Imithi Ye-Migraines, Ukuncintisana Kwezinzwa Zekhanda kanye Nezinsolo Zezinhlanzi Ze-Cluster
Hamba phansi umuthi wokuphuza ubuhlungu kunoma yisiphi isitolo sezidakamizwa futhi ungakwazi kalula ukucindezeleka. Kunezinhlobo ezibonakalayo ezingapheli zemithi ezitholakalayo zokwelapha ikhanda elibuhlungu. Uyazi kanjani ukuthi yikuphi okulungile kuwe? Kuxhomeke kakhulu ezintweni ezimbili: yiliphi uhlobo lwezinsizwa ezingapheli, nokuthi ubuhlungu bekhanda bubuhlungu kangakanani.
Imithi Ngokwezinhloko Zezinhloko
Ngenxa yokuthi kunezinhlobo eziningi zezinsizwa ezingapheli , kunezinhlobo eziningi zemithi yazo.
Kodwa iningi liwela emikhakheni emibili: imithi yobuhlungu oyithatha nsuku zonke ukuvimbela ikhanda (eyaziwa ngokuthi i-prophylactic), kanye nemithi oyithatha ngemva kokuqala ikhanda (eyaziwa ngokuthi uyabamba).
Imithi yokuhlunguphaza ubuhlungu ingahle itholakale ngaphezu kwe-counter noma ngomshwalense futhi ithathwe ngesikhathi sokuhlaselwa kanti imithi yokwelapha i-prophylactic ithathwa njalo ukuze kuvinjelwe ikhanda elingenangqondo lingakhi, futhi ngokuvamile lidinga umuthi odokotela. Ezinye izinhlobo zekhanda elingapheli zidinga zombili izinhlobo zemithi.
Imithi ye-Migraines
Imigraines ivame ukuphathwa ngemithi yokuvimbela i-prophylactic evamile kodwa imithi yokukhipha iyasiza ekuphumeleleni ubuhlungu be-migraine. Imithi eminingi ye-prophylactic idinga isikhathi sokwakha, futhi ngeke iphumelele ekuvimbeleni i-migraine amasonto ambalwa.
Ngenxa yokuthi i-migraines ingenangqondo, imishanguzo eminingi ye-prophylactic isebenza ngokushintsha indlela ubuchopho obusabela ngayo ezintweni ezithile.
Kungathatha izilingo eziningana ukuthola imithi ephumelelayo ebuhlungu bakho be-migraine.
- I-Tricyclic antidepressants . Okubhalwe kumanani aphansi kunokuba kube nokucindezeleka komtholampilo, i-tricyclics efana ne- amitriptyline ne-nortriptyline ingasiza ekuvimbeleni imithi ngaphambi kokuthi iqale.
- Amanye ama-anti-depressants . I-Serotonin-reuptake inhibitors (i-SSRIs) ayiphumeli njalo njenge-tricyclics, kodwa ilawula imigraines kwabanye abantu. I-SSRI evamile ye-migraines ifaka phakathi i-fluoxetine ne-sertraline.
- Abavimba be-Beta . Ngokuvame ukusetshenziselwa ukulawula ukucindezelwa kwegazi, i-beta blockers inganciphisa imvamisa ye-migraine noma ukuqina lapho ithathwa njalo. I-Propranolol ne-timolol zivame ukushiwo ngale njongo.
- Abavimbela isiteshi se-Calcium . Yize kungathatha amasonto amaningi ukuba abe abasebenza kahle, abavimba be-calcium abafana ne-verapamil bangasebenza ekuvimbeleni ukuhlaselwa kwe-migraine. Ezinye izivimbela zesiteshi se-calcium okwamanje zicwaningwa ngale njongo.
- Ama-NSAID . Izidakamizwa ezingekho ukuvuvukala ezifana ne-aspirin ne-ibuprofen zingathathwa njengemithi yokukhipha. Kodwa-ke, abanye odokotela bayabanika nokusetshenziswa kweprophylactic.
Amanye ama-prophylactics e-migraine afaka izidakamizwa zokulwa nezidakamizwa nakuba zivame ukubhekwa njengesinqumo sokugcina ngenxa yemiphumela yabo emibi kanye nesifo sobuthakathaka. Njengamanje, kwenziwa ucwaningo lokuhlola ukusebenza kwe-enzyme (ACE) inhibitors ye-angiotensin, ama-angiotensin-receptor blockers (ama-ARB), i-botulinum I-A (Botox), abaphikisi be-leukotriene nama-dopamine agonists.
