Iindlela eziqhelekileyo zokuPhathwa kweNtsholongwane kaGawulayo
Ukunyangwa iintlungu ezingapheliyo kunokuba ngumngeni, kuba isizathu asiqondanga ngaso sonke isikhathi. Ama-painkillers endabuko asetyenziswa yedwa, njenge-NSAID, ayedla ngokuphumelela ekuphatheni olu hlobo lentlungu; Nangona kunjalo, indlela yokwelapha i-multimodal ingakwazi ukugcina iimpawu zentlungu ephantsi kokulawula okungcono. Le ndlela ifaka phakathi i-painkillers yendabuko, imithi yentlungu engapheliyo kunye nezinye iintlobo zonyango ezinxulumene nentlungu.
Ukwelashwa Kweentlungu Ze-Neuropathic - Ii-Adjuvant Analgesics
Ama-analgesics adjuvant , afana ne-anticonbulsants kunye ne-anti-depressants, anokuhlala elwa neentlungu zesifo se-neuropathic. Ngenxa yokuba la mayeza ayenzelwe ukunyanga iimeko ngaphandle kweentlungu, ukusetyenziswa kwabo kwonyango lwe-neuropathic ebizwa ngokuba yi-off-label. Kodwa ungakuvumeli ukuba kukukhathazeke: amaninzi amanqaku ahlaziyileyo aqinisekisile ngakumbi ukuphatha iimpawu zentlungu engapheliyo kunezidalwa zephilisi zendabuko.
I-Anticonvulsants ezisetyenziselwa unyango lweentlungu:
- IGabapentin (Neurontin)
- Pregabalin (Lyrica)
- Carbamazepine (Tegretol)
- Oxcarbazepine (Trileptal)
- Phenytoin (Dilantin)
- Valproate (Depacon)
- Lamotrigine (Lamictal)
Iintsholongwane ezixhatshazwayo ezisetyenziselwa unyango lweentlungu:
- Amitriptyline (Elavil)
- Nortriptyline (Aventyl)
- Desipramine (i-Norpramin)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
- Fluoxetine (Prozac)
- I-Paroxetine (Paxil)
- I-Duloxetine (iCymbalta)
- Venlafaxine (Effexor)
Ukwelashwa Kweentlungu Ze-Neuropathic - AbaPailill Traditional
Kwiimeko ezininzi, iipilisi zendabuko zodwa azikwazi ukulawula iimpawu zentlungu engapheliyo .
Oku kungenxa yokuba abaninzi abanomdabu be-painkillers, njenge-NSAID, bajolise ekuvukeleni, okungenzeka okanye kungabi yimbangela yeentlungu zentlungu. Nangona kunjalo, abanye abadliwayo bendabuko banendima ekwenzeni unyango olungapheliyo. Zingasetyenziswa xa ama- analgesics adjuvant ayisebenzanga, okanye ahlanganisana ne-anticonvulsants okanye i-anti-depressants.
- NSAID . I-NSAID kuphela ayinakusebenza ngokuphatha ubuhlungu be-neuropathic ; Nangona kunjalo, kubantu abathile, ukuvuvukala kwenza iimpawu zentlungu zibi kakhulu. Ii-NSAID, ezifana ne-ibuprofen (Advil) okanye i- naproxen (i- Aleve ), inokudibaniswa nezinye iintlungu zonyango kwaye zinokunceda ukulawula intlungu.
- Acetaminophen . I-Acetaminophen (iTylenol) ingasetyenziselwa ukudibanisa nama-analgesics adjuvant ukulawula intlungu ye-neuropathic, okanye ingasetyenziselwa iziqwenga zentlungu . Ezinye i-opioids ezisetyenziselwa unyango lwe-neuropathic ziba ne-acetaminophen.
- Opioids . I-opioids inokumiselwa ukuba unyango olunzulu lwe-neuropathic, okanye njengomgca wokugqibela wokuzikhusela xa izilwanyana ezihlaziyiweyo ze-adjuvant zihluleka ukunciphisa intlungu. I-opioid "ebuthakathaka" eqhelekileyo echazwe ngokubandezeleka kwe-neuropathic yi- tramadol (Ultram); nangona kunjalo, ii-opioid ezinamandla zisenokufuneka.
- Uhlalutyo lweengqungquthela . Ngelixa lisoloko lisebenza kakuhle, abanye abantu abaneentlungu zentsholongwane bafumana imiphumo yonyango lwangaphandle, kuquka i-lidocaine kunye ne-capsaicin. Iimpawu ze-analgesics zingabandakanywa nezinye iyeza.
Ukwelashwa Kweentlungu Ze-Neuropathic - Ezinye iindlela
Imithi ayiyiyo kuphela impendulo xa kufikelele ekunyilweni kwentlungu ye-neuropathic. Ezinye iindlela ezingasetyenziselwa yedwa, okanye ngokudibanisa ne-painkillers, zibandakanya:
- Ulungiso lwenyama
- Iibhloko zentsholongwane
- Ukuvuselela intambo yomtya
- Utyando lwe-decompression operation
Iyeza elongezelelweyo kunye neyezinye (CAM) linokukunceda ekunyilweni kweentlungu ze-neuropathic, kubandakanywa nokunyangwa kwamathambo kunye neyeza zonyango . Nangona ezininzi ze-CAM azidingi imithi, kufuneka uqhubeke uthetha nodokotela wakho ngaphambi kokuba uqalise nayiphi na indlela unyango oluneentlungu zakho.
Imithombo:
I-Guideline Clearinghouse kaZwelonke. Izikhokelo ze-EFNS kwi-Pharmacological Treatment ye-Neuropathic Pain. http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10472&nbr=5495
Isiseko seSizwe soPhando. Ubuhlungu be-Neuropathic: Imithi. http://www.painfoundation.org/
I-Merck Manuals iTree Library yeLayibrari. Ubuhlungu be-Neuropathic. http://www.merckmanuals.com/professional/neurologic-disorders/pain/neuropathic-pain