Ukufezekisa Imigomo Yokwelapha
"Ukwelapha ukukhomba" yisimiso noma indlela eye yaphumelela ekwelapheni izifo ezithile nezimo ezithile. Isu ekuqaleni kwakusetshenziselwa ukwelapha umfutho wegazi ophakeme, i-cholesterol ephakeme, nesifo sikashukela. Kodwa, ububanzi buye banda futhi buphatha ngokubhekiswe kulokhu kuye kwaholela ekucabangeni kochwepheshe bezesifo se-rheumatic .
Ukuphatha ukubhekisa isu kufanele kube nalezi zinto ezintathu:
- i-target
- indlela yokukala uma ngabe ilitshe liye lawa noma lifinyelelwe
- izinketho zokuthola ukwelashwa ezitholakalayo ezenza kube lula ukushaya leli phuzu
Ngokuqondene nomfutho wegazi ophakeme, ukufundwa kwengcindezi yegazi okuhlosiwe kungaphansi kuka-150/100 mm Hg, okungaphansi kwama-140/90 okusebenza kangcono ekunciphiseni imicimbi ye-cardiovascular. Ukuze ufeze imigomo oyifunayo ye-cholesterol engqikithi ne-LDL, izitembu zivame ukushiwo. Kulabo abagulayo abanesifo sikashukela, kunezinhlahlandlela zokwelapha ngegazi ne-hemoglobin A1C. Yini ebhekwa njengento ehlosiwe ku-rheumatology?
Phatha I-Target ku-Arthritis Ye-Rheumatoid
Ku- arthritis ye-rheumatoid , umgomo oyinhloko ukukhululwa . Umsebenzi wesifo esiphansi ungenye futhi, mhlawumbe efinyeleleka nakakhulu futhi ezimweni eziningi. Ukushaya ilitshe, ukuvuvukala kufanele kulawulwe noma kuphethwe. Lokhu kulinganiswa ngokuhlola umsebenzi wesifo. I-DAS28 (I-Score Work Score) noma I-CDAI (I-Clinical Disease Activity Index) yilezi zindlela ezingenziwa ngazo izifo zesifo.
Imvamisa enhle yokuqapha umsebenzi wokugula ayizange yenziwe, kepha i-DAS28 engaphansi kwezingu-2.6 ngokuvamile ibhekwa njengendlela ekhombisa ukukhululwa kwesifo sengculazi.
Enye i-caveat ebalulekile engingayinakwa - izinhloso zokwelashwa kufanele zibe ngabanye. Ukwehluleka , umlando wemicimbi yezidakamizwa ezimbi, nokuthi yiziphi amalunga ezithintekayo kufanele zicatshangelwe uma kuthuthukiswa isu elibhekiswe kulo.
Phatha ukuze ukhishwe ku-Lupus
Iqembu lamazwe ngamazwe liye lahlakulela ukwelashwa ukuze kuhloswe isu le- lupus . Ibutho lezemisebenzi lalisungula ukuthi ukukhishwa kwezinto ezibonakalayo, kanye nezimpawu zesistimu ze-lupus, kuyisisusa esiyinhloko sokwelapha i-lupus. Olunye ukwelashwa ukukhomba umgomo we-lupus kuhilela ukuvimbela ama-flares , kuhlanganise nephritis , izimpawu ze-neuropsychiatric, kanye nezimpawu ze-lupus jikelele. Ukuvimbela umonakalo nakho kwasungulwa njengenhloso, ngenhloso yokuvimbela umonakalo wegciwane ngaphambi kokuqala nokugcina ngokulawula umsebenzi wesifo kanye nobuthi obuvela emithini. Ukunakekelwa esikhwameni sempilo yesiguli nakho kubalulekile.
Ukuqhubekela phambili, ibutho lezinhloso lihlose ukuthuthukisa izincazelo ze-lupus remission nokusebenza kwesifo esincane esamukelekayo. Kukhona nesidingo sokuhlolwa okungcono kwamarekhodi.
Ngenkathi kunethemba lemithi emisha ye-lupus esikhathini esizayo, sekuye kwasungulwa kakhulu futhi kuthengiswa ngamathambo e-rheumatoid kusukela ngo-1998 (ngenkathi u- Enbrel eba yisidakamizwa sokuqala se-biologic evunyelwe isifo se-rheumatoid arthritis). Ngokuphathelene nezidakamizwa okwamanje ezisetshenziselwa ukwelapha i-lupus, iqembu lemisebenzi lizofuna ukuthola ukuthi kunezinga eliphansi le- steroids elizobhekwa liphephile ekuphatheni ukuze kuhloswe isu.
Futhi, imibuzo mayelana nokufaneleka kwe- hydroxychloroquine yazo zonke iziguli ze-lupus zikhona.
