Amachiza, iinguqu zokuphila zixhomekeke kwiFomment Frequency
Unyango lwe- syndrome yemilenze engapheliyo (i-RLS) incike ngokukodwa kwiimpawu zeempawu kwaye kukho iindlela ezininzi, kuquka imithi kunye neenguqu zokuphila. Ngenjongo yokukhetha unyango ofanelekileyo, kufuneka uqaphele ukuba iimpawu zakho ziphakathi, imini, okanye i-refractory kunyango. Ngokuqhelekileyo, abo abaneempawu eziphakathi kufuneka basebenzise ukuguqulwa kwendlela yokuphila, imichiza echaphazela amazinga e-dopamine, i-opioids ye-dose ephantsi, okanye i-benzodiazepines.
Ukuba iimpawu zemihla ngemihla, i-gabapentin inokuba yinto eyongezelelweyo eyongezelelweyo. Ekugqibeleni, ukuba unempawu ezingaphenduliyo kumachiza, ungadinga ukuzama imveliso eyahlukileyo okanye yeyesibini.
Dopamine Iziyobisi
Ulwaphulo lokuqala lwezonyango zokuphulukana nemilenze yiziyobisi ezinokuchaphazela amazinga e-dopamine. Oku kunokufezwa ngokutshintshwa kwe-dopamine ngokuthe ngqo (kunye neziyobisi ezibizwa ngokuba yi-levodopa) okanye ngamachiza anyukisayo amanqanaba e-dopamine yangaphakathi ngokutshintsha indlela umzimba owusebenzisa ngayo. I-Levodopa ineziphumo ezinobungozi, kubandakanywa isicaphulelo, ukukhawuleza, nokulala. Ukongeza, i-levodopa inokukhokelela ekunyuseni, apho iimpawu ezinokuthi zenzeke ngaphambili kwimihla, ziba nzima kakhulu, okanye zisasazeka kwiingalo. Oku kungaphathwa ngokungongeza i-dose yangaphambili, kodwa ukuba iqhubeka i-levodopa kufuneka imiswe okanye idosi inciphise. Ngenxa yezi ngxaki, amayeza athiwa yi-dopamine agonists ahlala ekhethwa.
I-dopamine agonists ifaka imishanguzo efana ne- pramipexole (igama lophawu lwegama elithi Mirapex) kunye ne-ropinirole . Oku akunakwenzeka ukuba kubangelwe imiphumo emibi njengokongeza. Kukho nobunzima obunzima kunye nokukhathala, kodwa oku kusisombululo emva kweeveki ezimbalwa zonyango. Imiphumo engaphantsi kwemihla ibandakanya ukunyuka kwamanzi, ukuzitywa, ukulala , kunye ne-edema yomlenze.
Ukongezelela, kukho amathuba okwanda komngcipheko wokulawula ukunyakaza okungaquka ukugembula, ukutya okanye ukuthenga, okanye u-hypersexual.
Kukho eminye imithi emithathu engasetyenziswanga ngokuqhelekileyo enokuchaphazela amazinga e-dopamine ebizwa ngokuthi i-bromocriptine, i-gold, ne-cabergoline. Ezi zisetyenzisiweyo kaninzi ngenxa yezinto ezinqabileyo (kodwa ezinokuthi zinzulu) iingxaki ze-fibrosis (ukunqunyulwa) kweentsimbi zentliziyo. Ngenxa yeengxaki, i-perdri ayitholakali e-United States. I-Cabergoline ayivunyelwe i-FDA yokwenza unyango lwe-RLS, kodwa ngamanye amaxesha isetyenzisiwe ngaphandle kweleyile kule njongo. Kungabangela isicupunu, ukumbomboza, intloko yesisu, utywala, ukukhathala, okanye ukulala.