Imithi Yokunciphisa Inhliziyo
Imithi evame ukusetshenziselwa ubuhlungu obukhulu bekhanda kuhlanganisa:
- I-Tricyclic antidepressants . Ama-tricyclics afana ne-amitriptyline ne-imipramine asetshenziswa njenge-prophylactics, evimbela ukuhlukunyezwa kwekhanda ukuba kungenakuqala.
- Ukuzijabulisa . Ngokuvame ukusetshenziselwa ukulawula ukukhathazeka, ngezikhathi ezithile ama-sedative ayenesidingo esikhathini esifushane sokuhlunguphazeka kwezinhlungu zekhanda, ikakhulukazi uma kuhlobene nokucindezeleka. Lokhu kuhlanganisa i-alprazolam ne-clonazepam.
- Ama-NSAID . Ibuprofen kanye ne-naproxen ziyatholakala ngaphezu kwe-counter, kodwa ukugxila okunamandla kudinga isigwebo somdokotela. Zisebenza ngokuphumelelayo ekulawuleni ubuhlungu obukhulu bekhanda lobuhlungu bekhanda.
- Ama-opioids . Ama-opioids afana ne-codeine noma i-hydrocodone ingasetshenziselwa ukwelapha izinhlungu zekhanda ezinzima emva kokuba ama-NSAID aboniswe ukuthi awasebenzi.
Izindima ze-botulinum I-A, imithi yokulwa ne-anti-seizure kanye nama-muscle relaxants ekulawuleni izikhwama ezingapheli zengcindezi okwamanje iyaphenywa.
Imithi yezinhlanzi zeCluster
Ngenxa yokuthi ukuhlaselwa ikhanda kwamagciwane amaningi kuphila isikhathi esifushane, imithi ye-prophylactic ivame ukusebenza kangcono kunemithi yokukhipha. Eminye yemithi ejwayelekile ejwayele ukulawula ikhanda eliphakathi kwesikhumba elihlanganisa njalo:
- Abavimba be-calcium-channel . Njenge-migraines, i-verapamil i-block ejwayelekile ye-calcium-channel for ubuhlungu bekhanda lamagundane, nakuba empeleni yenzelwe ukwelapha isifo senhliziyo.
- Lithium . Ngokujwayelekile esetshenziselwa ukwelapha ukucindezeleka kwe-bipolar, i-lithium ingasetshenziswa yodwa noma ihlanganiswe nezinye izidakamizwa ukulawula ikhanda lekhanda.
- Izidakamizwa zokulwa ne-Anti-seizure . I-Valproate ne-topiramate zenzelwe ukwelashwa kwesibindi. Kodwa-ke, ziye zafakazela ukuthi ziwusizo ekulawuleni imvamisa yamakhanda eqoqo.
- I-Capsaicin . Inguqulo ye-nasal-spray ye-capsaicin, i-analgesic ye-topical, iye yaba ngu-50% ephumelelayo ekunciphiseni imvamisa yamakhanda ekhanda ekuhlolweni kwemitholampilo.
- Ama-transitional agents . Ama-transitional agents kukhona izidakamizwa ezisetshenziselwa ukuzinzisa umuntu emva kokuhlaselwa ikhanda leqoqo. Lokhu kufaka i-ergotamine ne-prednisone.
Ubuthi lwe-Botulinum ne-baclofen, okubili okusetshenziselwa ukunciphisa ubuhlungu be-muscle, okwamanje uphenywa ngenxa yokukwazi ukunciphisa imvamisa yokuhlaselwa ikhanda kwamagciwane.
Ngaphandle kwemithi
Imithi akuyona yodwa okukhethwa kukho ukulahla ubuhlungu bekhanda elingapheli. Eqinisweni, imithi eminingana ehambisanayo neyehlukile (i-CAMs) isetshenziswa kakhulu kule njongo. Lokhu kufaka phakathi i-yoga, ukusikhipha, ukugcoba umzimba, ne-aromatherapy.
Ngaphezu kwemithi kanye ne-CAMs, ukuthola izindlela zokubhekana nokubhekana nokuphathwa ikhanda okungapheli kungahamba phambili ekuqondeni ukuvimbela nokulawulwa ubuhlungu. Hlola amaqembu okusekela kanye namaforamu, faka umndeni wakho nabangani futhi uhlele ubuhlobo obuhle nodokotela wakho. Uma kuhlangene nezidakamizwa ezifanele, izindlela zokubhekana nazo zingakusiza ukuba uzwe ubuhlungu obukhulu bekhanda obungaphansi kokulawula.
Imithombo:
I-National Headache Foundation. Inhloko: Imibuzo Evame Ukubuzwa. http://www.headaches.org/headache-faq/
I-National Pain Foundation. Imithi yokwelapha yekhanda.
Isikhungo Sezokwelapha sase-University of Maryland. I-Migraine Headache.