Iyiphi indlela enhle yokwelapha ye-Gout?
I-Gout ivame ukuhlasela ngokuhlanganyela ngokuzumayo futhi ngokujulile. Ngokujwayelekile, ukuhlanganiswa kokuqala kwe-metatarsophalangeal ( okuyizinzwane ezinkulu ) kuhilelekile, kodwa amanye amalunga angathinteka. Ama-gouty amalunga abonisa izimpawu ezibonakalayo zokuvuvukala (okungukuthi, ukubomvu). Umgomo oyinhloko wokwelashwa ukuvimbela ukuhlaselwa okukhona nokuvimbela ukuhlaselwa kwe-gout esikhathini esizayo.
Nakhu:
- Ukuhlaselwa kokuqala kwe-gout kungadlulela izinsuku eziningana futhi kuyanyamalala ngisho noma kungalashwa. Ukuhlaselwa okungahle kwenzeke kungenzeki amasonto, izinyanga, iminyaka, noma cha. Izimo ezimbi ze-gout (okungukuthi, ukuhlaselwa okuphindaphindiwe okwenzeka esikhathini eside) kungabangela umonakalo kumalungu afintekile nokulahlekelwa kokuhamba. Uhlelo lwezokwelapha lubalulekile ekuvimbeleni ukuhlaselwa kanye nokulimala okuhlangene.
- I-Gout ihlobene nokungafani okuzuzwa njengefa lokucubungula uric acid emzimbeni. Amazinga e-uric acid angakhuphuka ngokudla ukudla okunengi ngokweqile kwe- purine , uma kune-overricduction ye-uric acid emzimbeni, noma uma izinso zingagcini i-uric acid engaphezulu.
- Izinjongo zokwelapha zihlanganisa ukuqeda ukuhlasela okunamandla , ukuphumula ubuhlungu nokuvuvukala, ukuvimbela ukuhlaselwa okuzayo, nokugwema izinkinga (isib. Ukwakheka kwe- tophi , amatshe ezinso, nokubhujiswa okuhlangene).
- Nakuba ukwelashwa kwe-gout kuvame ukwelashwa ngempumelelo futhi ngaphandle kokucindezeleka, kuba inselelo enkulu uma ezinye izimo zikhona kanye nomuthi noma uma kunesimo esifanele sokuhambisana nesimo sengqondo sokuguqula impilo noma umuthi wemithi.
- Ukunconywa kokudla kunconywa, njengokugwema ukudla okune-purine . Ezinye izinyathelo zokuvimbela zihlanganisa ukulondoloza ukudla okwanele oketshezi, ukwehlisa isisindo, ukunciphisa utshwala, kanye nemithi yokunciphisa ukuphathwa kwegazi.
- Imithi ye-gout ihlanganisa:
- izidakamizwa ezingekho-steroidal anti-inflammatory (NSAIDS)
- colchicine
- i-corticosteroids
- i-horrenone ye-adrenocorticotropic (ACTH)
- allopurinol
- probenecid
- sulfinpyrazone
- Uloric (febuxostat)
- I-Krystexxa (i-pegloticase)
- I-NSAIDS ijwayele ukuthi imithi yokuqala ekhishwe ukuphatha igciwane elimnandi. I-Indomethacin ithathwa njengokusebenza kahle. Ezinye i-NSAIDS ingase isebenze ngokulinganayo. I-NSAIDS iqalelwa ukuthi isetshenziswe esilinganisweni esiphezulu futhi iyancishiswa njengoba izimpawu zingaphansi. Imithi kufanele iqhutshwe kuze kube yilapho ubuhlungu nokuvuvukala kungekho okungenani amahora angu-48. I-COX-2 inhibitors ingase ibe usizo ezigulini ezinokukhathazeka ngamathumbu kodwa ukusetshenziselwa ukuguga okunamandla akuzange kufundwe ngokuqondile noma kubikwe.
- I-Colchicine isetshenziselwa ukwelapha ama-flare acute we-arthritis e-gouty nokuvimbela ukuhlaselwa kwe-acute okuphindaphindiwe. I-Colchicine ayiphili igciwane noma ithatha indawo yeminye imithi ehlisa inani le-uric acid emzimbeni. Umuthi uvimbela noma ukhulula ukuhlaselwa kwe-gout ngokunciphisa ukuvuvukala. I-Colchicine ingase isetshenziswe ngezindlela ezimbili: abanye abantu bathatha inani elincane njalo izinyanga noma iminyaka, kanti abanye bathatha inani elikhulu le-colchicine ngesikhathi esifushane (amahora amaningana).