Opioids
Iimvumi ze-opioid zisetyenziselwa ukunyanga iintlungu ezidityanisiweyo, kodwa zinokuba luncedo ekwenzeni unyango lwe-RLS. Ezinye zeendawo ezisetyenziswayo ziquka i-oxycodone, i-codeine kunye ne-methadone. Ngokubanzi zinikezelwa ngamayeza ahlukeneyo ngalo lonke usuku ukucima iimpawu ze-RLS. Ngokuchasene nokusetyenziswa kwe-opioid kwonyango lwentlungu, kukho umngcipheko omncinci wokulutha okanye ukunyamezela xa kusetyenziswa ukuphatha i-RLS. Ukugqithwa kwenzeka, kodwa ngokuqhelekileyo kuncinci.
Njengoko ezi ziyobisi zithinteka ngokunyanisekileyo ukuphefumula, ukusetyenziswa ngokucophelela ukuba ulale i-apnea yokulala . I-opioid isetyenziswa kuphela kubantu abangaphumeleli kwezinye iindlela.
Gabapentin
Ukuba iimpawu ze-RLS zenzeka rhoqo okanye zinganyangeki kwezinye iindlela zonyango, ukusetyenziswa kwe- gabapentin kunokuqeshwa . I-Gabapentin ngamanye amaxesha isetyenziselwa ukuphathwa kakubi okanye intlungu ye-neuropathic, kodwa iphinda iphumelele kwi-RLS. Inikwa ngamaxabiso ahlukeneyo ngalo lonke usuku. Kungabangela ukungaqiniseki ukuhamba okanye ukulala. Inokusebenza ngokukodwa xa intlungu ibonakala ngeempawu ze-RLS.
Benzodiazepines
Iklasi lemithi ebizwa ngokuba yi- benzodiazepines idlalwa luncedo kwiziganeko ezincinci ze-RLS, ngakumbi kubantu abaselula.
Ukuba unempawu eziphakathi, kunokukhetha okulungileyo. Iimbosa eziqhelekileyo ziquka i-clonazepam ne-diazepam. Impembelelo ngqo kwi-leg of discomfort is minimal, kodwa inokuphucula umgangatho wobuthongo. La mayeza angabangela ukungaqiniseki, ukulala kokusa, okanye ukucinga okucothayo.
Ezinye iindlela zokwelapha zeRLS
Ukuba ufunyanwe ukuba yintsimbi engenakho ukuvavanywa kokuqala kokuhlolwa kweempawu zakho ze-RLS, ukutshintshwa kwesebe kunokuba luncedo lonyango. Ngokuqhelekileyo akufanele isetyenziswe njengonyango lwenu kuphela, nangona kunjalo. Ngokusebenzisa izongezo zomnxeba zomlomo, i-vitamin C inokukunceda ukuphucula umxube.
Kukho ezinye iinguqulelo zokuphila ezingaba luncedo ekuphuculeni iimpawu zakho ze-RLS. Ezi zibandakanya ukusetyenziswa kokulula ngaphambi kokulala. Ukongezelela, ukugcina ingqondo ngokwengqondo ngexesha lexesha lokukhunjulwa kunokunciphisa iimpawu zakho. Oku kungabandakanya ukudlala imidlalo yevidiyo okanye ukwenza i-crossword puzzles.
Ekugqibeleni, kufuneka uphephe izinto ezinokunyusa iimpawu zakho ze-RLS. I-caffeine, i-nicotine, kunye notywala kunokusongela ngakumbi iimpawu zakho. Ngaphezu koko, ezinye izidakamizwa, i-antiemetics ezifana ne-metoclopramide kunye ne-antihistamines kufuneka zikhutshwe njengoko zinokunyusa i-RLS.
Imithombo
Chaudhuri, KR. "Imilenze yesifo esingenasiphako." N Engl J Med 2003; 349: 815.
Silber, MH et al . "I-algorithm yokulawula imilenze yesifo esingahlaliyo." I-Mayo Clin Proc 2004; 79: 916.
Amanzi, AS. "Iimilenze zesifo esingenasiphako kunye nokunyakaza kwamathambo ngexesha lokulala." Continuum. Neurol 2007; 13 (3): 115-138.