Ukulawula iiMpawu kunye neZenzo eziPhantsi
I-Gout yindlela ye-arthritis ebangelwa i-buildup kunye ne-crystallization ye-uric acid edibeneyo. Ngokuxhomekeka kubuqili bokuhlaselwa, unyango lunokubandakanya izidakamizwa ezichasene ne-anti-inflammatory (anti-inflammatory drugs) zokunciphisa intlungu, kunye nokuguqulwa kokuziphatha (ezifana nezithintelo zokutya kunye notywala) ukwenzela ukunciphisa amaxesha okuhlaselwa. Ukuhlaselwa okungapheliyo kunokufuna imithi yonyango ukunceda ukunciphisa izinga le-uric acid egazini.
IziPhulo zaseKhaya kunye nokuPhila
Iimpawu zeGout zibangelwa ukuqokelela ngokweqile kwe- uric acid , imeko ebizwa ngokuba yi- hyperuricemia . Ngokuhamba kwexesha, ukwakheka kungakhokelela ekwakheni i-uric acid crystals kunye nokujikeleza ukudibanisa, okubangela ukuba kubekho iintlungu ezinzima kunye nexesha elide elinokubandezeleka.
Ngaloo ndlela, unyango lwe-gout luya kugxila kwizinto ezimbini: ukunciphisa i-uric acid kunye nentlungu yokunciphisa i-gout. Kukho inani lezonyango zasekhaya kunye nokulungiswa kwendlela yokuphila enokukunceda.
Ulawulo lwezinhlungu
Ukuhlaselwa kwe-gout kuya kudla ukususela kwiintsuku ezintathu ukuya kwi-10. Intlungu ngexesha lokuqala lokuhlaselwa (ngokuqhelekileyo iiyure ezingama-36 zokuqala) ziya kuba zibi kakhulu.
Phakathi kokukhethwa kwonyango:
- Iphakheji yeqhwa okanye i-compress yokubanda inokubonelela ngokukhululeka kokuhlaselwa. Qinisekisa ukufaka ipakethe ye-ice kwipilisi elincinci kwaye usetyenzise ukudibanisa imizuzu eyi-15 ukuya kwe-20 ukukhusela i-frostbite. Unokwenza oku ngexesha elithile ngosuku.
- Phumla idibeneyo. Ekubeni inzondo enkulu ihlala ichaphazelekayo, iphakamisa unyawo ukunciphisa uxinzelelo oluchanekileyo. Gcina iinyawo zakho ngokungangoko kunokwenzeka, kwaye, ukuba ufuna ukufuduka, sebenzisa umkhwa.
Ukungenelela ngeZidlo
Esinye sezizathu eziphambili ze-hyperuricemia yinto esiyidlayo. Ezinye ziqulethe amanqanaba aphezulu e-organic compound eyaziwa ngokuba yi- purine , ekhutshwe phantsi, iguqulwa ibe yi-uric acid.
Ezinye ziqulethe izinto eziphazamisa ukuphuma kwe-uric acid kwizintso.
Nangona kungekho bungqina bokuba ukungenelela kokutya kunokunciphisa ubunzima okanye ixesha lokuhlaselwa, kufuneka wenze umgudu wokuphepha ukukhubaza imeko yakho.
Kule nto, uya kufuneka:
- Yeka ukusela utywala nayiphi na uhlobo, ngakumbi ubhiya.
- Gwema ukutya okuphezulu .
- Gwema iziphuzo ezinomsoco eziqhambileyo ezonakalisa i-uric acid excretion.
- Phuza amanzi amaninzi ukuze unciphise umxube we-uric acid egazini lakho.
I-Over-the-Counter (OTC)
Iimithi ze-OTC ziqhelekileyo zisetyenziswe ngexesha lokuhlaselwa okulula kuya kuluhlu lokunciphisa intlungu kunye kunye nokuvuvukala. Phakathi kwezi ndlela:
- Izidakamizwa ezichasene nezidakamizwa (i-NSAID), njenge-Aleve (naproxen) kunye ne-Advil (ibuprofen), isebenze ngokuthintela i- enzyme ye-COX ngendlela efana ne-analgesic (intlungu yokuxhoma) kunye ne-anti-inflammatory.
