Mankhwala ndi Chithandizo cha MS Progressive MS

Zamkati

• Mankhwala a PPMS
• Ocrelizumab (Ocrevus)
• Mankhwala opangira tsinde
• Mayesero azachipatala
• Lipoic asidi
• Mlingo wapamwamba wa biotin
• Masitinib (AB1010)
• Zamgululi
• Mankhwala achilengedwe komanso othandizira
• Thandizo lantchito
• Thandizo lakuthupi
• Matenda olankhula chilankhulo (SLP)
• Chitani masewera olimbitsa thupi
• Mankhwala othandizira (CAM)
• Kuchiza zizindikiro za PPMS
• Mankhwala
• Zosintha m'moyo
• Kukonzanso
• Tengera kwina

Primary progressive multiple sclerosis (PPMS) ndi imodzi mwamagulu anayi a multiple sclerosis (MS).

Malinga ndi National Multiple Sclerosis Society, pafupifupi 15% ya anthu omwe ali ndi MS amalandila PPMS.

Mosiyana ndi mitundu ina ya MS, PPMS imapita patsogolo kuyambira koyambiranso kapena kuchotsera. Ngakhale matendawa amapitilira pang'onopang'ono ndipo zimatenga zaka kuti adziwe, zimayambitsa mavuto poyenda.

Palibe chifukwa chodziwika cha MS. Komabe, mankhwala ambiri amatha kuthandiza kupewa kukula kwa zizindikiritso za PPMS.

Mankhwala a PPMS

Mankhwala ambiri omwe alipo a MS apangidwa kuti athetse kutupa ndikuchepetsa kuchuluka kwa kubwerera m'mbuyo.

Komabe, PPMS imayambitsa kutupa kocheperako poyerekeza ndikubwezeretsanso-multiple remler sclerosis (RRMS), mtundu wofala kwambiri wa MS.

Kuphatikiza apo, ngakhale pakhoza kukhala pang'ono pang'ono kusintha, PPMS ilibe zochotsera.

Chifukwa ndizosatheka kulosera zamtsogolo za PPMS mwa aliyense amene ali nazo, ndizovuta kuti ofufuza awunikire momwe mankhwala amathandizira pakadwala. Komabe, kuyambira mu 2017, mankhwala amodzi a PPMS alandila kuvomerezedwa ndi Food and Drug Administration (FDA).

Ocrelizumab (Ocrevus)

Ocrelizumab (Ocrevus) ndivomerezedwa ndi FDA kuti athetse PPMS ndi RRMS.

Ndi antioclonal antibody yomwe imawononga maselo ena B amthupi. Kafukufuku akuwonetsa kuti maselo a B ndi omwe amachititsa kuti ubongo ndi msana wa anthu omwe ali ndi MS awonongeke. Kuwonongeka kumeneku kumathandizidwa ndi chitetezo cha mthupi chokha.

Ocrelizumab imayendetsedwa ndi kulowetsedwa m'mitsempha. Matenda awiri oyamba amaperekedwa patadutsa milungu iwiri. Pambuyo pake infusions imaperekedwa miyezi isanu ndi umodzi iliyonse.

Mankhwala opangira tsinde

Cholinga chogwiritsa ntchito maselo amtundu wothandizira PPMS ndikulimbikitsa chitetezo cha mthupi kukonzanso kuwonongeka ndikuchepetsa kutupa m'katikati mwa manjenje (CNS).

Pogwiritsa ntchito njira yotchedwa hematopoietic stem cell transplantation (HSCT), maselo am'magazi amasonkhanitsidwa kuchokera kumatumba a munthu, monga mafupa kapena magazi, kenako amabwezeretsedwanso pambuyo poti chitetezo cha mthupi lawo chaponderezedwa. Izi zimachitika mchipatala ndipo pano akuvomerezedwa ndi FDA.

Komabe, HSCT ndi njira yayikulu yokhala ndi zotsatirapo zoyipa. Kafukufuku wowonjezereka ndi zotsatira kuchokera kumayeso azachipatala ndizofunikira izi zisanakhale chithandizo chamankhwala cha PPMS.

Mayesero azachipatala

Mayesero angapo azachipatala akuchitikabe mwa anthu omwe ali ndi PPMS. Mayesero azachipatala amadutsa magawo angapo asanalandire kuvomerezedwa ndi FDA.

Gawo I likuyang'ana kwambiri momwe mankhwalawa aliri otetezeka ndikuphatikizira gulu laling'ono la omwe akutenga nawo mbali.

Pakati pa gawo lachiwiri, ofufuza amayesetsa kudziwa momwe mankhwalawa amagwirira ntchito pazinthu zina monga MS.

Gawo lachitatu limaphatikizapo gulu lalikulu la omwe akutenga nawo mbali.

