Izindlela Zendabuko Nezohambisana Nezokwelapha
Ngenxa yokuthi akukho amacala amabili e-fibromyalgia afanayo, akukho ukwelashwa okulodwa okukwazi ukusiza izimpawu zesifo. Esikhundleni salokho, ukwelashwa kuzoba yizici eziningi futhi kufanelana nezinhlobo nobukhulu bezimpawu ozizwayo. Lokhu kungabandakanya ngaphezulu kwe-counter (i-OTC) nezidakamizwa zemithi, ukwelashwa ngokomzimba nokwesekela, ukunciphisa ukucindezeleka, izinguquko zokuphila, kanye nokwelapha okuhambisanayo okuhloswe ukunciphisa ubuhlungu bakho nokubuyisela izinga lakho lokuphila.
Imithi
Njengesici esichazayo se- fibromyalgia , ubuhlungu buyindlela ebalulekile yokwelashwa. Ukuze kube sekugcineni, odokotela bazophendukela ezihlukahlukene ze-OTC nemithi kadokotela, ezinye zazo ezivunyelwe ukwelashwa kwe-fibromyalgia nezinye ezisetshenziswa ngaphandle kwelebula.
Inhloso yokwelapha iwukuba ukwelapha izimpawu eziningi ezihlukahlukene ezihlukahlukene njengezidakamizwa ezimbalwa ngangokunokwenzeka ukuze kuzuze umphumela omkhulu wemitholampilo. Lokhu kungabandakanya ama-analgesics, ama-anti-depressants, ama-anticonvulsants, ama-relaxant muscle, nezinye izinhlobo zemithi yomlomo.
Ama-Analgesics
Ukuze ukwelashwa ubuhlungu obubuhlungu be-fibromyalgia, i-Tylenol (i-acetaminophen) ingahlinzeka ngokukhululeka okukhulu kwempawu ezinzima ngemiphumela embalwa, uma ikhona, imiphumela emibi (ikakhulukazi isicashu kanye nesisu esiswini). Ngenkathi izidakamizwa eziphikisana nezidakamizwa (anti-inflammatory drugs) (i-NSAID) njenge-Advil (ibuprofen) ne-Aleve (ne-naproxen) nazo zinikeza imiphumela ye-analgesic (ukukhulisa ubuhlungu), kubalulekile ukukhumbula ukuthi i-fibromyalgia ayiyona isifo sokuvuvukala nokuthi ukusetshenziswa kwe-NSAID isikhathi eside ukwandisa ingozi yokugaya esiswini, izilonda zesisu, nokukhubazeka kwesibindi.
Ama-NSAID enomsoco onjengeCelebrex (celecoxib) noma i- Voltaren (i-diclofenac) nawo aphethe izingozi ezifanayo njengabahlobo bawo be-OTC kodwa angase afanele ukusizwa isikhathi esifushane uma kugcinwa umthamo ophansi kakhulu osebenzayo.
Ama-antidepressants
Izidakamizwa zivame ukusetshenziselwa ukwelashwa ngoba ziyakwazi ukuphatha izimpawu eziningi, ukunciphisa ubuhlungu, ukukhathala nokucindezeleka ngakolunye uhlangothi ngenkathi kusiza ekubuthweni nokuphakamisa imizwelo komunye.
Kunezidakamizwa ezimbili ezidambisayo ezigunyazwe yi-US Food and Drug Administration (FDA), zombili zazo ziyi- serotonin ne-norepinephrine reuptake inhibitors (i-SNRIs) . Zisebenza ngokuvimbela i-serotonin ne-norepinephrine ekubuyiselweni kabusha kwamaseli futhi, ngokwenza kanjalo, kuqinisekiswe ukugxila okukhulu kwama-hormone "azizwa kahle" emzimbeni.
Lezi zidakamizwa ezimbili zinqunywe kanje:
- I-Cymbalta (duloxetine) inqunywe nge-dose yokulayishwa kokuqala yama-milligram angu-30 ngosuku ngaphambi kokunyuka kumthamo ohlosiwe wama-milligram angu-60 ngosuku.
