Isidakamizwa se-MS esithembisayo, kodwa kunemibuzo eminingi
Nakuba kungekho ukwelashwa kwe- multiple sclerosis (MS) , kukhona imithi engasiza ekunciphiseni lesi sifo-le mithi ibizwa ngokuthi izifo eziguqula isifo . Ukwengeza, kunezindlela zokwelapha ezinganciphisa izimpawu futhi zithuthukise ngempela ikhwalithi yomuntu yansuku zonke yokuphila nokusebenza.
Esinye isifo se-MS esilula-ukuphulukisa okungenzeka uzwile yi-cannabis, eyaziwa nangokuthi i-marijuana.
Ake sihlolisise indima ephuthumayo yobunikazi ku-MS, kanye nokuphikisana okubandakanya lesi sidakamizwa esithandwa kakhulu.
Indima ye-Marijuana ekuPhakameni iSpasticity ku-MS
I-Marijuzana isetshenziselwe ukusebenzisana ne-MS ukuze kukhululeke ukuphazamiseka kwengqondo , okuyisifo esilimaza futhi esibuhlungu kaningi esithinta abantu ababili kwezintathu zabantu abane-MS.
Ukuphazamiseka okubhekisela ekukhulumeni kwe-muscle tone, okusho ukuthi imisipha ethile (ikakhulukazi leyo emilenzeni) inzima kakhudlwana ukuphumula. Ukusabalalisa kungaba nzima kakhulu, kubangele ukuhlukumezeka kwemisipha nokuqina, ukuphazamisa ukuhamba noma ezinye ukunyakaza, futhi kuholele ekuweni.
Ngeshwa, imishanguzo yendabuko esebenzisa ukwelashwa ngokwemvelo e-MS (isibonelo, ukuphumula kwemizimba, i-benzodiazepines, noma i-anticonvulsants) ngokuvamile ayisebenzi futhi ithwale imiphumela emibi njengobuthongo, okungabangela ukukhathala okuhlobene ne-MS-i -double whammy. Ngaphezu kwalokho, njengale mithi, izidakamizwa ezingezona izidakamizwa zokwelapha izidakamizwa ku-MS (isibonelo, ukwelashwa ngokomzimba kanye nokwelashwa kwamagesi) kuye kwafunyanwa ukuthi kuyasiza kancane.
Yingakho odokotela bakwa-MS bephendukele emithonjeni yokwelapha njengenambuzane ukuze banikeze iziguli zabo impumuzo efanele.
Isifundo esisodwa eMarijuana Sokusabalalisa ku-MS
Ucwaningo olulodwa ku- Journal of Neurology, Neurosurgery, kanye ne-Psychiatry luhlolisise abahlanganyeli abangaba ngu-300 abane-MS. Abahlanganyeli babe nesifo esizinzile ngaphambi kwezinyanga eziyisithupha futhi babika ukuqina komfutho we-muscle nokucindezela okungenani izinyanga ezintathu ngaphambi kokubhalisa esifundweni.
Ingxenye yabathintekayo yathola ukukhishwa komuthi we-cannabis (inambuzane) kanti enye ingxenye yathola i-placebo. Abahlanganyeli kanye nabaphenyi babengazi ukuthi ngubani othole inambuzane ngokumelene nabanikezwa i-placebo, njengoba izinto zombili zenziwa nge-captionle ye-gelatine.
Abahlanganyeli babike izimpawu ezihlukahlukene, njengezinsizi ze-muscle, kanye nezinga labo lokuphucula ngaphambi kokwelashwa bese emva kwamasonto ayishumi nambili emva kokwelashwa (noma i-placebo) yaqala.
Ukukhululeka kokuqina kwemisipha ngemva kwamasonto ayishumi nambili kuthuthukiswe cishe kabili emgqeni wezinambuzane uma kuqhathaniswa neqembu le-placebo. Kwakukhona nokuthuthukiswa okuphawulekayo kwezimpikiswano ze-muscle nokuphazamiseka kokulala kulabo abathola inambuzane kulabo abathola indawo ye-placebo.
Imiphumela emibi
Ngokuphathelene nokuphepha, imiphumela emibi yayiphezulu eqenjini elikhishwe yi-cannabis kuneqembu le-placebo, nezinga eliphezulu kakhulu lemiphumela emibi ebikwe ekupheleni kwesigaba sokukhula kwesilinganiso se-cannabis (okwakuyinto esheshayo ngokushesha). Lokhu kwaholela ekutheni izinga eliphezulu lokuhoxiswa kulolu cwaningo.
