Ukusiza Ukuphatha I-Rheumatoid Arthritis
Imithi yilapho isisekelo somuthi wendabuko we- rheumatoid arthritis . Uma nje uthola ukuthi une-arthritis ye-rheumatoid , udokotela wakho uzongincoma futhi abeke inkambo yokwelapha.
Kukhona imithi embalwa esetshenziselwa ukwelapha isifo samathambo esihlukaniswe ngezidakamizwa ngokusekelwe ekusebenzeni kwazo. Kubalulekile ukuthi uqonde izinketho zakho, futhi uqonde ukuthi kungani umuthi othile ukhethwe wena.
Ngamanye amazwi, yimuphi umuthi okwenza emzimbeni?
Uma inkambo ethile yokwelashwa ingabonakali iyasebenza emva kwesikhathi, kuvamile ukuba udokotela wakho enze izinguquko ohlelweni lwakho. Ake sicabangele imithi ye-arthritis ye-rheumatoid. Ungabekwa okukodwa noma ngaphezulu kokulandelayo.
Ama-NSAID
Ama-NSAID (izidakamizwa ezingavumeli ukuvuvukala) azivimbela i- COX 1 ne-COX 2 (i-cyclooxygenase enzymes) ekwenzeni i- prostaglandin , ama-hormone abangela ukuvuvukala emzimbeni. Kukhona ama-NSAID angama-12 avela kuwo. I-NSAID ejwayelekile kakhulu eyi-Motrin (ibuprofen) , i-Naprosyn (naproxen) , i-Mobic (meloxicam) , ne-Voltaren (i-diclofenac) . I-celebrex (celecoxib) yiyona kuphela i-COX-2 inhibitor ekhethiwe etholakalayo e-US Futhi, i- Advil (ibuprofen) ne-Aleve (naproxen) iyatholakala ngamandla angaphezu kwamandla.
Ama-NSAID ahlanganiswe nengozi eyengeziwe yokwehla kwenhliziyo noma isifo sohlangothi, ngakho ekugcineni kwacaca ukuthi izidakamizwa kufanele zithathwe kumthamo ophansi kunazo zonke futhi kungenzeka ukuthi isikhathi esifushane singenzeka.
Futhi, akufanele nanini uthathe umkhiqizo we-NSAID angaphezu kwesinye ngesikhathi. Funda amalebula ngokucophelela njengoba ama-NSAID angaba yingxenye yemithi ehlukahlukene yokulwa nokukhwehlela, ukubandayo, ukuphuza, ukulala, nokuguliswa kwesisu.
Ama-Analgesics
Imithi ye-analgesic isebenza ngokukhulula ubuhlungu. I-Acetaminophen iyimithi ephulukisa kakhulu yokulwa nobuhlungu; empeleni yiyona kuphela imithi ye-analgesic etholakalayo phezu kwe-counter.
Futhi, ingaba emikhiqizweni eyahlukene, ngakho-ke kubalulekile ukufunda amalebula futhi uqaphele umphumela wokuqoqa we-acetaminophen.
Ama-analgesics anamandla atholakala kuphela ngemithi kadokotela. Zibizwa ngokuthi i-opioids noma izidakamizwa. Ama-opioids enza isistimu esemaphakathi yezinzwa ukuvimbela izimpawu zobuhlungu. Imithi ye-opioid ivela engozini yokuthembela, kodwa uma isetshenziselwa ukuqondiswa futhi ngokuqapha mayelana nemiphumela emibi kanye nemicimbi embi, lezi zidakamizwa zingaba usizo oluphuthumayo lwezinhlungu kubantu abane-arthritis ye-rheumatoid. Ngo-2016, amaCenter for the Disease Control and Prevention (CDC) akhiphe iziqondiso zokubeka ama-opioid . I-Hydrocodone / i-acetaminophen (i-brand Norco) ne- Tramadol (i-brand Ultram) yi-analgesics ejwayele kakhulu e-opioid. Ezinye zifaka i-oxycodone ne-MSContin.
Corticosteroids
I-Corticosteroids , eyaziwa ngokuthi i-glucocorticoids noma i-steroids, ilingisa imiphumela ye-hormone cortisol emzimbeni futhi idlala indima ekuphenduleni komzimba. I-Corticosteroids iyatholakala izinhlobo eziningi ezibandakanya amaphilisi, isisombululo esingenayo injini, amaconsi, kanye nama-cremic creams.
I-Corticosteroids imithi enamandla yokulwa nokuvuvukala. Ngenkathi ukusebenza kwabo kungabonakala kuyimangaliso, bahlobaniswa nemiphumela emibi kakhulu, hhayi okungenani ukuthi ingozi enkulu yokutheleleka.
Ukuze unciphise ingozi yemiphumela emibi, i-corticosteroids kufanele ithathwe kumthamo ophansi kunazo zonke futhi kungenzeka ukuthi isikhathi esifushane singenzeka.
Abanye abantu abane-arthritis ye-rheumatoid banqunywe umthamo we-corticosteroid ophansi njengengxenye yesimiso sabo semithi yokwenza njalo. Abanye basebenzisa kuphela i-corticosteroids ukuze banciphise izimpawu ze-arthritis ze-rheumatoid. Abantu abaye bathatha i-corticosteroid isikhathi eside bangathola izimpawu zokuhoxiswa uma beyeka umuthi ngaphandle kokuthinta. I-prednisone ne- methylprednisolone yi-corticosteroids yomlomo evamile kakhulu. I-Triamcinolone yi-injection ethandwa futhi ukhilimu.
