Imihlahlandlela evela ku-AHS / AAN
Ukugcina idayari yekhanda kukhona iningi lethu abenza imishanguzo ukuze sikwazi ukubona izinkinga zethu ze-migraine. Ngokulondoloza ngokucophelela ukulandelela nokugwema izimbangela zethu, sinethemba lokugwema ukuhlaselwa kwe-migraine ekudambiseni. Kodwa-ke, masingathembeki, naphezu kokugwema ukukhubaza, imishanguzo eminingi idinga imishanguzo yansuku zonke ukuvimbela lezi zinsizwa ezisabekayo.
Iyini imishanguzo yokuvimbela iMigraine?
Imithi yokuvimbela ithathwa nsuku zonke ukunciphisa inani, ubukhulu, nobude bokuhlaselwa kwe-migraine, kanye nokunciphisa ukukhubazeka okulethwa yizinsizwa eziningi. Zijwayele ukusetshenziselwa labo abahlukunyezwa yi- migraine engapheli , kodwa futhi zingasetshenziselwa izigulane ze-episodic.
Izibonelo zezibonakaliso ezingase zibe khona (ngaphandle kwe-migraine engavamile) yemithi yokuvimbela zihlanganisa: ukuphikisana nokuthola izindlela zokwelapha kanye / noma izinga elibi lokuphila noma ukusebenza kwansuku zonke. Izinhlobo eziningana ze-migraine ezifana ne- hemiplegic migraine noma i- basilar migraine zingase zibe yisibonakaliso semithi yokuvimbela.
I-American Headache Society (AHS) ne-American Academy of Neurology (AAN) yasungula imihlahlandlela ngemithi abayincoma ekuvimbeleni i-episodic migraine-migraines engenakwenzeka ezinsukwini ezingu-15 ngenyanga. Noma kunjalo, amaningi alawo mithi asetshenziselwa ukuvimbela kulabo ababhekene nemigraines engapheli.
Izindlela zokwelashwa ezivamile zokuvimbela imithi.
- Ama-antihypertensives (ama-agent aphansi wegazi)
- Ama-antidepressants
- Anticonvulsants
- I-Petasites (i-Butterbur)
Ukucindezelwa kwegazi Ukunciphisa Imithi Yokuvimbela I-Migraines
Izinhlobo eziningana zemithi zisetshenziswa ukuvimbela ukuhlasela kwe-migraine. Izindleko zokunciphisa igazi , ikakhulukazi i-beta-blockers, zisetshenziswe ngezigaba.
I-AHS / AAN inqume ukuthi i-metoprolol, propranolol, ne-timolol yizilinganiso zezinga A. Lokhu kusho ukuthi kubhekwa "okuphumelelayo" ekuvimbeleni i-migraine, kuyilapho i-atenolol ingumuthi we-Level B noma "mhlawumbe isebenzayo."
Ama-beta-blockers kufanele asetshenziswe ngokucophelela kulabo abane-asthma nesifo sikashukela futhi baqhathaniswa nalabo abane-bradycardia yesifo (izinga eliphansi le-heart). Ezinye imiphumela emibi ye-beta blockers zihlanganisa isimo sengqondo esincane, ukukhathala, nokusebenza kabi kwe-erectile.
Eminye imithi ye-blood pressure efana ne-verapamil, i -blocker yesiteshi se-calcium , futhi ngezinye izikhathi isetshenziselwa ukuvimbela imigraines, nakuba ubufakazi besayensi ngemuva kwayo abuqine njengalokho beta-blockers. Imikhombandlela ye-AHS / AAN 2012 ilandise i-verapamil njengesidakamizwa "U", okusho ukuthi "akukho idatha ewanele yokusekela noma yokuphikisa ukusetshenziswa kwe-migraine prophylaxis." Ama-antihypertensives lisinopril kanye ne-candesartan (eyaziwa njenge-ACE inhibitors) ahlukaniswe njengezidakamizwa zezinga C I-AHS / AAN, okusho ukuthi "kungenzeka ukuthi iphumelele" esekelwe isifundo esisodwa.
Izidakamizwa zokuvimbela ama-Epradic Migraines
Izidakamizwa , ikakhulukazi i-amitriptyline kanye ne-venlafaxine, zibhekwa njengezidakamizwa ze-Level B ("mhlawumbe ephumelelayo") zokuvimbela i-migraine. I-Venlafaxine (Effexor) iyi-inhibitor ekhethayo ye-serotonin-norepinephrine.
U-Amitriptyline (Elavil) yi-anti-depressant ejwayelekile kakhulu ye-tricyclic esebenza ngokuvimbela ukuphindwa kabusha kwama-neurotransmitter amabili ebuchosheni, i-serotonin ne-norepinephrin. Kuyinto imithi yokwelapha futhi ngokuvamile kuthathwe ngesikhathi sokulala.
