Ukuba une-asthma yesantya, umqulu wakho ophefumlelweyo wokuphefumula ( FEV1 ) unciphisa ubuncinane ngama-15 ekhulwini ukusuka ngexesha lokulala ukuvuka ekuseni. Kwabanye, ukwehla komsebenzi wamaphaphu kunokubaninzi kakhulu. Oku kuhambelana neempawu ezikhulayo, ezifana nokukhwehlela, ukuvutha, nokuphefumula okuphazamisa ubuthongo.
Iingcipheko ze-Asthma yasebusuku
Izigulane ezineentshintsho ezinkulu zobusika kwi-FEV1 yazo zinokuba nempawu ezininzi zemini kunye nokulawulwa kwe-asthma.
Omnye malunga nenyaniso kukuba i-asthma yesantya inokuthi ihlobene nokufa kwe-asthma. Amaphesenti angama-70 okufa kunye nama-80 ekhulwini ekubanjweni kokuphefumula okubangelwa yi-asthma kwenzeka ngeeyure zomzuzu. Ukutshintsha okukhulu kwi-peak flow exiratory akuhambelani nokuqina komzimba wesimo se-asthma kodwa kuyingozi yokuzibopha ukuphefumula. Uninzi lwezigulane ziqonda ukuba iimpawu ezinzima zidibene nomngcipheko wokufa, kodwa bambalwa kakhulu abantu abaqaphela ukuhluka okukhulu kwintsikelelo yokuphuphuma kwemiphumo yokuphefumula kuba yinkalo yobungozi kwiziphumo ezimbi.
Izizathu
Ayaziwa ukuba ukuncipha komsebenzi wamaphaphu kungenxa yokutshintsha kweengqungquthela zesigxina (utshintsho kumsebenzi wamaphaphu ngenxa ye-clock efana newashi) nokuba ingaba njani ihlobene nokulala. Kodwa zonke izigulane ze-asthma, nangona kunjalo, zifumana iingxaki ebusuku.
Kukho utshintsho lwe-physiologic ezenzeka ngexesha lokulala ezingancedisa ukuba iziphi izigulane ze-asthma zifumana iingxaki.
Ukuchasana kuthatha ukwandisa umsebenzi webusuku nomphuphu kunciphisa njengoko ixesha lokulala landa. Le nyaniso yokugqibela inyanisekileyo kwizigulane ezingenazo i-asthma, kodwa kungekhona kwindawo ekuhlaleni ngayo iimpawu.
Ukuxilongwa
Indlela elula yokufumanisa i-asthma yomsuku wobushushu kukujonga ukuhamba kwexesha lokulala nokuphakama kokuphakama kokuvuswa.
Ukuba kukho ukungafani kweepesenti ezili-15 kwindleko yakho yokuhamba, unokuhluka okubonakalayo okubangelwa yimiqondiso yakho. Nangona kunjalo, ukuphakama kweemitha ezingamanzi akukhathazeki kakhulu ukufumanisa utshintsho lwe-FEV1. Wena kunye nomboneleli wakho wezempilo unokufuna ukuqwalasela oku kwaye uqale isilingo sokwelapha .
Uphando lwe-asthma luye lwabonisa ukuba amaninzi angama-74 ekhulwini labantu abane-asthma bavuka ebusuku, kanye kanye ngeveki, ngelixa inani elingama-64 ekhulwini lingabi ne-asthma ebusuku ebusuku kathathu okanye ngaphezulu ngeveki. Kubaluleke kakhulu, abantu abangama-40 ekhulwini abantu abanamava e-asthma iimpawu zobusuku ebusuku.
Abantu abanesifo se-asthma banokungaziboni iimpawu zobusuku njengophawu lolawulo lwe- asthma olubi. Kwesinye isifundo, iipesenti ezingama-26 zezigulane ezazivothula i-asthma ngokuthi "zinyameko" ezichazwe iimpawu ze- asthma ezifana nokukhwehlela okungapheliyo , ukuvuthwa, kunye nokuphefumula kokuphefumula ebusuku. Kubalulekile ukuqaphela izimpawu zobusuku njengobunzima bokulawula ngenxa yokuba i-asthma ebulala abantu abadala kunye nabantwana abasuka ekubanjweni kokuphefumula kunye nokufa ngokukhawuleza kwenzeka phakathi kobusuku kunye no-8
I-Physiology emva kwe-Asthma yasebusuku
Nangona kungekho mntu uyazi ngokuqinisekileyo, i-asthma ebusuku idibaniswe nayo:
- Ukunciphisa amanqanaba e-nitric okwehla: Ngenxa yokuba i-nitric oxide iyinxalenye ye- bronchodilator enamandla, amanqanaba ayancitshiswayo anokuthi achaze iimpawu zobusuku ezandileyo.