Eminye yemiphumela emibi ebonwe ngesilinganiso esiphezulu esigodini samanothi ne-placebo kufakwe:
- Isizungu
- Ukukhathala
- Umlomo omile
- Ukungabi namandla
Lokho kusho ukuthi iningi lemiphumela emibi yayinomusa noma iyingcosana futhi incipha kakhulu ekupheleni kwesifundo.
Isifundo sesibili ngeMariju Ukusetshenziswa kweSpasticity ku-MS
Kwesinye isifundo, abantu abane-MS esithuthukisiwe kakhulu abangenalo imithi yokwelashwa abazange baphumelele ngemishanguzo yendabuko baphathwa nge-Sativex (nabiximol), ukufiphaza umlomo okuqukethe kokubili i-tetrahydrocannabinol (THC) ne-cannabidiol (i-CBD), ngesilinganiso ngasinye se-Sativex esihambisa i-THC I-CBD esilinganisweni esiseduze esingu-1: 1.
Ngaphandle, inambuzane ivela e-hemp isitshalo se- Cannabis sativa, esinezinhlanzi ezingamashumi ayisithupha noma ngaphezulu. Kulawo ma-cannabinoids, okubili kuningi yi-THC ne-CBD, kokubili okungasiza ekunciphiseni ubuhlungu obukhulu ngokunciphisa ubuhlungu nemisipha ephumuzayo.
Abahlanganyeli baqala ukuvivinya isonto eli-4 le-spray, futhi uma bezuza amaphesenti angu-20 noma ukuthuthukiswa okukhulu ekuphambeni kwabo, baqhubekele ekuvivinyweni kwamasonto angu-12. Kulesi sivivinyo sesibili, ababambiqhaza babenomsebenzi wokuthola i-nabiximol noma i-placebo.
Imiphumela yalolu cwaningo yembula ukuthi labo abathola i-nabiximol babe nokuthuthukiswa okuphezulu kakhulu ekuphambeni (okuchazwe okungenani amaphesenti angu-30 okuthuthukiswa kusukela esisekelweni sabo) kuneqembu le-placebo. Kubuye kube nokuthuthukiswa kokuvama kwe-spasm nokuphazamiseka kokulala endaweni yokwelashwa ngokumelene neqembu le-placebo.
Imiphumela emibi
Kuyafaneleka ukuphawula ukuthi kwabangu-124 abahlanganyeli abaye baqhubeka nokuhlolwa kweviki ezingu-12 futhi banikezwa i-nabiximol, kwakunabangu-15 kuphela abaye baphuma ekutadisheni (amaphesenti aphansi kakhulu kunesifundo esingenhla). Lokhu kungenxa yokuthi umthamo wokubamba i-dose (okusho ukuthi ngokushesha umthamo wezinambuzane usanda kanjani) wawuphuza futhi uqapha.
Ngokufanayo, kwakunezinga eliphansi lemiphumela emibi ekhonjisiwe kulolu cwaningo-elinye ibhonasi. Kulabo abaphatha i-nabiximol, imiphumela emibi kakhulu evamile yilezi:
- I-Vertigo
- Ukukhathala
- Ama-spasms we-muscle
- Ukutheleleka kwe-Urinary tract
Umlayezo osuka ekhaya ovela kulolu cwaningo wukuthi inambuzane (yomuntu ofanele, ngakho-ke "isikhathi sokuvivinya isonto eli-4") libonakala lizuzisa, liphephile futhi libekezelela kahle ngesikhathi esifushane sokwelapha isikhala esiningi kwi-sclerosis.
Yiziphi Izinhlangano Zomsebenzi Ezikushoyo
I-National MS Society isekela amalungelo abantu ukuba basebenze nodokotela wabo we-MS ukuze bathole inambuzane ngezinhloso zokwelapha, "ngokuhambisana neziqondiso zomthetho kulabo asetshenziswa lapho ukusetshenziswa okunjalo kuvunyelwe khona." Ngaphezu kwalokho, iNational MS Society isekela ucwaningo oluhlola izinzuzo nezingozi zokusebenzisa insangu njengokwelashwa kwe-MS.
Lokhu kusho ukuthi ngeshwa ukucwaninga ngamanoni ku-MS kuvinjelwe ngenxa yezimiso zikahulumeni, njengoba inambuzane isalokhu ingekho emthethweni ezingeni likahulumeni.