- I-Tylenol (i-acetaminophen) ingasetyenziswa kwiimeko ezinzima. Nangona ingenazo izakhiwo ezichasayo ze-NSAID, isisifo esichaphazela kakhulu.
- Amalungiselelo e-capsaicin esicatshulwayo , eyenziwe kwimizimba yeekhemikhali efumaneka kwi-pepper, iye yaboniswa ukubonelela ngokukhululeka kweempawu ze-gout. Zifumaneka iikrams, i-lotions, kunye neentambo ezithintekayo kwaye ziyafumaneka ngokukhawuleza kwi-counter.
Imigaqo
Izidakamizwa zamagqirha ziqhele ukusetyenziswa xa iindlela zokutya neendlela zokuphila zingaphumeleli ukubonelela kunye / okanye kukho ubungqina bokunyuka komonakalo. Imithi yokugonywa esetyenziselwa ukuphatha igulane ingabhidlizwa ngokubanzi zibe zimbini iintlobo: ukuchasana nokuvuvukala kunye ne-uric acid-ukunciphisa.
Izidakamizwa ezichasayo
Imithi echasene ne-inflammatory commonly used to treat gout ingabe isetyenziswe ngokuqhubekayo okanye isetyenziswe xa kuyadingeka ukunciphisa iimpawu ezinzima. Phakathi kwezi ndlela:
- I-Colchicine isilwanyana esisilumko esichasayo esisetyenziselwa ukunyanga igulane elingapheliyo. Isilwanyana sisebenza ngokuthintela i-enzymes evuthayo ebangela ukwakhiwa kwamakristali e-uric acid. I-Colchicine ingasetyenziselwa yodwa kodwa ichaneke ngokuqhelekileyo eceleni kwesicatshulwa sokunciphisa i-acid njengeprobenecid. Iziphumo ezichaphazelekayo zibandakanya uhudo, isicathulo sesisu, kunye nezikhonda zesisu.
- Ii-Corticosteroids , ezithathwe ngomlomo okanye ngejoyiyi, zibonelela ngoncedo olufutshane lweempawu ezinzima. Isilwanyana sisebenza ngokunyusa umzimba wokhuseleko lomzimba kwaye, njengenjalo, ayikwazi ukusetyenziswa njengoluhlobo lwonyango oluqhubekayo. Ukunyangwa komlomo (ngokuqhelekileyo kunye ne-drug prednisone ) kunokumiselwa ngaphezu kweentsuku ezintlanu. Iilenjini zeCorticosteroid zixhaphake kakhulu xa kukho ubungqina be-arthritis kunye nokukhula komzimba. Ukusetyenziswa ngokugqithiseleyo kunokukhokelela ekuzuzeni ubunzima, ukunyunyuza lula, i-osteoporosis, iingxaki zamehlo, uxinzelelo lwegazi oluphezulu kunye nokwanda komngcipheko wokusuleleka.
- I-Qutenza (i-capsaicin) i-patch ye-8.0 yepesenti inokubonelela ngokukhululeka kweentlungu ngexesha lokuhlaselwa kwamandla. Imiphumo emibi ibandakanya ukuphendulwa kwendawo yesicelo, kubandakanywa ukutshisa, ukutshabalalisa, ubomvu, ukuvuvukala, kunye nokugqithisa.
I-Uric Acid-Reducing Drugs
Ukuba ezinye iindlela zokungenelela zihluleka ukunciphisa amanqanaba e-uric acid, oogqirha baya kuhlala beza kumachiza anokunciphisa ukukhutshwa kwe-acric acid okanye ukwandisa ukuphuma kwe-uric acid emzimbeni.
Kukho izidakamizwa ezihlanu ezivunyiweyo yi-US Food and Drug Administration kule njongo:
- I-Probenecid yonyango lomlomo elithathwe imihla ngemihla ukunceda iintso zakho zisuse i-uric acid. Nangona iphumelele ekunciphiseni iimpawu, inokuthi ithathe ixesha ngaphambi kokuba izidakamizwa zisebenze. Kwezinye iimeko, ukuhlaselwa kwe-bout kunokunyuka ngexesha leenyanga ezintandathu ukuya kwi-12 de kube umzimba ulungele unyango.
Iziphumo ezichaphazelekayo zibandakanya amatye weentso , isicupunu, ukugqithisa, isisu, kunye nentloko. Ithebhulethi eyenziwe ngokubhaliweyo ebizwa ngokuthi iColBenemid iyafumaneka kwakhona edibanisa iprobenecid kunye ne-colchicine.