- Ukunciphisa i-beta 2-receptors: Inombini nomsebenzi we-beta 2 receptors-i-receptors enoxanduva lokuxhatshazwa kwe-airways-iyancipha phakathi kwe-4: 00 no-4 ekuseni.
- Ukwamkelwa kwe-steroid eyanciphayo: Efana ne-beta 2 receptors, zombini iinombolo kunye nomsebenzi we-receptors-abajongene nokunciphisa ukuvuvukala-ukuncipha ebusuku. Ukuhla kwehla kungabangela uxanduva lokunyuka okukhulu ngenxa yokungahambi kwempendulo kumzimba wakho ngokwemvelo eveliswa ngama-steroids okanye i-steroids egqitywe ngugqirha wakho.
- Umsebenzi ongeyomntu oqhelekileyo: Ukuveliswa kwe-cortisol, i-hormone eyenziwe yintsimbi ye-pituitary, iyancipha ubusuku bonke. Olu nciphiso ludibene nokuhla kwe- FEV1 . Ukunyanga izigulane ezinezinga eliphansi le-cortisol kunye ne-hydrocortisone (i-steroid thrapeutic), idibaniswa nophuculo kwi-FEV1.
- I-Melatonin: Izigulane ezine-asthma zobusika ziye zaphawulwa ukuba zinamazinga aphantsi e-melatonin xa kuthelekiswa nezigulane ezingenazo i-asthma.
Unyango
Uninzi lwezigulane ezine-asthma ebusuku zidibanisa imigaqo-nkqubo njenge- asthma eqhubekayo okanye eqhubekayo ngokulandela izikhokelo ze-NHLBI. Kufuneka uphathwe ngokuhambelana nezi zikhokelo, kodwa wena kunye nomboneleli wakho unokufuna ukuqwalasela ezinye zezi ngongoma zilandelayo ukuba ucinga ukuba unesifo se-asthma.
- Inhaled glucocorticoids: Kwisifundo ekuthelekiseni i-800 micrograms (inkunzi emine ye-Azmacort inhaler) nge-3 ntambama ngosuku ngalunye kwimizi yendabuko yokuqhuma enye emini ngosuku, i-dosing ye-3 pm isebenza kunye namaxesha amane ngosuku. Xa i-dosing yatshintshile ibe ngu-8: 30 ekuseni okanye ngo-5 ntambama ukulungelelanisa, i-dosing yangama-5: 30 ngama-dosing yayisenza ngcono ngaphezu kwezihlandlo ezine ngosuku, kodwa ukusa kwantambama kwakusasa ngakumbi.
- I-β2 i-agonists ye-adrenergic: I-agonists esebenza ixesha elide, efana ne-inhaler yakho yokuhlangula kodwa ihlala iiyure ezithandathu okanye ngaphezulu njenge-salmeterol, iboniswe ukuphucula umsebenzi wamaphaphu ngobusuku, ubuthongo bokulala, kunye nomgangatho wobomi obumnyama.
- Ii-agonists zomlomo ze-β2 zomlomo: Iifom zomlomo ze-albuterol ezinikezwa njengepilisi yokukhupha i-slowly increase morning rate incirator flow rates kunye nokunciphisa ukuphefumula nokuphefumula.
- Theophylline: Iindidi ezahlukeneyo ze theophylline zinempahla ehlukileyo. Omnye unokunceda ngokukhethekileyo i-asthma yomsuku womzimba ngumalungiselelo owenzelwe ukuba namazinga aphezulu ebusuku-njengo-Uniphyl-xa ufumana iimpawu ezingaphezulu. Ngale rejimeni, amazinga e-theophylline ahla ngethuba lemini kwaye izigulane zineempembelelo ezimbalwa zecala kunezidalwa zemveli.
- Ukunyangwa kweminye imimiselo eyingozi ngakumbi kwesifo se-asthma : Ezinye zeemeko zonyango, ezifana ne-reflux yesisu, iingxaki zesinus , kunye nokukhuluphala, zingalimaza i-asthma yakho. Ukuba unesifo se-asthma ebusuku , qiniseka ukuba awukho mngcipheko kule miqathango.
Imithombo:
> Ginsberg D. I-Monster engaziwayo kwiBhedi-Ukuhlola i-Asthma yasebusuku kubantwana. I-McGill Journal of Medicine: MJM . 2009; 12 (1): 31-38.
> UMartin RJ. I-Asthma yasebusuku. Isemgangathweno. https://www.uptodate.com/contents/nocturnal-asthma.