- I-Savella (i-milnacipran) inqunywe ngesilinganiso sokuqala sokulayishwa kwama-12.5 milligrams esithathwe kanye nsuku zonke ngaphambi kokukhuphukela kuma-milligram angu-50 athathwe kabili nsuku zonke. Umthamo wezinsuku ezingu-200 wamanandi wansuku zonke ungasetshenziswa ezimweni ezimbi.
Imiphumela emibi ingafaka isicashu, umlomo owomile, ukuqothulwa, ukunciphisa ukudla, ukulala, ukukhukhuma nokukhungatheka.
Amanye ama-anti-depressants avame ukushiywa ngaphandle kwelebuli ukuze aphathe i-fibromyalgia, kuhlanganise ne-SNRI njengeCelexa (citalopram), i-Lexapro (escitalopram), i-Paxil (i-paroxetine), ne-Zoloft (i-sertraline).
Ngenkathi izidakamizwa zokuvimbela i-tricyclic endala zingasetshenziswa kakhulu, umthamo ophansi u- Elavil (u-amitriptyline) uqinisekisile ukuthi usebenza njengobuthongo bokulala ngenkathi usiza lula ubuhlungu obungapheli nokucindezeleka.
(Ukulala amaphilisi ngokuvamile kugwenywa nganoma yini kodwa ukuphumula kwesikhashana njengoba ukusetshenziswa isikhathi eside kungaholela ekuthembekeni.)
Anticonvulsants
Nakuba ososayensi abaqiniseki ukuthi basebenza kanjani, izidakamizwa ze-anticonvulsant , ezivame ukusetshenziselwa ukwelashwa nokuhlushwa, ziye zafakaza ngokuphumelelayo ekuphatheni i-fibromyalgia. Kucatshangwa ukuthi basiza ukunciphisa inani lezibonakaliso zesisindo futhi, ngokwenza kanjalo, ulalise amaseli we-nerve aphezulu kakhulu.
I-Lyrica (pregabalin) yi-antiticonvulsant yokuqala evunywe yi-FDA yokwelashwa kwe-fibromyalgia. Uma kunqunywe, uzoqala ukwelashwa ngamanani amancane ngaphambi kokuba ufinyelele umthamo wansuku zonke wamamitha ayi-300 we-capsule njalo (uthathwe kathathu nsuku zonke ngamanani angu-100-milligram) noma ama-milligram angu-330 wethebhulethi ekhulisiwe (ethathwe kanye ngosuku).
Imiphumela emibi evamile ihlanganisa isizungu, ubuthongo, nokuzuza kwesisindo.
Amanye ama-anticonvulsants afana ne- Neurontin (gabapentin) anikeza indlela efanayo yesenzo futhi angasebenza ngokuphumelelayo. I-Vimpat (lacosamide) neKeppra (levetiracetam) nayo isetshenzisiwe.
Ama-Relaxant Muscle
Ama-relaxant ama-muscle nawo abonakala esiza ezimweni ezithile, futhi ososayensi abaqiniseki kahle ukuthi kungani. Ngenxa yokuthi izidakamizwa zingabangela ukulala, zivame ukuthathwa ebusuku ngaphambi nje kokulala.
Njengoba ubuthongo obungapheliyo buyindlela evamile ye-fibromyalgia, kuye kwaphakanyiswa ukuthi ukubuyiswa kwemidwebo evamile yokulala kunganciphisa ubuzwe bomuntu ebuhlungu. (Ngokuphambene, ukulahlwa kokulala kuyaziwa ukuqala izimpawu zobuhlungu ngokuvamile.)
Iziphumuli zomzimba ezimbili ezivame ukusetshenziselwa ukwelapha i-fibromyalgia yi- Flexeril (cyclobenzaprine) no-Zanaflex (tizanidine). Imiphumela emibi ingabandakanya umlomo owomile, isizungu, isicanucanu, nombono ongenalutho.
