ya nyamakazi. Ngakhale kuti ali ndi njira zosiyana, mtundu uliwonse umagwira ntchito kuchepetsa kapena kuteteza kuyankha kwa chitetezo cha mthupi.
Immunosuppressives ndi DMARD zomwe zimagwiritsidwa ntchito pochiza lupus zikuphatikizapo:
- Cyclophosphamide (Cytoxan)
- Mycophenolate mofetil (CellCept): Mankhwalawa amagwiritsidwa ntchito pa lupus nephritis kapena mankhwala osagwira ntchito a lupus erythematosus, njira yaikulu ya lupus, ndipo amathandizira kuchepetsa mlingo wa steroids yomwe mungafunike.
- Azathioprine (Imuran, Azasan): Azathioprine imagwira ntchito poletsa kutengako kwa mafupa komanso kutsegula kwa maselo T. Pogwiritsa ntchito murine (mouse ndi rat) ndi maphunziro a anthu, azathioprine amaonedwa kuti ndi ofooka oteteza immunosuppressive agent. Komabe, ndi yotchipa kusiyana ndi ena omwe amagwiritsa ntchito ma immunosuppressive ndipo angagwiritsidwe ntchito m'malo mwa steroids. Mwapadera, azathioprine imagwira ntchito bwino pambuyo poyambitsa mankhwala ndi cyclophosphamide kapena mycophenolate.
- Methotrexate (Rheumatrex)
Zotsatira za mankhwalawa zingaphatikizepo:
- Nausea
- Kuthamanga
- Kutaya tsitsi
- Matenda a chikhodzodzo
- Kuchepetsa kubereka
- Kuonjezera ngozi ya khansa ndi matenda
Kuopsa kwa zotsatirapo kumawonjezeka ndi kutalika kwa mankhwala. Mofanana ndi mankhwala ena a lupus, pali ngozi yoti abwererenso pambuyo poti maselo a immunosuppressives achotsedwa.
Zamoyo
Benlysta (belimumab) ndi mankhwala ena ovomerezeka a FDA ochizira matendawa, omwe amagwiritsa ntchito corticosteroids, antitimalarials, immunosuppressives, ndi NSAIDs (mankhwala osakanikirana ndi anti-inflammatory). Benlysta amawongolera ngati mankhwala osokoneza bongo ndipo ndi mankhwala oyamba omwe amawombera mapuloteni a B-lymphocyte (BLyS) omwe ayenera kuchepetsa chiwerengero cha maselo osadziwika B-vuto la lupus.
Zosankha za mitundu ina ya Lupus
Ngati mwapezeka kuti muli ndi matendawa, kapena kuti matenda a lupus, omwe nthawi zambiri amakhala osiyana ndi machitidwe a systemic lupus erythematosus (SLE), mapulogalamu anu ayenera kuyamba kuchiritsidwa pamutu ndi mankhwala owonjezera a corticosteroid kapena mafuta odzola. Mavitaminiwa akhoza kugwiritsidwa ntchito ku zilonda usiku usanakagone; Khungu loyenera liyenera kukhala ndi filimu ya pulasitiki kapena tepi ya Cordran. Ngati zipikazo zatsalira popanda chivundikirochi, mafuta a corticosteroid ndi gels ayenera kugwiritsidwa ntchito kawiri pa tsiku.
Njira ina yowonetsera malo omwe amayamba chifukwa cha matendawa amachititsa kuti lupus isagwiritsidwe ntchito pogwiritsa ntchito mapuloteni a calimirum monga kirimu kapena tacrolimus mafuta. Ngati zilonda zanu sizikugwirizana ndi corticosteroids kapena calcineurin inhibitors, dokotala wanu akhoza kuyesa injection ya corticosteroid m'matenda anu a khungu.
Ngati palibe mankhwala awa, dokotala wanu akhoza kuyesa njira yothandizira. Njira yothandizira mzere woyamba imaphatikizapo mankhwala otentha monga hydroxychloroquine sulfate, chloroquine, kapena quinacrine. Izi ndi zothandiza kwa anthu ambiri.
Ngati nthendayi sizichita chinyengo, dokotala wanu akhoza kuyesa imodzi mwa mankhwalawa:
- Matenda osadziletsa, monga methotrexate kapena mycophenolate mofetil (MMF)
- Retinoid yamagetsi, monga isotretinoin kapena acitretin
- Dapsone, sulfonamide
- Thalidomide, wothandizira ma immunomodulatory agent
Chimodzi mwa zotsatira zowopsya za mankhwala a mtima ndi psoriasis, omwe ndi mtundu wina wa matenda a khungu omwe ali ndi zizindikiro zofanana ndi zomwe zimawopsyeza ndikupeza lupus. Isotretinoin ndi thalidomide ndizoopsa kwambiri, zomwe zikutanthauza kuti mankhwalawa akhoza kuwononga mwana, choncho musatenge izi ngati muli ndi pakati kapena mukuganiza kutenga mimba.
Mankhwala Osakaniza Owonjezera
Chifukwa cha chikhalidwe ndi mtengo wa mankhwala omwe amagwiritsidwa ntchito pochiza lupus ndi zomwe zingayambitse mavuto aakulu, odwala ambiri amafuna njira zina zothandizira matendawa. Njira zina zowonjezera ndizo:
- Zakudya Zapadera
- Zitsamba zowonjezera
- Mafuta a nsomba amawonjezera
- Kusamalira tizilombo
- Tizilombo toyambitsa matenda
- Kupangidwanso
- Tai Chi
- Kuchiza mankhwala
- Biofeedback
- Kusinkhasinkha
Ngakhale njira izi sizingakhale zovulaza mwa iwo okha ndipo zingakuthandizeni ndi zizindikiro zina pokhazikitsa ndondomeko yanu yothandizira, palibe kafukufuku wokhala ndi chiwonetsero chomwe chimakhudza matendawa kapena kuteteza kuwonongeka kwa thupi. Ndipotu, zitsamba zowonjezera zingakhale zovulaza, zomwe zingapangitse kuti lupus yanu ikhale yoipitsitsa komanso / kapena yotsutsana ndi mankhwala anu.
Nthawi zonse funsani dokotala musanayambe njira yothandizira kapena yothandizira, ndipo onetsetsani kuti mukupitiriza kumwa mankhwala omwe mwalangizidwa.
> Zotsatira:
> Clarke J. Poyamba Kulandila Discoid Lupus ndi Subacute Lupus Yotsalira. Zaposachedwa. Kusinthidwa pa Meyi 16, 2017.
> Clarke J. Kasamalidwe ka Zokonzera Chotsani Lupus ndi Subacute Lupus yodulidwa. Zaposachedwa. Idasinthidwa pa January 11, 2017.
> MedlinePlus. Prednisone. Laibulale ya National National Medicine. Idasinthidwa November 15, 2015.
> Wallace DJ. Zowonongeka za Utsogoleri ndi Kugonjetsa kwa Lupus Erythematosus Yodabwitsa mwa Anthu Achikulire. Zaposachedwa. Idasinthidwa pa January 24, 2018.