Imithi, Ukuguquka Kwendlela Yokuphila Kuxhomeke Emvamisa Yesifo
Ukwelashwa kwemithi yezinyawo ezingenalutho (RLS) kuncike ekutheni imvamisa yezimpawu futhi kunezinketho eziningi, kuhlanganise nemithi kanye nezinguquko zokuphila. Ngenhloso yokukhetha ukwelashwa okufanele, kufanele unqume ukuthi izimpawu zakho ziphakathi, zansuku zonke, noma zikhanyela ekwelapheni. Ngokuvamile, labo abanezimpawu zangaphakathi kufanele basebenzise ukuguqulwa kwendlela yokuphila, imithi ethinta amazinga e-dopamine, i-opioids ye-dose ephansi, noma i-benzodiazepines.
Uma izimpawu zansuku zonke, i-gabapentin ingase ibe yindlela ewusizo eyengeziwe. Ekugcineni, uma unezimpawu ezingaphenduli imithi, kungadingeka uzame imithi ehlukile noma yesibili.
Izidakamizwa zeDopamine
Ukwelashwa kokuqala kwemigudu yezinyawo ezingenalutho yizidakamizwa ezingathinta amazinga e-dopamine. Lokhu kungafezwa ngokuphindaphindiwe kwe-dopamine (enezidakamizwa ezibizwa ngokuthi i-levodopa) noma ngemithi ekhulisa amazinga akho angaphakathi we-dopamine ngokushintsha indlela umzimba owusebenzisa ngayo. I-Levodopa inamandla okuba nemiphumela emibi, kuhlanganise ne-nausea, ikhanda eliphansi, nokulala. Ngaphezu kwalokho, i-levodopa ingaholela ekukhusheni, lapho izimpawu zingase zivele ngaphambi kosuku, zibe nzima kakhulu, noma zisakaze ezandleni. Lokhu kungelashwa ngokungeza umthamo wangaphambili, kodwa uma kuqhubeka i-levodopa kumele imiswe noma umthamo wehlisiwe. Ngenxa yalezi zinkinga, imithi ebizwa ngokuthi i-dopamine agonists ivame ukukhetha.
I-dopamine agonists ihlanganisa imithi efana ne- pramipexole (igama lomkhiqizo okuthiwa i-Mirapex) ne- ropinirole (igama lomkhiqizo u-Requip) . Lezi zincane kakhulu ezingabangela imiphumela emibi njenge-augmentation. Kungase kube khona ukukhanya okulula nokukhathala, kodwa lokhu kuvame ukuxazulula ngemuva kwamasonto ambalwa okwelashwa. Imiphumela emibi engavamile yocansi ibandakanya ukuzwakalisa okungasese, ukuqunjelwa, ukuleleka , kanye ne-edema legalo.
Ngaphezu kwalokho, kunokwenzeka ukuthi ingozi yokwanda yokucindezeleka ingabandakanya ukugembula okungokwemvelo, ukudla okuphoqelekile noma ukuthenga, noma ukuxhumene kocansi okungalungile.
Kuneminye imithi emithathu engasetshenzisiwe engasetshenziswa kakhulu engathinta amazinga e-dopamine okuthiwa i-bromocriptine, i-per gold, ne-cabergoline. Lokhu akusetshenzisiwe kaningi ngenxa yezinkinga ezingavamile (kodwa ezingase zibe nzima) ze-fibrosis (ukukhwabanisa) kwe-valves yenhliziyo. Ngenxa yalezi zinkinga, i-perdune ayitholakali e-United States. I-Cabergoline ayilona i-FDA-evunyelwe ukwelashwa kwe-RLS, kodwa ngezinye izikhathi isetshenzisiwe ngaphandle kwelebuli kulezi zinhloso. Kungabangela ukucwenga, ukuqothuka, ikhanda, isizungu, ukukhathala, noma ukulala.