Eminye Imithi
Imithi e-opioid efana ne- Vicodin (i-hydrocodone) ne- OxyContin (oxycodone) sekuyisikhathi eside isetshenziselwa ukwelapha i-fibromyalgia, nakuba lo mkhuba namuhla ukhonjelwa ngenxa yobungozi obukhulu bokulutha umuthi kanye nokutholakala kwezidakamizwa ezintsha zokuzalwa kwezidakamizwa ze-fibromyalgia. Okuwukuphela kwendlela okungenzeka kube ukusetshenziswa kwe- dolt low- ultram (tramadol) yokusetshenziswa okwesikhashana kwama-acute fibromyalgia . Ngisho noma kunjalo, lesi sidakamizwa sigcinelwe amacala ahlukumezekile kuphela uma abanye abahlukumezayo behlulekile ukunikeza usizo.
I-irritable bowel syndrome (IBS) ivame kubantu abane fibromyalgia futhi bakholelwa ukuthi babelana ngezindlela ezifanayo zesifo. Kuye ngezibonakaliso zakho ungase ubeke umyalelo we- laxative, i- antidiarrals njenge-imodium (loperamide) noma i-Lomotil (i-diphenoxylate), noma i- antispasmodics njenge-Norpramin (desipramine).
Ukwelashwa Kwemvelo Nokululekwa
Ngaphandle kwemithi, udokotela wakho angakunikeza ochwepheshe ukuze basize ukunqoba noma yiziphi izinselele ezingokomzimba noma ezingokomzwelo ongase ubhekane nazo. Ngenkathi sivame ukucabanga nge-fibromyalgia njengesifo sezinzwa, empeleni kuyinkinga ye-multi-dimension lapho ukucindezeleka, ukukhathazeka, nokugula konke kudlala ingxenye.
Kulokhu, ungazuza ngokubona ochwepheshe abalandelayo:
- Ama-Psychiatrists angasiza uma unesifo sokucindezeleka, ukuhlaselwa kwesabisa, nokukhathazeka kokukhathazeka okunjenge-post-traumatic stress disorder (PSTD) evame ukubonwa kubantu abane-fibromyalgia. Vala ukusebenzisana nodokotela wakho wokwelapha kuyadingeka ukuqinisekisa ukuthi akukho ukuqhuma noma ukuphikisana kwemithi yokwelapha.
- Izazi zengqondo zinganikeza ukweluleka futhi zisebenzise ukwelapha okuziphatha okunengqondo (CBT) ukuthuthukisa injabulo ngokushintsha imizwelo engasebenzi, ukuziphatha, noma imicabango.
- Abahlinzeki bezinto ezingokwenyama bangathuthukisa amandla akho kanye nenhlalakahle engokwenyama ngokukufundisa izindlela zokwelula nokuzivocavoca ngendlela engagcini izimpawu zakho. Futhi banganikeza zokwelapha zokwelapha ukuze unciphise ubuhlungu futhi bathuthukise ukuhlelwa kwemisebenzi yokusebenza kwemisipha ephumelelayo.
- Abahlinzeki bezisebenzi bangakunika amathuluzi namasu okuzivumelanisa nezinselele zokuphila ne-fibromyalgia. Kungabandakanya ukulondolozwa kwamandla, ukuphathwa kobuhlungu, amasu okuphumula, ukuxazulula izinkinga, ukuhlanzeka ubuthongo , nokuhlelwa kwezinhloso.
Ukulungiswa Kwendlela Yokuphila
Njengoba sithembele emithini yokwelapha i-fibromyalgia, angeke ibe yinto eyodwa yokwelapha. Ngaphezu kwezidakamizwa, udinga ukwenza izinqumo zokuphila ezinempilo ukuqinisekisa ukukhululeka okuqhubekayo kwezimpawu zakho.
Ukuzivocavoca kubalulekile kulokhu. Ngenkathi ukuhlakanipha kwakho kungakutshela ukuthi ungadluli ukwesaba okubangela ubuhlungu, kuzokwenza izinto zibe zimbi nakakhulu uma kufanele uhambe. (Futhi, sibhekene nakho, sonke senza.) Ngokusebenza ngaphakathi kwemikhawulo yakho futhi kancane kancane ukwakha amandla akho nokuguquguquka, uzokwehlisa kancane ubuzwe bakho ebuhlungu. Ukusebenza ngokuzivocavoca uhlela umhlinzeki wakho womzimba kuyindlela enhle yokuqalisa.
