Impact ye-Hand Osteoarthritis Yokukhubazeka Kubalulekile
I-EULAR Task Force ihlola i-Osteoarthritis yesandla
Isifo somzimba se- osteoarthritis sithinta amaphesenti angu-20 abantu abangaphezu kweminyaka engu-55 ubudala. I-EULAR (I-European League Against Rheumatism) ibutho elinikeze izincomo zokwelashwa kwe-hip ne-knee osteoarthritis, iziqondiso ezikhishwe ngo-2006 zokwelashwa kwesifo se- osteoarthritis.
Iqembu elisebenza nge-EULAR, elinamalungu angu-21 ahlanganisa ama- rheumatologists amaningana, udokotela ohlinzayo wamazinyo, kanye nomzimba phakathi kwamanye ochwepheshe bezempilo, ucwaningo olususelwe ebufakazini obuncike ebucayi futhi wavuma ukuthi izincomo ezingu-11 ezisekelwe ezinkambisweni ezingu-17 zokwelapha zazifaneleka kakhulu ukwelashwa isandla se-osteoarthitis.
Lezi zincomo zisezingeni eliphakanyisiwe kakhulu kunconywa ngokunciphisa ngokwezinga lobufakazi. Kwaphawulwa ukuthi izindlela eziyisithupha zokwelashwa ezingu-6 kuphela zisekelwe ebufakazini bokucwaninga. Ezinye izincomo zisekelwe ebuchwepheshe bomtholampilo noma idatha etholakala ezifundweni ze-osteoarthritis zamalungu ngaphandle kwesandla.
Izincomo Eyishumi Nanye Zokwelashwa Kwe-Hand Osteoarthritis
Iqembu elisebenza nge-EULAR linikeze lezi zincomo zokuphatha nokuphatha i-osteoarthritis yesandla:
- Kunconywa ukwelashwa kwe-pharmacologic (izidakamizwa) kanye non-pharmacologic (okungewona izidakamizwa), okwenzelwe umuntu isifo se-osteoarthritis isiguli.
- Ukwelashwa kwesifo se-osteoarthritis kufanele kube ngabanye ngesiguli. Izingozi, uhlobo lwe-osteoarthritis, izinga lokuvuvukala, izinga lobuhlungu, ubunzima, ukukhubazeka, ikhwalithi yokuphila, ukunciphisa umzimba kanye nemithi yokwelashwa kufanele konke kucatshangwe kanye nezifiso zesiguli.
- Iziguli kufanele zifundiswe ngokuvikelwa okuhlangene futhi zinikezwe umgomo wokuzivocavoca.
- Isicelo sokushisa (isib. Iphakethe elishisayo , i-heat pad, i- parafini wax ) kanye ne-ultrasound kuyasiza ekuphathweni kwe-osteoarthritis yesandla.
- Kunconywa ukuncintisana ngesisekelo sesithupha. Ama-Orthotics anconywa ukuvimbela ezinye izimo ezimbi.
- Ukuze ubuhlungu bube bukhulu futhi bube bukhulu futhi izimbangi eziningi zingathinteki, ukwelashwa kwendawo noma izintambo (isib. Ama-NSAID angama-topical, i- capsaicin ) angcono kunezokwelapha zesistimu.
- I-Acetaminophen (isb., I-Tylenol) yi-analgesic yomlomo ephakanyisiwe. Kufika ku-4 g / ngosuku kubhekwa njengokuphephile nokuphumelelayo.
- Kulezi ziguli ezithola impendulo enganelisayo kusuka ku-acetaminophen, ukhetho olulandelayo yi- NSAID yomlomo (izidakamizwa ezingavumelani nokuvuvukala) ezingeni eliphansi kakhulu, ngoba isikhathi esifushane singenzeka. Ukuzikhethela kwe-NSAID yesiguli ngasinye kufanele kubhekane nengozi yokugaya emathunjini kanye nenengozi yomzimba.
