Funsani Katswiri: Kuchiza ndi Kusamalira Matenda a Idiopathic Urticaria

Zamkati

• 1. Antihistamines asiya kugwira ntchito kuti athane ndi matenda anga. Kodi njira zanga zina ndi ziti?
• 2. Kodi ndi mafuta ati kapena mafuta ati omwe ndiyenera kugwiritsa ntchito kuthana ndi kuyabwa kosalekeza kuchokera ku CIU?
• 3. Kodi CIU yanga idzachokapo?
• 4. Kodi ofufuza amadziwa chiyani pazomwe zingayambitse CIU?
• 5. Kodi pali zosintha pazakudya zomwe ndiyenera kusintha kuti ndigwiritse ntchito CIU yanga?
• 6. Kodi muli ndi malangizo otani okuthandizani kuzindikira zomwe zimayambitsa?
• 7. Kodi ndingagwiritse ntchito mankhwala otani pangozi?
• 8. Kodi ndi mankhwala ati omwe dokotala wanga angafune?

1. Antihistamines asiya kugwira ntchito kuti athane ndi matenda anga. Kodi njira zanga zina ndi ziti?

Ndisanasiye mankhwala a antihistamines, nthawi zonse ndimaonetsetsa kuti odwala anga akuwonjezera mlingo wawo. Ndizotheka kutenga kanayi mlingo woyenera wa tsiku ndi tsiku wa ma antihistamine osakhala pansi. Zitsanzo ndi loratadine, cetirizine, fexofenadine, kapena levocetirizine.

Ma antihistamines osagwiritsidwa ntchito mopitirira muyeso akulephera, njira zotsatirazi zimaphatikizapo kukhazikika kwa antihistamine monga hydroxyzine ndi doxepin. Kapena, tidzayesa ma H2 blockers, monga ranitidine ndi famotidine, ndi leukotriene inhibitors ngati zileuton.

Kwa ming'oma yovuta kuchiza, ndimakonda kupita kuchipatala chobayira m'jekeseni chotchedwa omalizumab. Ili ndi phindu lokhala wopanda ma steroid ndipo imathandiza kwambiri odwala ambiri.

Matenda a idiopathic urticaria (CIU) ndimatenda amthupi omwe amatetezedwa. Chifukwa chake, zikavuta, nditha kugwiritsa ntchito ma systemic immunosuppressants monga cyclosporine.

2. Kodi ndi mafuta ati kapena mafuta ati omwe ndiyenera kugwiritsa ntchito kuthana ndi kuyabwa kosalekeza kuchokera ku CIU?

Kuyabwa kuchokera ku CIU kumachitika chifukwa chamasulidwe amkati a histamine. Othandizira pamitu - kuphatikiza ma antihistamine am'mutu - sakhala othandiza pakuwongolera zizindikilo.

Tengani mvula yamadzi ofunda pafupipafupi ndi kuthira mafuta otonthoza komanso ozizira ming'oma ikaphulika ndipo imawuma kwambiri. A topical steroid itha kuthandizanso. Komabe, ma antihistamine am'kamwa ndi omalizumab kapena zina zoteteza chitetezo cha mthupi zimapereka mpumulo waukulu.

3. Kodi CIU yanga idzachokapo?

Inde, pafupifupi milandu yonse ya idiopathic urticaria pamapeto pake imatha. Komabe, ndizosatheka kuneneratu kuti izi zichitika liti.

Kukula kwa CIU kumasinthanso nthawi, ndipo mungafunike mankhwala osiyanasiyana nthawi zosiyanasiyana. Palinso nthawi zonse chiopsezo kuti CIU ibwerera ikadzakhululukidwa.

4. Kodi ofufuza amadziwa chiyani pazomwe zingayambitse CIU?

Pali malingaliro angapo pakati pa ofufuza pazomwe zimayambitsa CIU. Lingaliro lofala kwambiri ndiloti CIU ndimakhalidwe ofanana ndi thupi.

Mwa anthu omwe ali ndi CIU, nthawi zambiri timawona ma autoantibodies omwe amayang'aniridwa ndi maselo omwe amatulutsa histamine (mast cell ndi basophil). Kuphatikiza apo, anthuwa nthawi zambiri amakhala ndi zovuta zina zama autoimmune monga matenda a chithokomiro.