Ngokusho kweNational MS Society, isisekelo sokuba isikhundla sabo emanzini sivela esitatimendeni sika-2014 esakhishwa yi-American Academy of Neurology (AAN). Isitatimende se-AAN sinikeza iziphakamiso ekusebenziseni izindlela zokwelapha ezihlukahlukene kanye nezinye izindlela zokwelapha ezise-MS ngokusekelwe kokuhlolwa kocwaningo lwezocwaningo.
Ngokuqondene nosizi, i-AAN iphakamisa ukuthi uketshezi lwe-cannabis ngomlomo kanye nokwenziwa komthamo we-tetrahydrocannabinol (THC) kungenzeka ukuthi uyasebenza ekunciphiseni ubuhlungu nobuhlungu.
Lesi sitatimende siphinde sisho ukuthi i-Sativex ye-oral spray (i-naxibimol) kungenzeka isebenze ekuthuthukiseni ubuhlungu, ubuhlungu, kanye nemvamisa yamanzi; nakuba i-Sativex ayitholakali okwamanje e-United States.
Ngakolunye uhlangothi, ngokusho kwe-AAN, abukho ubufakazi obwanele besayensi bokusekela inzuzo noma ukuphepha kwe-cannabis yokubhema yokuphatha izimpawu ze-MS.
Okokugcina, izingozi zesikhathi eside zokusebenzisa inambuzane yokwelapha izimpawu ezihlukahlukene e-MS zivele zingaziwa ngalesi sikhathi ngenxa yenani elincane lezifundo. Eqinisweni, enye yezinkathazo ezinkulu mayelana nokusetshenziswa kwesikhumba eside isikhathi eside kunemisebenzi engqondweni yokungaqondakali, njengememori nokusebenza okusebenzayo.
Izwi elivela
Ngokuqinisekiswa kokusetshenziswa kwebambiso ngezimo ezihlukahlukene zezokwelapha ezikhulwini ezingamashumi amabili nesishiyagalolunye kanye neSifunda saseColombia (futhi kungenzeka ukuthi sengiyahamba), inani labantu abane-MS abasebenzisa inambuzane ukuze banciphise izimpawu zabo ze-MS cishe kuzovuka.
Kodwa-ke, ukucacisa ukuphepha okuncane kanye nokuhlala isikhathi eside nokuthola inzuzo, futhi ukuxazulula izinkinga, njengokuthi yiziphi izimpawu eziphathwa kahle nge-cannabis noma yiziphi izilinganiso noma indlela yokuphatha ekahle, sidinga ubufakazi obuningi besayensi.
Kuze kube yileso sikhathi, uma ucubungula insangu ngenxa ye-spasticity yakho, sicela uqinisekise ukuthi uyayisebenzisa ngaphansi kokuqondiswa kwedokotela wakho we- MS . Ngale ndlela, ungakwazi ukwandisa inzuzo yayo futhi unciphise umphumela wayo omubi. Ngokuvamile, lokhu kuhlanganisa uhlelo lokuqothula inambuzane nokucubungula.
> Imithombo:
> Amatya B, Khan F, La Mantia L, Demetrios M, Wade DT. Ukungenelela kwamakhemikhali okungahambi kahle kwamakhemikhali okwehlukana kwezifo eziningana ze-sclerosis. Cochrane Database Syst Rev. 2013 Feb 28; (2): CD009974. i-doi: 10.1002 / 14651858.CD009974.pub2.
> National MS Society. Imibuzo ye-Medical Marijuana (Cannabis).
> Novotna A et al. I-randomols (Sativex (®), ebizwa ngokuthi i-Sativex (®), ebizwa ngokuthi i-satifx (®), ebizwa ngokuthi i-sativex (®), ebizwa ngokuthi i-Sativex (®), ebizwa ngokuthi i-Sativex (®) I-Eur J Neurol . 2011 Sep; 18 (9): 1122-31. i-doi: 10.1111 / j.1468-1331.2010.03328.x.
> Rudroff T, Honce JM. I-cannabis ne-multiple sclerosis-Indlela eya phambili. Ngaphambili Neurol. 2017; 8: 299.
> Zajicek JP, Hobart JC, Slade A, Barnes D, uMattison PG, i-MUSEC Research Group. I-multiple sclerosis kanye nokukhishwa kwe-cannabis: imiphumela yesilingo se-MUSEC. J Neurol Neurosurg Psychiatry. 2012 Nov; 83 (11): 1125-32. i-doi: 10.1136 / jnnp-2012-302468.