Osteoarthritis unyango
Abantu abangaphezu kwezigidi ezingama-27 e-US banama-osteoarthritis . Ngokukodwa, ngokwemiGangatho yokuLawula nokuVimbela (i-CDC), i-osteoarthritis ithintela kuma-13.9 ekhulwini abantu abadala abaneminyaka engama-25 ubudala nangaphezulu kunye nama-33.6 ekhulwini abantu abadala 65 nangaphezulu. Uhlobo oluqhelekileyo lwe-arthritis. Amadolo , izandla , iinyawo , isisu kunye nomgudu ngamalungu amaninzi achaphazelekayo yi-osteoarthritis.
Abantu abane- symptomatic osteoarthritis badinga unyango olusebenzayo ukulawula intlungu edibeneyo, ukuqina, ukuvuvukala kunye nezinye iimpawu.
Ezinye iinjongo zonyango ziquka ukugcina okanye ukuphucula umsebenzi ohlangeneyo, ukunciphisa ukukhubazeka, nokuphucula umgangatho wobomi.
Abantu abanesifo badla ngokudideka ngamanyathelo amaninzi kunyango-kwaye ngokunyanisekileyo, banqwenela ukunqumla into engasebenzi kwaye ugxininise kwintoni. Asikho isisombululo esinye kubo bonke, kodwa abaphandi baye bavelisa izikhokelo zonyango lwe-osteoarthritis.
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Yintoni eyahlukileyo phakathi kwe-Advil and Aleve?
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Ukusebenzisa i-Viscosupplement Hyalgan yokuphatha i-Knee Osteoarthritis
Kukho iinkqubo ezingonyango ze-pharmacologic (ezingekho iziyobisi) zonyango lwe-osteoarthritis, unyango lwe-pharmacologic (iziyobisi), unyango lwemihla ngemihla, iil injini zangaphakathi, ukuguqulwa kwendlela yokuphila-kunye neyokugqibela, ukuhlinzwa.
Ngo-2012, i-American College of Rheumatology (ACR), ipapashwe nge-pharmacologic kunye ne-non-pharmacologic yeengcebiso zonyango kwisandla, i-hip, namadolo. Iphaneli yeengcali zeklinikhi zanikezela isincomo esinamandla, isincomo esinemiqathango, okanye akukho ncomo lwezinto ezithile zokonyango. Ukuba kuthathwa njengesincomo esinamandla, ubungqina obuphezulu obufunekayo, kunye nobungqina obuncedo kakhulu kunoma yimuphi umngcipheko ochaphazelekayo kunyango.
Isiphakamiso esinyanisiweyo sasinxulumene nokungabikho kokwanela ubungqina obuphezulu obufanelekileyo okanye ubungqina obungafani nakakhulu xa kunzima ukuxhamla kunye neengozi. Ukuba akukho nconywa enikezelwayo, kukho idatha engonelanelekanga okanye akukho datha esuka kwiimvavanyo zeclini ezilawulwe ngokungapheliyo.
Isandla (i-Pharmacologic Treatment Options)
Akukho ziphakamiso ezinamandla ezenziwe yiingcali ezinxulumene ne-ACR kule candelo lonyango. Iingcali ziphakanyiswe ngokusemthethweni ukusetyenziswa kwesinye okanye ngaphezulu kwezi zikhetho zonyango ezilandelayo:
- capsaicin
- ii-NSAID zeengqungquthela , kuquka i-sallamine salicylate
- I- NSAID yomlomo, kuquka i- COX-2 inhibitors
- Ultram (tramadol)
Iphaneli yecandelo leengcali licebisa ukuba ezi zilandelayo zingasetyenziswa:
- zonyango lwe-intra-articular
- iilpiyoid medgesic medication
Kwakhona, kwakunyanzeliswa ngokwenkqubo ukuba abantu abane-osteoarthritis abaneminyaka engama-75 ubudala okanye ngaphezulu bafanele basebenzise ii-NSAID zemixholo kunokuba zi-NSAID zomlomo.
Isandla (Ungekho-Pharmacologic Treatment Options)
Kwakungekho ubungqina obaneleyo bokufumana iziphakamiso ezinamandla kule nkcazo yonyango kwakunye, kodwa iziphakamiso ezinemiqathango zenziwe.