Lingaliro lina ndiloti pali oyimira pakati pa seramu kapena plasma ya anthu omwe ali ndi CIU. Amkhalapakati awa amachititsa ma cell kapena ma basophil, mwina mwachindunji kapena m'njira zina.

Pomaliza, pali "malingaliro olakwika am'manja." Izi zimati anthu omwe ali ndi CIU ali ndi zolakwika pamalonda a basophil, kugulitsa, kuwonetsa, kapena kugwira ntchito. Izi zimapangitsa kuti histamine amasulidwe.

5. Kodi pali zosintha pazakudya zomwe ndiyenera kusintha kuti ndigwiritse ntchito CIU yanga?

Sitilangiza pafupipafupi zosintha pazakudya kuti tisamalire CIU popeza maphunziro sanawonetse phindu lililonse. Kusintha kwa zakudya sikuthandizidwanso ndi malangizo ambiri ogwirizana.

Kutsata zakudya, monga zakudya zochepa za histamine, kumakhalanso kovuta kutsatira. Ndikofunikanso kuzindikira kuti CIU siyomwe idadza chifukwa chakudyetsa kochokera pachakudya, chifukwa chake kuyezetsa zakudya sizimabala zipatso.

6. Kodi muli ndi malangizo otani okuthandizani kuzindikira zomwe zimayambitsa?

Pali zingapo zoyambitsa zomwe zitha kukulitsa ming'oma yanu. Kutentha, mowa, kupanikizika, kukangana, komanso kupsinjika kwamaganizidwe zimanenedwa kuti zimawonjezera zizindikilo.

Kuphatikiza apo, muyenera kuganizira zopewera aspirin ndi mankhwala ena osagwiritsa ntchito zotupa (NSAIDs). Amatha kukulitsa CIU nthawi zambiri. Mutha kupitiliza kumwa mankhwala ochepetsa mphamvu ya mwana, aspirin mukamagwiritsa ntchito kuteteza magazi kuundana.

7. Kodi ndingagwiritse ntchito mankhwala otani pangozi?

OTC anti-anti-antihistamines, kapena ma H1 blockers, amatha kuyang'anira ming'oma kwa anthu ambiri omwe ali ndi CIU. Izi zimaphatikizapo loratadine, cetirizine, levocetirizine, ndi fexofenadine. Mutha kumwa kangapo mlingo wa tsiku ndi tsiku osakhala ndi zovuta zina.

Muthanso kuyesa kusungitsa ma antihistamine ngati mukufunikira, monga diphenhydramine. Ma H2-anti-antihistamines, monga famotidine ndi ranitidine, atha kuperekanso mpumulo.

8. Kodi ndi mankhwala ati omwe dokotala wanga angafune?

Nthawi zina, antihistamines (onse H1 ndi H2 blockers) amalephera kuyang'anira ming'oma ndi kutupa komwe kumayenderana ndi CIU. Izi zikachitika, ndibwino kuti mugwire ntchito ndi katswiri wodziwitsa anthu za matendawa. Amatha kukupatsirani mankhwala omwe amawongolera bwino.

Dokotala wanu akhoza kuyesa kukhala pansi mwamphamvu, antihistamines yoyamba ngati hydroxyzine kapena doxepin. Pambuyo pake amatha kuyesa omalizumab ngati mankhwalawa sagwira ntchito pochiza matenda anu.

Nthawi zambiri sitimalimbikitsa ma corticosteroids am'kamwa kwa anthu omwe ali ndi CIU. Izi ndichifukwa cha kuthekera kwawo pazotsatira zoyipa. Ma immunosuppressants ena nthawi zina amagwiritsidwa ntchito pamavuto akulu, osagonjetseka.

Marc Meth, MD, adalandira digiri yake ya zamankhwala kuchokera ku David Geffen School of Medicine ku UCLA. Anamaliza kukhala ku Internal Medicine ku Mount Sinai Hospital ku New York City. Pambuyo pake adamaliza kuyanjana ndi Allergy & Immunology ku Long Island Jewish-North Shore Medical Center. Dr. Meth pakadali pano ali ku Clinical Faculty ku David Geffen School of Medicine ku UCLA ndipo ali ndi mwayi ku Cedars Sinai Medical Center. Onse ndi Diplomate wa American Board of Internal Medicine ndi American Board of Allergy & Immunology. Dr. Meth akuchita mwayekha ku Century City, Los Angeles.