Ochita kafukufuku amayang'ananso anthu ena, miyezo, ndi kuphatikiza mankhwala kuti adziwe zambiri za momwe mankhwalawo aliri otetezeka.

Lipoic asidi

Kafukufuku wachiwiri wazaka ziwiri gawo lino akuwunika pakamwa antioxidant lipoic acid. Ofufuzawa akuphunzira ngati zingateteze kuyenda komanso kuteteza ubongo kuposa maloboti osagwira ntchito mu mawonekedwe a MS.

Kafukufukuyu akhazikika pamayeso am'mbali yachiwiri omwe amayang'ana anthu 51 omwe ali ndi MS (SPMS) yachiwiri yopitilira muyeso. Ofufuza apeza kuti lipoic acid imatha kuchepetsa kuchepa kwa minofu yaubongo poyerekeza ndi placebo.

Mlingo wapamwamba wa biotin

Biotin ndi gawo limodzi la mavitamini B ovuta ndipo amakhudzidwa ndikukula kwamaselo komanso kagayidwe kake ka mafuta ndi amino acid.

Kafukufuku woyang'anira akulemba anthu omwe ali ndi PPMS omwe akutenga biotin (300 milligrams) tsiku lililonse. Ofufuza akufuna kuwona ngati zili zothandiza komanso zotetezeka pochepetsa kukula kwa anthu omwe ali ndi PPMS. M'maphunziro owonera, ofufuza amayang'anira omwe akuchita nawo kafukufukuyu osalowererapo.

Kafukufuku wina wa gawo lachitatu akuwunika kapangidwe kake ka biotin wodziwika bwino wotchedwa MD1003 kuti awone ngati ndiwothandiza kuposa placebo. Ochita kafukufuku akufuna kudziwa ngati zingachepetse kulemala kwa anthu omwe ali ndi MS, makamaka omwe ali ndi vuto lotopa.

Chiyeso chaching'ono chotseguka chidayang'ana zovuta za biotin wokhala ndi mlingo waukulu mwa anthu omwe ali ndi PPMS kapena SPMS. Mlingo umachokera ku mamiligalamu 100 mpaka 300 patsiku kwa miyezi 2 mpaka 36.

Ophunzira nawo pamayesowa adawonetsa kuwonongeka kwa mawonekedwe okhudzana ndi kuvulala kwamitsempha yamawonedwe ndi zizindikilo zina za MS, monga magwiridwe antchito ndi kutopa.

Komabe, kafukufuku wina adapeza kuti biotin wokhala ndi mulingo wokwera pafupifupi pafupifupi katatu kuchuluka kwakubwerera kwa omwe ali ndi PPMS.

Wachenjezanso kuti kuchuluka kwa biotin kumatha kubweretsa zotsatira zolakwika za labu kwa anthu omwe ali ndi zovuta zina, kuphatikiza MS.

Masitinib (AB1010)

Masitinib ndi mankhwala osokoneza bongo am'thupi omwe apangidwa ngati chithandizo cha PPMS.

Chithandizochi chakhala chikuwonetsa lonjezo m'chiyeso chachiwiri. Ikufufuzidwa pakadali pano mu gawo lachitatu la anthu omwe ali ndi PPMS kapena SPMS yopanda kubwerera.

Zamgululi

Ibudilast imaletsa enzyme yotchedwa phosphodiesterase. Amagwiritsidwa ntchito ngati mankhwala a mphumu makamaka ku Asia, awonetsanso kuti amalimbikitsa kukonzanso kwa myelin ndikuthandizira kuteteza maselo amitsempha kuti asawonongeke.

Ibudilast adapatsidwa dzina lachangu ndi a FDA. Izi zitha kufulumizitsa chitukuko chake chamtsogolo ngati chithandizo chotheka cha MS.

Zotsatira zoyeserera gawo lachiwiri mwa odwala 255 omwe ali ndi MS opita patsogolo zidasindikizidwa mu The New England Journal of Medicine.

Phunziroli, ibudilast imalumikizidwa ndikukula pang'ono kwaubongo kuposa placebo. Komabe, zidadzetsanso kuchuluka kwamankhwala oyambira m'mimba, mutu, komanso kukhumudwa.

Mankhwala achilengedwe komanso othandizira

Mankhwala ena ambiri, kupatula mankhwala, atha kuthandiza kukhathamiritsa magwiridwe antchito komanso moyo wabwino ngakhale zovuta za matendawa.

Thandizo lantchito

Thandizo lantchito limaphunzitsa anthu maluso omwe angafunike kuti azisamalira okha kunyumba komanso kuntchito.