Njengobhonasi owengeziwe, ukuvivinya umzimba kuvuselela ukukhiqizwa kwama- endorphin , ama-hormone okungenayo kuphela umphumela we-analgesic kodwa angakhulisa umzwelo wakho.
Ukudla nokulahleka kwesisindo kubaluleke kakhulu. Ukuthatha isisindo esiningi akugcini nje kuphela kwengeza umthwalo wesakhiwo emisipha kanye namalungu akho, kunciphisa ukusebenza kahle kwesistimu yakho yezinhliziyo futhi kukushiye ukhathele kakhulu futhi ukhathele.
Nakuba kungekho-fibromyalgia ethi "yokudla," odokotela abaningi bayokwamukela uhlelo lokudla okunomsoco oluhlanganisa:
- Ezingxenye ezimbili kwezintathu izithelo, imifino, kanye nezinhlamvu ezigcwele
- I-third-fat milk fat and fat protein
- Ukudla nsuku zonke ama-25 kuya ku-30 amagremu we -fibre ehambisanayo yokudla ukuze kugcinwe ukugaya okunempilo
- Amafutha anempilo afana namafutha omnqumo
- Ukugwema i-caffeine okuyinto ephakathi kwenqubo yesishukela eshukumisayo
- Ukugwema ukudla okucutshungulwa, ukudla okuthosiwe, noshukela ocolile
Njengomuntu ocindezelayo, utshwala kufanele ubuyekezwe emuva futhi kungase kudingeke kugwenywe uma kuthatha i-Cymbalta, i-Savella, ne-Tylenol ngenxa yengozi yokukhulelwa kwesibindi.
Kumele futhi ucabangele ukuyeka ugwayi njengoba izifundo eziningi zihlobanisa ukubhema nokwanda okukhulu ubuhlungu nokulala kwabantu abampofu kubantu abane-fibromyalgia.
Imithi yokwelapha ehambisanayo (i-CAM)
Abantu ababhekene nezifo ezingelapheki bavame ukuphenduka imithi ehambisanayo kanye neyehlukile (CAM) njengendlela yokuphatha impilo yabo engokwenyama, engokwengqondo nengokomoya. Lokhu kuyiqiniso ngokukhethekile esimweni esifana ne-fibromyalgia lapho imbangela engacaciswanga ngokugcwele .
Uma uphishekela enye indlela yokwelapha, qiniseka ukuthi utshele udokotela wakho ngakho ukuqinisekisa ukuthi akuphazamisi ukwelashwa kwakho (njengoba izindlela zokwelapha ezifana no-St. John's Wort ngezinye izikhathi zingenza) futhi akukulimazi. Ukuthi into ethi "yemvelo" ayisho ukuthi lokho kuphephile.
I-Mind-Body Therapies
Izindlela zokwelashwa kwengqondo ziyiqembu lemikhuba evame ukusetshenziswa ngabantu abanesifo esingapheli ukunciphisa imiphumela yomzimba yokucindezeleka ngenkathi kuthuthukisa inhlalakahle ngokomzimba nangokomzwelo. Ngesifo esifana ne-fibromyalgia, noma yimuphi umkhuba ongadambisa impendulo yomzimba ngokucindezeleka ngaphandle kwezidakamizwa kufanele kubhekwe njengenzuzo.
Phakathi kweminye imikhuba emihle engqondweni-yomzimba:
- Ukuzindla kwengqondo kuyindlela yokuzindla lapho ukufunda ukungahambi kahle ngemicabango engase ibangele ukucindezeleka.
- Izithombe eziqondiswayo yindlela yokwenza izithombe zengqondo ukuze udale ukuzola.
- Ukuzivocavoca okujulile (pranayama) sebenzisa amasu okuphefumula okuyisigqi ukuze kuqhutshwe isimo sokuzindla
- I-Yoga ne- Tai chi zifaka ingqondo ngokunyakaza ukuze zithole amandla amakhulu ngaphezu kokulawula umzimba wakho.
