Ukuphatha Izimpawu Nezimbangela Eziyisisekelo
I-Gout iyindlela ye-arthritis ebangelwa ukwakhiwa kanye ne-crystallization ye-uric acid ehlangene. Ngokuya ngobukhulu bokuhlaselwa, ukwelashwa kungabandakanya izidakamizwa ezingaphezu kwe-anti-inflammatory (OTC) zokunciphisa ubuhlungu, kanye nokuguqulwa kokuziphatha (njengemikhawulo yokudla nokuphuza utshwala) ukunciphisa imvamisa yokuhlaselwa. Ukuhlaselwa okungapheli kungadinga imishanguzo yezokwelapha ukuze kusize ukunciphisa amazinga e-uric acid egazini.
Amakhambi asekhaya kanye nendlela yokuphila
Izimpawu ze-Gout zibangelwa ukuqoqwa ngokweqile kwe- uric acid , isimo esaziwa ngokuthi i- hyperuricemia . Ngokuhamba kwesikhathi, ukwakheka kungaholela ekwakheni ama-crystals e-uric acid ngaphakathi nangakuzungezile ukuhlanganiswa, okubangela ukuhlukumeza okubuhlungu nokuphuthumayo okubuhlungu nokuvuvukala.
Ngenxa yalokho, ukwelashwa kwe-gout kuzogxila ezintweni ezimbili: ukunciphisa uric acid nokuhlukunyezwa kwe-gout pain. Kunezinhlobo eziningi zokwelapha ekhaya kanye nokulungiswa kwendlela yokuphila okungasiza.
Ukuphathwa kobuhlungu
Ukuhlasela kwe-gout kuzovame ukuhlala ezinsukwini ezintathu ukuya kwezingu-10. Ubuhlungu phakathi nengxenye yokuqala yokuhlaselwa (ngokuvamile amahora angu-36 okuqala) kuzoba kubi kakhulu.
Phakathi kwezinketho zokwelapha ekhaya:
- Iphakethe leqhwa noma ukucindezeleka okubandayo kunganikeza ukukhululeka okukhulu kokuhlaselwa okuncane. Qinisekisa ukuthi ugoqa iphakethe leqhwa ngendwangu elincane bese usebenza kuhlanganyelwe imizuzu engu-15 ukuya kwangu-20 kuphela ukuvimbela ama-frostbite. Ungakwenza lokhu izikhathi eziningana ngosuku.
- Phinda uhlanganyele. Njengoba inzwane enkulu inesithinteka kakhulu, yenze inyawo linciphise ukunciphisa ukucindezela okuqondile. Gcina izinyawo zakho ngangokunokwenzeka, futhi, uma udinga ukuhamba, sebenzisa umoba.
Ukungenelela Kwezondlo
Esinye sezimbangela eziyinhloko zokuxilongwa kwegazi kungukudla esikudlayo. Ezinye ziqukethe amazinga aphezulu ekomidi eliphilayo elibizwa ngokuthi i- purine , lapho, lapho ephukile, iguqulwa u-uric acid.
Ezinye ziqukethe izinto ezivimbela ukuphuma kwe-uric acid ezivela ezinsweni.
Nakuba kungekho bufakazi bokuthi ukungenelela kokudla kunganciphisa ubukhulu noma isikhathi sokuhlaselwa, kufanele wenze umzamo wokugwema ukwandisa isimo sakho.
Kulokhu, kuzodingeka ukuthi:
- Yeka ukuphuza utshwala kunoma yiluphi uhlobo, ikakhulukazi ubhiya.
- Gwema ukudla okuphezulu-purine .
- Gwema iziphuzo ezifudumele ezithinta uric acid.
- Phuza amanzi amaningi ukuze unciphise ukuhlushwa kwe-uric acid egazini lakho.
Imithi ye-Over-the-Counter (OTC)
Imithi ye-OTC ivame ukusetshenziswa ngesikhathi sokuhlaselwa komnene kuya ekunciphiseni ukunciphisa ubuhlungu obuhlangene nokuvuvukala. Phakathi kokukhethwa kukho:
- Izidakamizwa eziphikisayo ezingekho ukuvuvukala (i-NSAID), njenge-Aleve (naproxen) ne-Advil (ibuprofen), isebenza ngokuvimbela i- COX enzyme ngendlela efana ne-analgesic (ukuphumula ubuhlungu) nokulwa nokuvuvukala.