I-ACR imeko ikhuthaza ukuba abaqeqeshi bezempilo (umboneleli oyintloko, umgulana womzimba okanye umphathiswa wezemisebenzi) kufuneka:
- ukuvavanya amandla omguli ukwenza imisebenzi yokuphila kwansuku zonke
- ukunika umyalelo kwizixhobo zokukhusela ngokudibeneyo
- ukubonelela ngezixhobo zokuncedisa ukuze zisincede ngemisebenzi yokuphila kwansuku zonke
- unikeze umyalelo wokusetyenziswa kwemimiselo ye- thermal (oko kukuthi, ukushisa nokubanda)
- unikezela izibalulelo kubantu abane-trasteziometacarpal joint joint osteoarthritis (isiseko sesithupha )
I-Hip (Pharmacologic Treatment Options)
Akukho ziphakamiso ezinamandla ezenzelwe ukhetho lokuqala lwe-pharmacologic ukunyanga i-hip osteoarthritis. Iingcebiso zemiqathango ziquka ukusetyenziswa kwesinye seyeza kulandelayo unyango:
- acetaminophen
- NSAID zomlomo
- tramadol
- injini zeerticular corticosteroid
Iingcaphephe zemeko zicebisa ukuba ezi zikhetho zonyango alandelayo zingasetyenziselwa i-hip osteoarthritis:
Akukho ndululo esenziwe malunga nokusetyenziswa kwe:
- iiNSAID zeengqungquthela
- ii- injection ze hyaluronate
- I-Cymbalta (duloxetine)
- iilpiyoid medgesic medication
I-Hip (engekho-Pharmacologic Treatment Options)
Iingcali zincoma kakhulu ukuba abantu abane-hip osteoarthritis:
- ukuthatha inxaxheba kwisenzo somzimba okanye sokumelana nomhlaba, okanye zombini
- bathathe inxaxheba ekusebenziseni amanzi
- ukulahlekelwa isisindo, ukuba kuninzi
Iingcali ziphakamisa ukuba abantu abane-hip osteoarthritis:
- ukuthatha inxaxheba kwinkqubo yokulawula ukuzimela
- fumana unyango olusesikweni (ukuhlalisa umzimba) kunye nokuzivocavoca
- fumana ukungenelela kwengqondo
- fumana umyalelo malunga nokusetyenziswa kweendlela zokuhamba
- ukufumana nokusebenzisa izixhobo zokuhamba , njengoko kuyimfuneko
Iingcali azizange zinike iingcebiso malunga nolu hlobo lulandelayo lwenyango:
- ukulinganisela ukuzivocavoca, yedwa okanye idibaniswe nokuziqinisa
- tai chi
- yonyango unyango kuphela
I-Knee (i-Pharmacologic Treatment Options)
Akukho ziphakamiso ezinamandla zokuqala unyango lwe-osteoarthritis. Iingcaphephe zemeko zicebisa ukuba enye yezi zinto zilandelayo zisetyenziswe:
- acetaminophen
- NSAID zomlomo
- iiNSAID zeengqungquthela
- tramadol
- injini zeerticular corticosteroid
Iingcali ziphakamisa ukuba abantu abane-osteoarthritis ngamadolo AYisebenzisi:
- sondatein sulfate
- glucosamine
- capsaicin
Akukho ndululo ezenziwe ukusetyenziswa kwe-hyaluronate intra-articular, i-duloxetine, okanye iyeza-opioid.
I-Knee (I-Non-Pharmacologic Treatment Options)
Iingcali zincoma kakhulu ezi zilandelayo ezikhethiweyo zonyango ezikhethiweyo kubantu abanama-knee osteoarthritis:
- ukuthatha inxaxheba ekusebenziseni i-aerobic okanye ukunyanzeliswa kokusetyenziswa komhlaba, okanye zombini
- bathathe inxaxheba ekusebenziseni amanzi
- ukulahlekelwa isisindo, ukuba kuninzi
Iingcaphephe zengqondo zikhuthaza ukuba abantu abane-knee osteoarthritis:
- ukuthatha inxaxheba kwinkqubo yokulawula ukuzimela
- ufumana unyango olusesikweni kunye nokuzivocavoca
- fumana ukungenelela kwengqondo
- sebenzisa i-patellar ephathekayo
- bembatha i-insoles edibeneyo (xa ixilongo yecalaal osteoarthritis)
- kunxiba i- subtalar edibeneyo ngokukhawuleza ibophe insoles (ukuba uxilongo lugqirha lwe-osteoarthritis)
- fumana umyalelo malunga nokusetyenziswa kweendlela zokuhamba
- fumana kunye nokusebenzisa izixhobo zokuhamba, ukuba kubonisiwe