- Ukuphulukisa imishanguzo , njengokukhululwa kwe-myofascial , kuhloswe ukuba ukhululeke ukukhululeka kwemisipha nokucindezeleka ngaphandle kobuhlungu.
- Ukuphumula kwemisipha okuqhubekayo (PMR) kuyindlela lapho uhlehlisa khona futhi ukhululeke imisipha emzimbeni wakho ukuze wenze ukuzola.
- I-Biofeedback isebenzisa ukuqapha kwe-elektroniki ukukusiza ukuthi ugcine futhi ulawule ukucindezeleka kokuphendula.
Imithi Ephelele
Imithi yemvelo, kuhlanganise namakhambi, ama-extracts, amavithamini, nemithi yokwelapha yaseShayina (TCM), iyamukelwa abanye njengendlela yokwelapha ehambisanayo. Phakathi kwalabo abanganikeza izinzuzo kubantu abane fibromyalgia:
- I-5-HTP (i-5-hydroxytryptophan), i-amino acid ehlanjululwe evela esitshalweni sase-African Griffonia simplicifolia ngenkathi ingasiza ekuphakameni amazinga e-serotonin. Ngenkathi isithasiselo sibhekwa sengathi siphephile, kukhona idatha encane etholakalayo ekusebenzeni kwayo ekuphatheni i-fibromyalgia.
- I-Capcaisin iyisakhi esisebenzayo ku-pepper esiphundu esitholakala ku-creams, i-sprays, ne-patches. Isetshenziselwa ukwelapha izinhlobo ezahlukene ze-neuralgia (ubuhlungu bomunyo), futhi kubhekwa njengokuphephile kodwa kungabangela ukubomvu okwenziwe endaweni, ukuchithwa noma ukushisa. Isifundo se-2013 esivela e-Italy sabika ukuthi ukusetshenziswa kwe-0.075% ye-capsaicin cream eqoshiwe, isetshenziswe kathathu nsuku zonke amasonto ayisithupha, ukunciphisa amanxephezelo ngamaphesenti angu-73 kubahlanganyeli abangu-130.
- Inambuzane yezokwelapha iyaziwa ngokukwazi kwayo ukunciphisa ubuhlungu, ukuphakamisa imizwelo, nokusiza ukulala kangcono. Isifundo esincane esivela ku-Israyeli esenziwa ngo-2018 sabika ukuthi ukusetshenziswa kwe-cannabis yezokwelapha kubantu abadala abangu-60 abane-fibromyalgia eqinile kubangele ukuthuthukiswa kwezikolo zobuhlungu kubo bonke abahlanganyeli. Ngemuva konyaka owodwa, abangu-13 bakwazi ukuvimbela izidakamizwa zabo ze-fibromyalgia, kuyilapho abangu-8 bebika imiphumela emibi kuphela.
> Imithombo:
> Casanueva, B .; Rodero, B .; kanye ne-Quintial, C. "Ukusebenza okwesikhashana kwe-capiaicin thérapial ephathekayo ezigulini ezinomthelela kakhulu we-fibromyalgia." I-Rheumatol Int . 2013; 33 (10): 2665-70. I-DOI: 10.1007 / s00296-012-2490-5.
> Habib, G. no-Artul, S. "I-Cannabis yezokwelapha yokwelashwa kwe-Fibromyalgia." J Clin Rheumatol. 2018. [I-Epublished ngaphambi kokuphrinta.] I-DOI: 10.1097 / RHU.0000000000000702.
> I-Sanam, K. ne-Choy, E. "Ukubuyekezwa Kwesiqondiso Sokwelapha ku-Fibromyalgia Syndrome ne-Focus on Pharmacology." I- Biomedicines. 2017; 5 (2): 20. I-DOI: 10.3390 / i-biomedicines5020020.
> Isikhungo Sikazwelonke Sempilo Ephelele Nezohlanganiswa. "Izenzo Nemikhuba Yomzimba Ye-Fibromyalgia: Okushiwo Isayensi." I-Bethesda, e-Maryland; eshicilelwe ngo-September 2017; ibuyekeziwe ngoMashi 27, 2018.