Phatha I-Target ye-Spondyloarthritis
Ngo-2013, iphaneli lezobuchwepheshe libheke ukuthi iziguli ezine- spondyloarthritis zingazuzisa yini ekuthathweni kwelashwa. Baphetha ngokuthi ukuphatha okubhekiswe kuzo kungasebenza ku-spondyloarthritis kodwa ukuthi isiqondiso sendlela yokuchaza, ukulinganisa noma ngisho nokufeza imigomo yokukhululwa noma isifo esingasebenzi kungafinyeleli kulesi sigaba sesifo. Izivivinyo azikakabi khona ezicacisa izinyathelo ezingalinganiselwe zomsebenzi wesifo ku-spondyloarthritis. Umsebenzi udinga ukwenziwa. Okwamanje, izincomo zenziwe ngokusekelwe ebufakazini obuqondile.
Kodwa-ke, isifundo esisodwa, esiqondile kwi- psoriatic arthritis , siqhathanisa neqembu leziguli ezithola ukunakekelwa okujwayelekile nge- methotrexate kwelinye iqembu elathola ukunakekelwa okujulile nomuthi. Ngokusho kwe-Rheumatology News, iqembu elikhulu lilandela isimiso esilandelayo futhi uma imingcele yokusebenza yesifo esincane ihluleka ukuhlangana, khona-ke umthamo we-methotrexate wanda. Futhi, uma iziguli zingaphumeleli ukuhlangabezana nezinqubo zemisebenzi yesifo, zanikezwa inhlanganisela enamandla ye- DMARD . Uma bengakafinyelelanga kulitshe, leli qembu elikhulu linikezwe i- blocker ye-TNF . Imiphumela yabonisa ukuthi iqembu elikhulu lalingcono kuneqembu elijwayelekile elihlala ku-methotrexate ngaphandle kohlelo lokukhula kwezidakamizwa noma ukulinganisa umsebenzi wesifo.
Futhi, e-European Congress of Rheumatology yonyaka wonyaka (EULAR 2014), ukunwetshwa kweminyaka engu-5 yokulingwa okungahleliwe nokulawulwa kwe- Simponi (golimumab) kweziguli ezine-arthritis ye-psoriatic kubonise imiphumela engcono kakhulu yesikhathi eside ezigulini ezikwazi ukufeza umsebenzi wesifo esincane ukuphatha okubhekiswe kulo.
Okubalulekile
Abacwaningi benza ucwaningo oluhlelekile lwezincwadi zesayensi (Schoels, M. et al.) Mayelana nokuphatha ukubhekela ku-rheumatology. Baphetha ngokuthi "izifundo ezimbalwa kuphela eziye zasebenzisa izindlela zokuhlola ukulingana kwenani lokuthola ukwelashwa. Kodwa kunjalo, bonke banikeze ubufakazi obunamandla bokuthola izindlela ezinjalo zokwelapha. Kodwa-ke, kudinga idatha eminingi mayelana nemiphumela ye-radiographic kanye nemisebenzi futhi iziguli ezine-RA [i-rheumatoid arthritis] ehlala isikhathi eside azizange zenziwe uphenyo ngokwanele. "
Ngokwemvelo, ukuba nemigomo ethile yokwelapha, ikakhulukazi imigomo yokwelashwa efinyelelekayo, inengqondo. Ukuze usebenzise lokhu, izinhloso noma imigomo kumele iqondiswe kahle ngezifo zesifo se-rheumatic.
> Imithombo:
> 'Phatha Okubhekiswe Kuyo': Ukuhambisa Amathegethi Asuka Ekugulweni Kwenhliziyo, Hyperlipidaemia kanye nesifo sikashukela ku-Rheumatoid Arthritis. Dan Atar et al. Ama-Annal of the Rheumatic Diseases . April 2010.
> Ubufakazi bokuphatha i-Arthritis ye-Rheumatoid ukuze kuhlolwe: Imiphumela ye-Systematic Literature Search. Schoels M. et al. Ama-Annal of the Rheumatic Diseases . April 2010.
> Ukwelapha-I-Target ku-Systemic Lupus Erythematosus: Izincomo Zomsebenzi Wezwe Lomhlaba Wonke. UVan Vollenhoven RF et al. Ama-Annal of the Rheumatic Diseases . Ishicilelwe ku-inthanethi ngo-Ephreli 16, 2014
> Ukwelapha i-Spondyloarthritis, Kubandakanya i-Ankylosing Spondylitis ne-Psoriatic Arthritis, ku-Target: Izincomo ze-International Task Force. U-Smolen JS et al. Ama-Annal of the Rheumatic Diseases . Juni 8, 2013.
> Indlela yokuThola-kuya-Target ye-Psoriatic Arthritis Yathola Inzuzo. I-Rheumatology News . Doug Brunk. Novemba 4, 2013.
> Ukwelapha I-Target Ibonisa Ukuthuthukiswa Okuhlala Phakade ku-Psoriatic Arthritis. I-Internal Medicine News . Jennie Smith. Juni 12, 2014.