- Uloric (febuxostat) ngumlomo we-xanthine oxidase inhibitor (XOI) eyanciphisa umveliso womzimba we-uric acid. Kuthatyathwa imihla ngemihla, i-Uloric inokunciphisa ubunzima kunye namaxesha amaninzi okuhlaselwa. Ukuqhafaza kuqhelekile xa kuqala uqala unyango. Nangona zikhona, kufuneka uqhubeke nokuthatha amachiza njengoko kuchaziwe.
Iziphumo eziqhelekileyo ezibandakanya izibilini, iintlungu ezidibeneyo, kunye ne-muscle ache. Ungathathi i-Uloric ukuba usebenzisa i-azathioprin (esetyenziselwa ukuphatha i-rheumatoid arthritis) okanye i-mercaptopurine (esetyenziselwa ukuphatha i-lymphoma, isifo sika-Crohn, okanye isifo se-ulcerative colitis). - I-Zyloprim (allopurinol) yenye yeziyobisi ze-XOI zomlomo. Njengoko u-Uloric, ukutshatyalaliswa kweempawu kungenzeka ngexesha lokuqala unyango. Ukuthintela oku, isilwanyana sisoloko sichazwe kwii-dosages ezisezantsi kwaye koko ngokunyuka kwanda.
Imiphumo emibi ingaphantsi kakhulu kunezinye izidakamizwa zokunciphisa i-uric kwaye ingabandakanya ukugqithisa kunye nesisu esicasulayo. Iingxaki zesisu zihlala zihamba njengoko umzimba wakho ulungelelanisa unyango. - I-Zurampic ( lesinurad ) yisidakamizwa esisemlomo esandisa imiphumo ye-XOI xa i-XOI yedwa yanele. Ingathathwa kunye ne-Uloric okanye i-Zyloprim kodwa kufuneka isetyenziswe ngokuqaphela njengoko inokunyusa ingozi yakho ye-cardiovascular. Uya kufuneka kwakhona uhlale uhlaziye kakuhle ukuze ukhusele amatye eentso.
Imiphumo emibi ingabandakanya intloko yesifo, umkhuhlane omncinci, i-accle muscle, intlungu edibeneyo kunye ne-acid reflux. I-Lesinurad iphinda ifumaneke ne-allopurinol kwipilisi ebizwa ngokuba yiDuzallo. - I-Krystexxa (i-pegloticase) iyisicatshulwa esitsha se- biologic esithunyelwa ngokunyuka kwe-intravenous into vein kwaye isetyenziselwa kuphela xa ezinye iindlela zonyango zihlulekile. I-Krystexxa isebenza ngokuguqula i-uric acid ibe yinto ebizwa ngokuthi i-allantoin ekhishwa ngokukhawuleza emzimbeni. Ilawulwa rhoqo kwiiveki ezimbini kwiiklinikhi kwaye ngoko ke igcinelwe kuphela iimeko ezinzima kakhulu.
Iziphumo eziqhelekileyo ezichaphazelekayo zibandakanya ukutshatyalaliswa kwexesha elifutshane, isicupunu, ukutyumza, umqala, ukumbamba, intlungu yesifuba nokuhlanza. Kwiimeko ezinqabileyo, isenzo esichukumisayo siphumelele.
Ezinye iziyobisi ezincedisayo zingasetyenziselwa unyango lwe-gout, kuquka neCozaar (losartan), iziyobisi ezinqamlekileyo, kunye neTricor (i-fenofibrate), isilwanyana esiphantsi kwe-lipid. Bobabini banokunceda ekunciphiseni izinga le-serum uric acid.
> Imithombo:
> Anaud, P. kunye noBley, K. "I-capsaicin yeengqungquthela yokulawulwa kwintlungu: amandla kunye nokusetyenziswa kwe-new-concentration capsaicin 8%." Br J Anaesth. 2011; 107 (4): 490-502. INGXELO: 10.1093 / bja / aer260.
> Hanier, B; UMatheson, E. noWilke, T. "Ukuxilongwa, unyango kunye nokukhuselwa kweGout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. noBarden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. INGXELO: 10.1016 / S0140-6736 (09) 60883-7.