I-DMARD
Izidakamizwa eziguqula izifo ezivimbela izifo ( DMARDs ) izidakamizwa ezisebenza kancane ezisebenza ukunciphisa ukuqhubekela phambili kwezifo nokunciphisa umonakalo ohlangene.
Kunezinhlobo ze-DMARD zendabuko, izinketho zangempela nezindala kunazo zonke. Kukhona futhi ama-DMARD e-biologic-okuqala kwawo avela endaweni yesehlakalo ngo-1998. Futhi, maduze nje, elinye i-sub-class of DMARDs eyaziwa ngokuthi imithi emincane ye-molecule.
Ku-DMARD yendabuko, i- methotrexate yiyona ejwayelekile kakhulu. Empeleni kubhekwe ukwelashwa okujwayelekile kwegolide kwe-arthritis ye-rheumatoid. Ezinye i-DMARD zendabuko zifaka i- Arava (i-leflunomide) , i- Plaquenil (i-hydroxycholorquine) , ne- Azulfidine (i-sulfasalazine) . Igolide ne- Imuran (azathioprine) ziyatholakala kepha ayisasetshenziswa ngokujwayelekile ukuba isifo samathambo asifo sengculaza . I-DMARD yendabuko ithonya isistimu yomzimba , ngakho-ke kungase kube nzima ukulwa nokutheleleka futhi kungenzeka ukuthi ingozi eyandayo yokuthuthukisa ezinye umdlavuza. Kumele uqaphele imiphumela emibi engaba khona kanye nezixwayiso ezihambisana nama-DMARD. Ngokujwayelekile, ukuhlola kwegazi njalo kuyiwe ukuba kuhlolwe ukusebenza kwesibindi nokuqeda ukubala kwegazi.
I-Biologic DMARD
Izidakamizwa ze-Biologic , ezibizwa nangokuthi i-Biologic DMARD noma i-Biologic Response Modifiers, ziyimithi eyadalwa ukuvimbela noma ukunciphisa ukuvuvukala okulimaza amalunga. I-Biologics ihlose ngokuqondile ama-molecule emasethini omzimba omzimba kanye nemikhiqizo ehlanganiswe ekuhlanganyeleni okubandakanyekayo ekubangela ukuvuvukala nokubhujiswa okuhlangene.
Kunezinhlobo eziningana zezinto eziphilayo, ngayinye enezinhloso ezithile. Amakhredithi afaka isifo se-necrosis se-tumor (TNF) , ama-interleukins (IL-1, IL-6, IL-12, ne-IL-23), amaseli B, namaseli T. Izidakamizwa ze-biologic zibiza kakhulu, kodwa usizo lwezimali luyatholakala kubantu abafanelekayo. Lezi zidakamizwa zenziwa ngokumnika noma ukujova. Ngenxa yemiphumela yezinto eziphilayo eziphathelene nesimiso somzimba sokuzivikela, ezinye izinto ezingathandeki nezimbi kakhulu zingenzeka.
Ama-DMARD amancane ahlosiwe amancane
Iklasi elisha kunazo zonke izidakamizwa ze-rheumatoid arthritis "lihloselwe i-molecule encane DMARD" ephazamisa ukusayina kwe-intracellular. Ngokuphazamisa izibonakaliso ezithile ze-intracellular, kungenzeka ukuhlunga imisebenzi ethile yamaseli, kufaka phakathi ama-receipt surface, ukusayina amaprotheni nokubhaliselwa kwamaprotheni enuzi. Ngokwenza kanjalo, ukuziphatha kwezinhlobo zeli cell ezihlosiwe kungathonywa noma kuthinteke.
Izinhloso ezithandwa kakhulu abacwaningi, ngenhloso yokwelapha izifo ezizimele nezivuvu, zihlanganisa i-kinase ehlobene noJanus, i-spleen tyrosine kinase, i-phosphodiesterase-4, i-tyrosine kinase ye-Bruton, ne-phosphatidylinositol-3 kinase. Ukuhlolwa kobuntu kuyadingeka ukuze kunqume ukuthi kungenzeka ngayiphi injongo. I-JAK (Janus kinase) inhibitors yiyona eyakhiwe kakhulu futhi enye i-FDA-evunyelwe, i-Xeljanz (tofacitinib).
Izwi elivela
Abanye abantu abane-arthritis ye-rheumatoid besaba imithi, ngokuyinhloko ngenxa yemiphumela emibi engaba khona, okunye okungaba nzima. Kubalulekile ukuhlola izinzuzo nezingozi zemithi nodokotela wakho.
Cabanga ngesimo sakho samanje somsebenzi wesifo bese unquma izinhloso zokwelashwa nodokotela wakho. Cishe, uzobe unqunywe ukuhlanganiswa kwezinketho ezitholakalayo ezichazwe ngenhla. Gcina idayari yesifo emva kokuqala imithi ukusiza ukuthi uhlole uma isebenza kahle yini kuwe. Yiba nolwazi ngemiphumela emibi engase ibe khona futhi ubike noma yini engavamile kudokotela wakho.
> Imithombo:
> I-Arthritis Namuhla. Isiqondiso Sezidakamizwa 2016. Ishicilelwe yi-Arthritis Foundation.
> Kelly, V. kanye noGenosvese, M. Novel imithi yamakhemikhali encane ku-arthritis ye-rheumatoid. I-Rheumatology (Oxford) (2013) 52 (7): 1155-1162.
> Kelley's Bookbook of Rheumatology. Umagazini wesishiyagalolunye. Elsevier.