Ukukunceda Ukulawula I-Rheumatoid Arthritis
Amachiza ngowona mthombo wonyango lwemveli yesifo se-rheumatoid arthritis . Ngokukhawuleza ukuba ufumene ukuba une-arthritis ye-rheumatoid , ugqirha wakho uya kuncomela aze amisele inkqubo yokonyango.
Kukho imithi embalwa esetyenziswa ekuphatheni i-rheumatoid arthritis ekwahlulwe ngokwahlula izidakamizwa ngokusekelwe kwindlela abasebenza ngayo. Kubalulekile ukuba uqonde izinto ozikhethayo, kunye nokuqonda ukuba kutheni ukhethe iyeza elithile.
Ngamanye amagama, yintoni isilwanyana esenza emzimbeni?
Ukuba inkqubo ethile yokwelashwa ayibonakali iyasebenza emva kwexesha, kuyaqhelana nodokotela wakho ukwenza utshintsho kwi-regimen yakho. Makhe sicinge ngamachiza e-rheumatoid arthritis. Unokumiselwa enye okanye ngaphezulu kwezi zilandelayo.
NSAID
I-NSAID (izidakamizwa ezichasayo ezingekho komzimba) zithintela i- COX 1 kunye ne-COX 2 (i-cyclooxygenase enzymes) ekuveleni i-prostaglandin , i-hormone efaka isandla ekuvukeleni emzimbeni. Kukho ii-NSAID eziliqela ezivela kuyo. IiNSAID eziqhelekileyo eziqhelekileyo yiMotrin (ibuprofen) , i-Naprosyn (naproxen) , i-Mobic (meloxicam) kunye ne-Voltaren (i-diclofenac) . I-Celebrex (celecoxib) yiyona kuphela i-COX-2 inhibitor yokukhetha ekhoyo e-US Kananjalo, i- Advil (ibuprofen) ne-Aleve (naproxen) ikhona kwi-over-counter- power force .
Ii-NSAID zidibene nomngcipheko ophezulu wokuhlaselwa kwintliziyo okanye ukubetha, ngoko ekugqibeleni kwagqitywa ukuba izidakamizwa kufuneka zithathwe kwiqondo elisezantsi kakhulu kwaye kubekho ixesha elifutshane kunokwenzeka.
Kwakhona, akufanele uthathe umkhiqizo we-NSAID ngaphezulu kwexesha. Funda amalebula ngokucophelela njengoko i-NSAID ingaba yinkampani yeeyeza ezahlukeneyo zokukhwehlela, ukubandisa, ukugula, ukulala, kunye nesisu esicasulayo.
Uhlalutyo
Iimvavanyo zonyango zisebenza ngokunciphisa intlungu. I-Acetaminophen yinto eyaziwayo yonyango ngokubanzi; Eyona nto yodwa imishanguzo ye-analgesic ekhoyo kwi-counter.
Kwakhona, kunokusetyenziswa kwimveliso eyahlukeneyo, ngoko kuyafuneka ukuba ufunde iilebula kwaye uqaphele umphumo we-acetaminophen.
Ama-analgeics anamandla atholakala kuphela ngeyeza. Zibizwa ngokuba yi-opioids okanye izidakamizwa. I-opioids isebenza kwinkqubo yesistim ephakathi ukuvimba izibonakaliso zentlungu. Amachiza e-opioid afika enobungozi bokuxhomekeka, kodwa xa esetyenziswe njengoko iyalathwayo kwaye ngokuqapha malunga neziphumo ezimbi kunye neziganeko ezimbi, ezi ziyobisi zingabangela ukuba iintlungu ziphumelele kubantu abane-arthritis ye-rheumatoid. Ngo-2016, amaZiko okuLawulwa kweNtsholongwane kunye noKhusela (CDC) akhulula izikhokelo zokumisela i-opioids . I-Hydrocodone / i-acetaminophen (i-brand Norco) kunye neTramadol (uphawu lwe-Ultram) zimbini zee-analgesics eziqhelekileyo eziqhelekileyo. Ezinye ziquka i-oxycodone kunye neMSContin.
Corticosteroids
I-Corticosteroids , eyaziwa nangokuthi i-glucocorticoids okanye i-steroids, ilinganisa imiphumo ye-hormone cortisol emzimbeni kwaye idlala indima ekuphenduleni komzimba. I-Corticosteroids ifumaneka iifom ezininzi, kubandakanya iipilisi, isisombululo esingenayo, amaconsi kunye nama-creams.
I-Corticosteroids iyimithi echasayo kakhulu. Nangona ukuphumelela kwabo kubonakala kunemimangaliso, badibaniswa nemiphumo emibi kakhulu, kungeyona encinci yengozi yokwanda kwesulelo.
Ukunciphisa umngcipheko wemiphumo emibi, i-corticosteroids kufuneka ithathwe kwiqondo elisezantsi kakhulu kwaye ixesha elifutshane linokwenzeka.
Abanye abantu abane-arthritis ye-rheumatoid bamiselwe i-corticosteroid ye dose ephantsi njengenxalenye yesiganeko sazo. Abanye basebenzisa kuphela i-corticosteroids ukuba banqande impawu zesifo se-rheumatoid arthritis. Abantu abaye bathatha i-corticosteroid ixesha elide banokufumana iimpawu zokulahla xa beyeka isilwanyana ngaphandle kokucoca. I-Prednisone kunye ne- methylprednisolone yizona eziqhelekileyo ze-corticosteroids zomlomo. I-Triamcinolone yi-injection ephambili kunye nekhefu.