Ama-opioids
Imithi yama-opioid ivame ukusetshenziselwa ukuphatha ubuhlungu obunzima, kodwa futhi ingasiza ekunakekeleni i-RLS. Amanye ama-agent ajwayelekile asetshenziselwa afaka i-oxycodone, i-codeine, ne-methadone. Zivame ukunikezwa ngamanani okuhlukaniswa phakathi nosuku ukucindezela izimpawu ze-RLS. Ngokungafani nokusetshenziswa kwe-opioid ekunakekeleni ubuhlungu, kunengozi encane yokumlutha noma ukubekezela lapho isetshenziselwa ukuphatha i-RLS. Ukuqokwa kungase kwenzeke, kodwa ngokuvamile kuyinto encane.
Njengoba lezi zidakamizwa zicindezela ngokuphefumula ukuphefumula, ukusetshenziswa okucophelelayo kunconywa uma une- apnea yokulala . Ama-opioid ngokuvamile asetshenziswa kuphela kubantu abahluleka kwezinye izifo.
I-Gabapentin
Uma izimpawu ze-RLS zenzeka nsuku zonke noma zingamelana nezinye izifo, ukusetshenziswa kwe- gabapentin kungaqashwa . Ngezinye izikhathi i-Gabapentin isetshenziselwa ukwelapha ubuhlungu noma ubuhlungu be-neuropathic, kodwa futhi isebenza kahle ku-RLS. Inikezwa ngezilinganiso ezihlukene phakathi nosuku. Kungabangela ukungaqiniseki ukuhamba noma ukulala. Kungaba yimpumelelo ngokukhethekile uma ubuhlungu bubonakala ngezimpawu ze-RLS.
Benzodiazepines
Iklasi lemithi ebizwa ngokuthi i- benzodiazepines ivame ukuwusizo ezimweni ezincane ze-RLS, ikakhulukazi kubantu abasha.
Uma unezimpawu eziphakathi, kungase kube ukukhetha okuhle. Ama-agent ajwayelekile kakhulu ahlanganisa i-clonazepam ne-diazepam. Umphumela oqondile ongenamalenze omlenze awuncane, kodwa ungathuthukisa ikhwalithi yokulala. Le mithi ingabangela ukungahlali kahle, ukuguga kwamanje, noma ukucabanga okuphuthumayo.
Ezinye izindlela zokwelapha ze-RLS
Uma utholakala ukuthi unesimbi esingenayo ekuhloleni kokuqala kwesizathu sezimpawu zakho ze-RLS, ukushintshwa kwensimbi kungaba yindlela yokwelapha ewusizo. Ngokuvamile akufanele isetshenziswe njengokwelashwa kwakho kuphela, noma kunjalo. Ngokusebenzisa izithako zensimbi zomlomo, i-vitamin C ingasiza ekuthuthukiseni ukumuncwa.
Kukhona ezinye izinguquko zokuphila ezingaba usizo ekuthuthukiseni izimpawu zakho ze-RLS. Lokhu kufaka phakathi ukuzivocavoca okulula ngaphambi kokulala. Ukwengeza, ukuzigcina uhlala engqondweni ngesikhathi sokukhulelwa kunganciphisa izimpawu zakho. Lokhu kungafaka phakathi ukudlala imidlalo yevidiyo noma ukwenza amaphuzu e-crossword.
Okokugcina, kufanele ugweme izici ezingase zikhulise izimpawu zakho ze-RLS. I-caffeine, i-nicotine, no-alcohol ingase ibe nzima kakhulu izimpawu zakho. Ngaphezu kwalokho, ezinye izidakamizwa zokulwa nokucindezeleka, i-antiemetics njenge-metoclopramide, nama-antihistamine kufanele futhi agwenywe njengoba zingase zikhulise i-RLS.
Imithombo
Chaudhuri, KR. "Imilenze yezinyawo ezingapheli." N Engl J Med 2003; 349: 815.
Silber, MH et al . "I-algorithm yokuphathwa kwemigudu yezinyawo ezingenalutho." I-Mayo Clin Proc 2004; 79: 916.
Amanzi, AS. "Imilenze yezinyawo ezingenasiphelo kanye nokunyakaza kwezinyawo ngezikhathi ezithile ebuthongweni." Okuqhubekayo. I-Neurol 2007; 13 (3): 115-138.