U-Amitriptyline uphinde uvimbele i-acetylcholine receptors ne- histamine receptors ebuchosheni, okwenza kube nemiphumela emibi ye-anticholinergic njengomlomo omile, ukuqotshwa, nokugcinwa kwamanzi. Futhi kungabangela ukuzuza kwesisindo nokudideka. Okokugcina, i-amitriptyline ingaba nemiphumela emibi kakhulu njengokwenza ukukhubazeka kwenhliziyo, ngakho kufanele kugwenywe kulabo abanesifo senhliziyo.
Ama-Anticonvulsants Ukuvimbela Imigraines Yama-Episodic
Ngokuphathelene nama- anticonvulsants , i-American Academy of Neurology yaphetha ngokuthi imikhiqizo ye-valproate, i-divalproex sodium, ne-valproate ye-sodium, kanye ne-topiramate (topamax) iyasebenza (i-Level A izidakamizwa) ekuvimbeleni i-migraines. Imiphumela emibi ye-topiramate ifaka
- ukulahlekelwa isisindo
- ukukhathala
- isiyezi
- i-paresthesias
- ukungasebenzi komqondo
- ukunambitha ukuguqulwa.
Imiphumela emibi yemithi ye-valproate ifaka phakathi: ukuzuza kwesisindo, isicanucanu, ukuthuthumela nokushaywa izinwele.
I-Butterbur Neminye Imithi Yokuvimbela I-Migraine Ye-Episodic
I-Petasites (butterbur) enye i-Level A imithi ephumelelayo yokuvimbela i-migraine. Lena imishanguzo yemithi noma imithi ethathwa kabili nsuku zonke. Umthelela ohlangothini oluyinhloko ukucasula kwe-GI, ikakhulukazi ukubhoboza.
Ezinye izidakamizwa zezinga B noma izidakamizwa "eziphumelelayo" zokuvimbela i-migraine, njengoba kuphawulwe yi-American Headache Society kanye ne-American Academy of Neurology kuhlanganisa:
- Ezinye izindlela zokwelashwa : i-feverfew, i-magnesium, ne-riboflavin
- Ama-NSAID athile (ibuprofen, naproxen)
- Amanye ama-triptans (naratriptan, zolmitriptan): Sicela uqaphele , lokhu kuboniswa ngezinkinga zokuya esikhathini .
Okubalulekile
Ngezinye izikhathi imithi yokuvimbela iboniswa ukunciphisa inombolo, ubunzima, ubude, nokukhubazeka okuhlobene nemigraines. Ngokusho kochwepheshe, abanye beta-blockers (metoprolol, timolol, propanolol), i-anticonvulsants (imikhiqizo ye-valproate, i-topiramate), kanye ne-butterbur supplement butterbur iye yasungulwa njenge-Level A noma "ephumelelayo" njengemithi yokuvimbela imithi ye-episodic migraines.
Uma uthola ukuthi i-migraines yakho ithinta kabi ukusebenza kwakho kwansuku zonke noma ikhwalithi yokuphila, khuluma nodokotela wakho mayelana nezinzuzo nezingozi zokuqala imithi yokuvimbela i-migraine - kungase kube into oyidingayo okwesikhashana uze unqume ukuthi i-migraine yakho iqala yini noma thola enye indlela yokubhekana nayo.
Imithombo:
Bajwa Z, Sabahat A. Ukwelashwa kokuvimbela ukuguquka kwamagciwane kubantu abadala. Ku: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
I-Lipton RB, iGöbel H, i-Einhäupl KM, uWilks K, i-Mauskop A. I-Petasites hybridus izimpande (butterbur) iyindlela yokwelapha ephumelela yokuvimbela i-migraine. I-Neurology . 2004 Dec 28; 63 (12): 2240-4.
Loder E, Burch R, Rizzoli P. Imihlahlandlela ka-AHS / AAN ka-2012 yokuvimbela i-epradic migraine: isifingqo futhi kuqhathaniswa neminye imihlahlandlela yokusebenza emtholampilo. Izinwele . 2012; 52: 930-45 .
I-Podrid P. Imiphumela emibi yemiphumela ye-beta blockers.Ku: UpToDate, iBasow DS (Ed), UpToDate, Waltham, MA, 2013.
I-Silberstein SD, i-Holland S, i- Freitag F, et al. Ukubuyekezwa okusekelwe ebukhosini: Ukuphathwa kwe-pharmacologic yokuvimbela i-episodic migraine kubantu abadala: umbiko we-Quality Standards Subcommittee ye-American Academy of Neurology kanye ne-American Headache Society. I-Neurology 2012; 78: 1337.
QAPHELA: Ulwazi olukulesi sayithi lunguzinhloso zemfundo kuphela. Akufanele isetshenziswe njengengxenye yokunakekelwa ngumuntu udokotela olayisenisi. Sicela ubheke udokotela wakho ukuze ahlolwe futhi aphathwe noma yiziphi izimpawu noma isimo sezokwelapha .