- I-corticosteroids noma i-hormone ye-adrenocorticotropic ingasetshenziselwa iziguli ezingenakuthatha i-NSAIDS noma i-colchicine. Iziguli ezine-gout ezivame kakhulu zithola ukulinganisa nsuku zonke kwe-prednisone (20-40mg) noma elilingana nezinsuku ezintathu kuya kwezingu-4, bese kuthiwa i-tapered kancane kancane ngemva kwamasonto amabili kuya kwamabili. I-ACTH ilawulwa njengemjovo ye-intramuscular (i-dose yokuqala kanye nokulinganisa okulandelayo ngemva kwezinsuku ezimbalwa njengoba kudingeka).
- I-Allopurinol (igama lomkhiqizo - iZyloprim) , elinqunyelwe i-gout engenasifo noma i-arthritis engavamile, isebenza ngokuthinta uhlelo olwenza i-uric acid emzimbeni. Isetshenziselwa ukuvimbela ukuhlasela kwe-gout, hhayi ukuwaphatha uma kwenzeka.
- I-Probenecid (amagama omuthi - i-Benemid, i-Probalan) inqunyelwe i-gout engenasifo nesifo samathambo esibi kakhulu. Isetshenziselwa ukuvimbela ukuhlaselwa okuhlobene no-gout, hhayi ukuwaphatha uma kwenzeka. Isebenza ezintsheni ukusiza umzimba ukuba uqede i-uric acid. I-probenecid yaziwa njenge-agent ye-uricosuric.
- I-ColBenemid (amanye amagama omkhiqizo yi-Col-Probenecid ne-Proben-C) imithi ye-gout equkethe i-Probenecid, i-agent ye-uricosuric, ne-Colchicine, enezindawo zokulwa ne-gout.
- I-Sulfinpyrazone (igama lomshicileli - i-Anturane) liyaziwa nangokuthi i-agent e-uricosuric futhi lisetshenziselwa ukuphatha i-arthritis e-gouty. Isebenza ngokunciphisa inani le-uric acid egazini lakho, ukuvimbela ukuhlasela kwe- gout . Isidakamizwa sisiza ukuvimbela ukuhlaselwa kodwa asisetshenziselwa ukuphatha ukuhlasela uma sekuqalile. I-Sulfinpyrazone okwamanje ayitholakali e-US
- I- osartan, (amagama amabizo - i-Cozaar ne-Hyzaar), akuyona imithi yemithi ye-gout kodwa i-angiotensin II receptor antagonist, izidakamizwa ezingenamandla kakhulu ezingasiza ekulawuleni amazinga e-uric acid. I-fenofibrate, (igama lomkhiqizo - iTricor), akuyona imithi ethile ye-gout kodwa i-lipid-downing drug engasiza amazinga e-uric acid.
- Ama-painkillers ase- analgesic asetshenziselwa ukukhulula ubuhlungu obukhulu be-gout. Zonke izidakamizwa ezibalulwe ngenhla zingasetshenziswa ngokuhlanganiswa, ukulawula izimpawu, ukuvimbela ukuhlaselwa kwesikhathi esizayo, nokugcina amazinga e-uric acid enempilo.
- I-Krystexxa (i-pegloticase) yisidakamizwa se- biologic . Isebenza ngokuphula i-uric acid. It isetshenziswa iziguli gout ngubani ehlulekile noma abakwazi ukubekezelela imithi gout evamile.
- I-uloric (febuxostat) iyisidakamizwa esetshenziselwa ukuphathwa okungapheli kwe- hyperuricemia ku-gout . I-uloric yehlisa amazinga we-serum uric acid ngokuvimbela i-xanthine oxidase - i-enzyme ephethwe ukukhiqizwa kwe-uric acid.
Amathiphu:
- Gcina ukondla okwanele kwamanzi.
- Gcina isisindo sakho ngaphansi kokulawula. Ukukhuluphala kuhlanganiswe ne-gout.
- Izinguquko zokudla zingasiza ekuvimbeleni ukuhlaselwa kwe-gout. Gwema ukudla okucebile kwe-purine. Nciphise ukusetshenziswa kotshwala.
- Imithi ingasiza ukulawula ubuhlungu nokuvuvukala kokuhlaselwa kwe-gout futhi kusize ukuvimbela ukuhlaselwa okuzayo ngokuqeda uric acid ngokweqile noma kuthinta ukukhiqizwa kwe-uric acid excess.
- Hlonipha uhlelo lokwelapha udokotela wakho atusa.
Okudingayo:
- Yidla kancane kuma-purines.
- Imithi yokulawula ubuhlungu.
- Imithi yokulawula ukuvuvukala.
- Imithi yokulawula izinga le-uric acid.