- I-Tylenol (i-acetaminophen) ingasetshenziswa ezimweni ezinzima. Ngenkathi engenayo izakhiwo eziphikisanayo ze-NSAID, i-medges analgesic kakhulu.
- Amalungiselelo e-capsaicin ehlosiwe , okwenziwa ngamakhemikhali atholakalayo ku-pepper, aye aboniswa ukuhlinzeka ngokukhululeka kwempawu ze-gout. Zitholakala ama-creams, lotions, nama-transdermal patches futhi zitholakala kalula phezu kwe-counter.
Imigomo
Imithi yesiguli iyasetshenziswa uma izindlela zokudla nezindlela zokuphila zihluleka ukunikeza usizo kanye / noma kukhona ubufakazi bokulimala okuhlangene okuhlangene. Imithi yokwelashwa esebenzisa ukuphatha igciwane ingahlukana ngokubanzi ibe yizinhlobo ezimbili: anti-inflammatory kanye uric acid-ukunciphisa.
Izidakamizwa eziphikisayo
Izidakamizwa zokulwa nezidakamizwa ezivame ukusetshenziselwa ukwelapha i-gout zingabekwa ngokuqhubekayo noma zisetshenziswe uma kudingeka ukuze unciphise izimpawu ezimbi. Phakathi kokukhethwa kukho:
- I-Colchicine yisidakamizwa esilwe ngomlomo esivimba ukuvuvukala esetshenziselwa ukuphatha igciwane elingapheli. Isidakamizwa sisebenza ngokuvimbela ama-enzyme avuthayo abangelwa ukwakhiwa kwamakhekhedi e-uric acid. I-Colchicine ingasetshenziselwa yona kuphela kodwa ivame ukubekwa eceleni kwesidakamizwa sokunciphisa i-uric njenge-probenecid. Imiphumela emibi ihlanganisa isifo sohudo, isicanucanu, nesisu esiswini.
- I-Corticosteroids , ethathwe ngomlomo noma ngomjovo ibe yingxenye, inikeze usizo olufushane lwezimpawu ezinzima. Isidakamizwa sisebenza ngokushisa amasosha omzimba wonke futhi, njengoba kunjalo, ngeke isetshenziswe njengendlela yokwelashwa okuqhubekayo. Ukwelashwa ngomlomo (ngokuvamile nge- prednisone yezidakamizwa) kungenziwa kunqunywe ngaphezu kwezinsuku ezinhlanu. Ukujola kwama-corticosteroid kuvame ukusetshenziselwa uma kukhona ubufakazi bokuthi i-arthritis kanye nokuguguleka okuhlangene. Ukweqa ngokweqile kungaholela ekuzuzeni isisindo, ukulimala kalula, ukuphefumula ngokweqile, izinkinga zamehlo, ukucindezeleka kwegazi, kanye nengozi yokutheleleka.
- I-Qutenza (i-capsaicin) i-patch engu-8.0 ye-patch inganikeza ukuphumula okulinganiselwe ngesikhathi sokuhlasela okunamandla. Imiphumela emibi ihlanganisa ukusabela kwendawo yesicelo, kufaka phakathi ukuvutha, ukushaywa, ukubomvu, ukuvuvukala nokuphuza okuncane.
Uric Acid-Ukunciphisa Izidakamizwa
Uma ezinye izindlela zokungenelela zingaphumeleli ukunciphisa amazinga e-uric acid, odokotela bavame ukuphendukela emithini yemithi enganciphisa ukukhiqizwa kwe-uric acid noma ukwandisa ukuphuma kwe-uric acid emzimbeni.
Kukhona okwamanje izidakamizwa ezinhlanu ezivunyelwe yi-US Food and Drug Administration kulezi zinhloso:
- I-Probenecid imithi yomlomo ethathwe nsuku zonke ukusiza izinso zakho zisuse i-uric acid. Ngenkathi esebenza kahle ekunciphiseni izimpawu, kungathatha isikhathi ngaphambi kokuba umuthi usebenze ngempela. Kwezinye izimo, ukuhlaselwa kobuchopho kungakhuphuka phakathi nezinyanga eziyisithupha kuya kwezingu-12 kuze kube yilapho umzimba ulungisa ukwelashwa.