- bathathe inxaxheba kwinkqubo ye-tai
Akukho siphakamiso esinikezelwa:
- ukulinganisela, ukuphela okanye ukudibanisa nokuqiniswa kokusebenza
- begqoke i-insol lateral wedding
- ukufumana unyango lonyango kuphela
- bembethe iidolo
- usebenzisa i-patellar ephathekayo ngokulandelelana
Kwakhona kwakukho iindlela ezimbini zokonyango eziye zacetyiswa kuphela NGABANTU abantu abanama-knee osteoarthritis abanesifo esiqhathaniswayo kunye nentlungu yokuguqulwa kwamadolo kodwa bengenakukwazi okanye bangakwazi ukungena kwinkqubo:
- kwi-Chinese acupuncture
- ukukhutshwa kombane
Unyango lwalamanye amajoyina
Nangona iinyawo kunye nomgudu, kunye namanye amalunga, awazange afakwe kwiingcebiso zonyango ezivela kwi-American College of Rheumatology, ezininzi izikhokelo zisebenza kunoma yiphina into echaphazelekayo-ngokukodwa iingcebiso ze-pharmacologic. I-osteoarthritis yomgudu ivela xa kukho ukungonakaliswa kwidiski phakathi kwama-vertebrae. Uninzi lwabantu abaneengxaki ze-diserative degenerative aludingi ukuhlinzwa kwaye bancedwa ngokwaneleyo ngamanyango okulondoloza. Nangona imilinganiselo yokulondoloza ingaphumeleli, kunjalo, ukhetho oluchanekileyo lunokuquka i-lumbar laminectomy, i-discectomy, okanye i-spinal fusion .
Njengamanye amalunga, unyango lweenyawo lwe-osteoarthritis lujolise ekuphumuleni kweempawu. Ukugqithwa kwamathambo okanye inkxaso yeenyawo kunokunceda. Ukulahlekelwa isisindo xa ukugqithisa kunokuba luncedo kuzo zonke izilingo zokunyamezela. Ukuba ukhetho lwezonyango olungapheliyo aluphumelelanga ukuphendula impendulo eyaneleyo, utyando lunokuthatyathwa njengento yokugqibela. I-Arthroscopy , i- arthrodesis (i-fusion), okanye i-arthroplasty (ukutshintshwa ngokubambisana) ingathathwa ingqalelo, kuxhomekeke kumdibaniselwano ochaphazelekayo enyawo okanye enqeni. Injongo yokuhlinzwa ngenyawo kukunciphisa intlungu kunye nokuphucula umsebenzi ohlangeneyo.
ILizwi
Iikholeji ze-American College of Rheumatology zonyango lwe-osteoarthritis zisekelwe kububungqina obunokufumaneka ngo-2010. Iphaneli yeengcali zazibandakanya oogqirha bezonyango, ii-physiatrists, i-geriatricians, i- rheumatologists , ugqirha wamazinyo, kunye neengcali zempilo. Iphaneli edibeneyo yanikezela ngombono wezifundo ezahlukeneyo ukuvavanya ubungqina.
Iziphakamiso zibalulekile kuba kukho iindlela ezininzi zokonyango kwe-osteoarthritis-kunye nesiphakamiso malunga nokuqala apho kuyimfuneko. Uninzi lwabantu abaxilongwa nge-osteoarthritis basebenzisa inzululwazi ye-pharmacologic kunye neyiyo-pharmacologic.
Ukunikezele ngolu xwebhu lwenkcukacha ngoba kulula ukuyiqonda kwaye luyakukuvumela ukuba uxoxe ngeendlela zakho zokuqala unyango kunye nodokotela wakho. Ukuba impendulo yakho ayinelanga, unokukwazi ukubona ezinye izinto ozikhethayo. Kwaye, ukulungiselela unyango oluthile, kukho iziqhagamshelana nolwazi olubanzi.
> Imithombo:
> Hochberg MC, Altman RD, uEpreli KT, et al. Ikholeji yaseRamerika yeRheumatology 2012 Iziphakamiso zokusetyenziswa kwee-Nonpharmacological and Pharmacologic Therapies kwi-Osteoarthritis ye-Hand, Hip, ne-Knee. Ukunyamekela kweArthritis noPhando . 2012; Vol. 64 No. 4, iphe. 465-474.
> Kalunian KC. I-Pharmacologic yokuqala ye-Osteoarthritis. Isemgangathweno. Ukuhlaziywa ngoMeyi 19, 2016.
> Moskowitz RW, et al. I-Osteoarthritis - Ukuxilongwa kunye noLawulo lwezoNyango / loPhando. Umqulu wesine. LWW.