DMARD
Izidakamizwa ezichanekileyo zokuguqula izidakamizwa (i- DMARD ) zizonyango ezisebenza ngokukhawuleza ezisebenza ukuthoba isifo sokunyuka nokunciphisa umonakalo.
Kukho i-DMARD yendabuko, okhethekileyo kunye neyona ndlela endala. Kukho kwakhona i-DMARD ye-biologic-eyona yokuqala eyabonakala kwindawo yesehlakalo ngo-1998. Kwaye, ngoku kutshanje, elinye i-sub-class ye-DMARD eyaziwa ngokuba yimilwanyana encinci.
Kwimveli ye-DMARD, i- methotrexate yinto echazwe ngokuqhelekileyo. Ngokwenene ithathwa njengonyango lwegolide oluqhelekileyo lwe-rheumatoid arthritis. Ezinye i-DMARD zemveli ziquka i- Arava (i-leflunomide) , i- Plaquenil (i-hydroxycholorquine) , ne- Azulfidine (i-sulfasalazine) . I-Gold kunye ne- Imuran (azathioprin) iyafumaneka kodwa ayifuni ngokuqhelekileyo ukuba i-rheumatoid arthritis. Iimpembelelo zeMveli zeMveli zichaphazela isistim somzimba , ngoko ke kunokuba nzima kunzima ukulwa nesifo kwaye kukho umngcipheko okhulayo wokuphucula ii-cancer. Kumele uqaphele ingqalelo kwimiphumo emibi kunye nezilumkiso ezinxulumene ne-DMARD. Ngokuqhelekileyo, iimvavanyo zegazi ngezikhathi ezithile ziyalelwa ukuba zihlole umsebenzi wesibindi kunye nokuzaliswa kwegazi.
Biologic DMARD
Iziyobisi ze-Biologic , ezibizwa ngokuba yi-Biologic DMARD okanye i-Biologic Response Modifiers, ziyeza unyango oluye lwadalwa ukukhusela okanye ukunciphisa ukuvuvukala okulimaza amalunga. I-biologics ijolise ngqo kwiimodeli kumaseli omzimba kunye neemveliso ezifihliweyo kwidibeneyo ezibandakanyekayo ekubangela ukuvuvukala kunye nokutshabalalisa.
Kukho iintlobo ezininzi zezinto eziphilayo, ngasinye sinomxholo othile. Iithagethi ziquka i- tumor necrosis factor (TNF) , i-interleukins (IL-1, IL-6, IL-12, kunye ne-IL-23), iiseli ze-B kunye neeseli ze-T. Iziyobisi ze-Biologic zibiza kakhulu, kodwa uncedo lwemali lufumaneka kubantu abafanelekileyo. Amachiza alawulwa ngumngxowuni okanye umjovo. Ngenxa yesiphumo sezinto eziphilayo kwi-immune system, ezinye iziphumo ezingathandekiyo nezibi kakhulu ziyakwenzeka.
DMARD ezincinci ezijolisiweyo
Iklasi elitsha lonyango le-rheumatoid arthritis "lijoliswe kwi-molecule ye-DMARD" ephazamisa ukubonakaliswa kwe-intracellular. Ngokuphazamisa iimpawu ezithile ze-intracellular, kunokwenzeka ukuba ulandelelanise imisebenzi ethile yeseli, kuquka i-receptors yomhlaba, ukusayina amaprotheni kunye nokubhaliselwa kweeprotheni zenyukliya. Ngokwenza njalo, ukuziphatha kweentlobo zeeseli ezijoliswe kuyo kunokuchaphazeleka okanye kuthinteke.
Iithagethi zentshisekelo ebalulekileyo kubaphandi, ngenjongo yokunyanga izifo ezizimelayo kunye nezivuthayo, ziquka i-kinase ehlobene noJanus, i-tyleenine kinase, i-phosphodiesterase-4, i-tyrosine kinase ye-Bruton kunye ne-phosphatidylinositol-3 kinase. Iilingo zoluntu zifunekayo ukuchonga ubunako beenjongo nganye. I-JAK (uJanus kinase) inhibitors yona nto iphuhlisiwe kwaye enye i-FDA-ivunyiwe, i-Xeljanz (tofacitinib).
ILizwi
Abanye abantu abane-arthritis ye-rheumatoid bayayesaba imithi, ngokukodwa ngenxa yeziphumo ezinobungozi, ezinye zazo ezinokuba nzima. Ngokuqinisekileyo kubalulekile ukuvavanya iingenelo kunye nobungozi bamayeza kunye nogqirha wakho.
Khawucinge ngezinga lakho langoku yesifo kwaye wenze isigqibo malunga neenjongo zonyango kunye nogqirha wakho. Mhlawumbi, uya kutyunjwa ulunye udibaniso lwezinto ezikhoyo ezichazwe ngasentla. Gcina idayari yomqondiso emva kokuba uqalise amayeza ukuze uncede ukuba uhlole ukuba asebenza kakuhle kuwe. Yiba nolwazi malunga neziphumo zempembelelo kwaye ungabika into engavamile kudokotela wakho.
> Imithombo:
> IArthritis Namhlanje. Isikhokelo seDrama 2016. Ishicilelwe yiArthritis Foundation.
> Kelly, V. kunye noGenvese, M. Novel i-molecule yonyango kwi-rheumatoid arthritis. I-Rheumatology (Oxford) (2013) 52 (7): 1155-1162.
> Kelley's Bookbook yeRheumatology. I-ninth edition. Elsevier.