Imiphumela emibi ihlanganisa amatshe wezinso , isicanucanu, ukuqhuma, isisu esithukuthele, kanye nokukhanda ikhanda. Ithebhulethi ehlanganisiwe ebizwa nge-ColBenemid iyatholakala futhi ehlanganisa i-probenecid nge-colchicine.
- Uloric (febuxostat) i-oral xanthine oxidase inhibitor (XOI) eyenza ukukhiqizwa komzimba we-uric acid. Kuthathwa nsuku zonke, i-Uloric inganciphisa ubukhulu nokuvama kokuhlaselwa. Ama-flare-ups avamile uma kuqala ukuqala ukwelashwa. Ngisho noma kwenzeka, kufanele uqhubeke uthatha imithi njengoba kunqunywe.
Imiphumela emibi evamile ihlanganisa ukunxanxathela, ubuhlungu obuhlangene, nobuhlungu bomzimba. Ungathathi i-Uloric uma usebenzisa i-azathioprin (esetshenziselwa ukwelapha isifo samathambo) noma mercaptopurine (esetshenziselwa ukwelapha i-lymphoma, isifo se-Crohn, noma isifo sofuba esiswini). - I-Zyloprim (allopurinol) ingenye imithi yomlomo we-XOI. Njenge-Uloric, ukushaywa kwesifo kungenzeka ngesikhathi sokwelashwa kokuqala. Ukuze uvimbele lokhu, izidakamizwa zivame ukubekwe ezinyangeni eziphansi bese kancane kancane zanda.
Imiphumela emibi kakhulu kakhulu kunezinye izidakamizwa zokunciphisa i-uric futhi ingase ifaka ukuqhuma nokukhushulwa kwesisu. Izinkinga zesisu ngokuvamile ziyahamba njengoba umzimba wakho ulungisa imithi. - I- Zurampic ( lesinurad ) yisidakamizwa somlomo esiqinisa imiphumela ye-XOI uma i-XOI yodwa yanele. Kungathathwa eceleni kwe-Uloric noma i-Zyloprim kodwa kufanele isetshenziswe ngokuqapha njengoba kungandisa ingozi yakho ye-cardiovascular. Kumele futhi uhlale uhlanzekile kahle ukuze uvimbele amatshe ezinso.
Imiphumela emibi ingabandakanya inhloko, ikhanda elincane, ama-muscle aches, ubuhlungu obuhlangene, ne-reflux ye-asidi. I-Lesinurad iyatholakala futhi nge-allopurinol kuthebhulethi ehlanganisiwe ebizwa ngokuthi i-Duzallo. - I-Krystexxa (i-pegloticase) yisidakamizwa esisha se- biologic esithunyelwa ngokumnika okufakwe emzimbeni futhi isetshenziselwa kuphela uma ezinye izifo zihlulekile. I-Krystexxa isebenza ngokuguqula i-uric acid ibe yinto ebizwa ngokuthi i-allantoin ekhishwa kalula emzimbeni. Iphethwe njalo ngemva kwamasonto amabili emtholampilo ngakho-ke igcinelwe kuphela amacala ahlukumezayo.
Imiphumela emibi evamile ihlanganisa ukushaywa kwesikhashana esifushane, isicanucanu, ukulimaza, umkhuhlane, ukuqothulwa, ubuhlungu besifuba nokuhlanza. Ezimweni ezingavamile, ukusabela okungathí sina okwenzekayo kungase kwenzeke.
Ezinye izidakamizwa ezihambisanayo zingase zisetshenziswe ekwelapheni kwe-gout, kuhlanganise neCozaar (losartan), izidakamizwa ezinamandla kakhulu, kanye ne-Tricor (ukufiphaza), isidakamizwa esinciphisa i-lipid. Bobabili bangasiza ekunciphiseni amazinga e-serum uric acid.
> Imithombo:
> Anaud, P. noBley, K. "I-capsaicin yomsindo yokuphathwa kobuhlungu: ukukwazi ukwelapha kanye nezinqubo zesenzo se-new-concentration capsaicin 8%." Br J Anaesth. 2011; 107 (4): 490-502. I-DOI: 10.1093 / bja / aer260.
> Hanani, B; UMatheson, E. noWilke, T. "Ukuxilongwa, Ukwelashwa, Nokuvimbela I-Gout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. noBarden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. I-DOI: 10.1016 / S0140-6736 (09) 60883-7.