- I-Glucosamine ne- chondroitin , i- avocado ye-soybean engenawo ama-aponifiables , i- diacerein , ne- viscosupplementation yizo zonke zokwelapha okuphuza isikhathi eside kwe-osteoarthritis. Bangase banikele ukukhululeka nge-poisonous low.
- Imishanguzo ye-corticosteroid e-intra-articular iphumelela, ikakhulukazi ngesikhathi se-osteoarthritis ebuhlungu.
- Ukuhlinzwa (isb., I-arthroplasty, i- arthrodesis , noma i-osteotomy) ingacatshangelwa iziguli ezingazange zinenhlanhla ngezokwelapha ezengeziwe. Kunconywa ukwelashwa iziguli ezinomunyu obukhulu nokukhubazeka kusuka e-osteoarthritis yesandla.
Kungani Kunconywa Iziphakamiso Ezizimele Ezihlangene
I-osteoarthritis ithinta izandla, iziqhwa, namadolo ngokuhlukile.
Amalungu ahluke ngokwemvelo nokusebenza, kanti iziguli zihlukile ngokufaneleka kokwelashwa nokuphendula ukwelashwa.
Izincomo eziyisithupha kwezingu-11, embikweni owavela kuma- Annal of the Rheumatic Diseases , zisekelwa idatha yocwaningo:
- imfundo nokuzivocavoca
- Ama-NSAID
- I-COX-2 inhibitors
- Ama-NSAID angama-topical
- i-capsaicin yocingo
- chondroitin sulfate
Izincomo ze-ACR ze-Hand Osteoarthritis (2012)
Ngo-2012, i-American College of Rheumatology ivuselele izincomo zokwelapha isandla se-osteoarthritis. Baye batusa ukuthi odokotela benze lokhu okulandelayo ngenxa yokwelashwa okungewona izidakamizwa:
- Hlola ikhono lokwenza imisebenzi yokuphila kwansuku zonke (i-ADLs)
- Fundisa amasu wokuvikelwa okuhlangene
- Nikeza amadivayisi okusiza, njengoba kudingeka, ukusiza iziguli zenze ama-ADL
- Fundisa ekusetshenzisweni kwezimiso ezishisayo
- Nikeza izigulane zeziguli ezine-osteoarthritis ezihlangene ze-trapeziometacarpal
Izincomo eziphathekayo ze-pharmacologic zifaka lokhu okulandelayo (sebenzisa eyodwa noma ngaphezulu kwalokhu okulandelayo):
- I-capsaicin yendaba
- Ama-NSAID e-Topical, kuhlanganise ne-sallamlate ye-trolamine
- Ama-NSAID omlomo, kufaka phakathi i-COX-2 inhibitors ekhethiwe
- I-Tramadol
I-ACR iphakanyiswe ngokomthetho ukuthi ochwepheshe bezempilo bangasebenzisi lokhu okulandelayo:
- Izindlela zokwelashwa ezingaphakathi
- Ama-analgesics e-opioid
Futhi, iziguli ezineminyaka engama-75 ubudala kumele zisebenzise ama-NSAID ezingokoqobo.
Imithombo:
Izincomo ezisekelwe e-Element ezisekelwe ekuphathweni kwesifo se-osteoarthritis. Zhang, W. Annals of the Rheumatic Diseases. Ishicilelwe ku-inthanethi Ngo-Okthoba 17, 2006.
http://ard.bmj.com/content/66/3/377
I-American College of Rheumatology 2012 Izincomo zokusetshenziswa kweMithi ye-Nonpharmacologic ne-Pharmacologic e-Osteoarthritis ye-Hand, Hip, ne-Knee. Hochberg M. et al. Ukwelashwa kwe-Arthritis & Ucwaningo Vol. 64, No. 4, Ephreli 2012.
http://www.rheumatology.org/Portals/0/Files/ACR%20Recommendations%20for%20the%20Use%20of%20Nonpharmacologic%20and%20Pharmacologic%20Therapies%20in%20OA%20of%20the%20Hand,%20Hip%20and % 20Knee.pdf