Othandizira pantchito amawonetsa anthu momwe angasungire mphamvu zawo, popeza PPMS imayambitsa kutopa kwambiri. Amathandizanso anthu kusintha zochita zawo za tsiku ndi tsiku ndi ntchito zapakhomo.

Othandizira atha kupereka malingaliro amomwe angakonzere kapena kukonzanso nyumba ndi malo ogwirira ntchito kuti athe kufikirako anthu olumala. Angathandizenso kuthana ndi mavuto okumbukira komanso kuzindikira.

Thandizo lakuthupi

Othandizira athupi amagwira ntchito kuti apange zochitika zina zolimbitsa thupi kuti zithandizire anthu kuwonjezera mayendedwe awo, kusunga mayendedwe awo, ndikuchepetsa kuchepa kwamphamvu ndi kunjenjemera.

Othandizira athupi atha kulangiza zida zothandizira anthu omwe ali ndi PPMS kuti aziyenda bwino, monga:

• Ma wheelchair
• oyenda
• ndodo
• njinga zamoto

Matenda olankhula chilankhulo (SLP)

Anthu ena omwe ali ndi PPMS ali ndi vuto ndi chilankhulo, mayankhulidwe, kapena kumeza. Akatswiri azachipatala amatha kuphunzitsa anthu momwe:

• konzani chakudya chosavuta kumeza
• idyani mosamala
• gwiritsani machubu oyenera moyenera

Angathenso kulangiza zothandizira ma telefoni ndi zokuthandizira pakulankhula kuti azilankhulana mosavuta.

Chitani masewera olimbitsa thupi

Kuchita masewera olimbitsa thupi kumatha kukuthandizani kuti muchepetse kuchepa komanso kuti muziyenda mosiyanasiyana. Mutha kuyesa yoga, kusambira, kutambasula, ndi machitidwe ena ovomerezeka.

Inde, nthawi zonse ndibwino kuti mukambirane kachitidwe kalikonse katsopano ndi dokotala wanu.

Mankhwala othandizira (CAM)

Mankhwala a CAM amaonedwa ngati mankhwala osagwirizana ndi mankhwala. Anthu ambiri amaphatikiza mtundu wina wa mankhwala a CAM monga gawo la kasamalidwe ka MS.

Pali kafukufuku wochepa kwambiri wowunika chitetezo cha CAM mu MS. Koma mankhwala oterewa cholinga chake ndikuthandizira kupewa matendawa kuti asawononge dongosolo lanu lamanjenje komanso kukhala ndi thanzi labwino kuti thupi lanu lisamve zambiri za matendawa.

Malinga ndi kafukufuku wina, njira zodalirika kwambiri za CAM za MS ndi izi:

• chakudya chochepa mafuta
• Omega-3 mafuta acid amawonjezera
• lipoic acid amathandizira
• mavitamini D owonjezera

Lankhulani ndi dokotala musanawonjezere CAM pa dongosolo lanu la mankhwala, ndipo onetsetsani kuti mukupitiliza kutsatira mankhwala omwe mwapatsidwa.

Kuchiza zizindikiro za PPMS

Zizindikiro zodziwika bwino za MS zomwe mungakhale nazo ndi monga:

• kutopa
• dzanzi
• kufooka
• chizungulire
• kuwonongeka kwazidziwitso
• kusasunthika
• ululu
• kusalinganika
• mavuto a mkodzo
• zosintha

Gawo lalikulu la dongosolo lanu lonse la mankhwala lidzakhala kuthana ndi matenda anu. Mungafunike mankhwala osiyanasiyana, kusintha kwa moyo wanu, ndi chithandizo chowonjezera kuti muchite izi.

Mankhwala

Kutengera ndi zizindikilo zanu, adokotala angakupatseni izi:

• zopumulira minofu
• mankhwala opatsirana pogonana
• mankhwala a chikhodzodzo kulephera
• mankhwala ochepetsa kutopa, monga modafinil (Provigil)
• mankhwala opweteka
• zothandizira kugona ndi tulo
• mankhwala othandizira kuchiza matenda ophera erectile (ED)

Zosintha m'moyo

Kusintha kwa moyo wanu kumatha kupangitsa kuti zizindikilo zanu zizitha kuwongoleredwa:

• Idyani chakudya chopatsa thanzi chokhala ndi mavitamini, michere, ndi ma antioxidants.
• Chitani zolimbitsa thupi zolimbitsa thupi ndikulimbikitsa mphamvu.
• Yesani masewera olimbitsa thupi komanso kutambasula mapulogalamu monga tai chi ndi yoga kuti muthandizire moyenera, kusinthasintha, komanso kulumikizana.
• Pitirizani chizolowezi kugona mokwanira.
• Sinthani nkhawa ndikutikita minofu, kusinkhasinkha, kapena kutema mphini.
• Gwiritsani ntchito zida zothandizira kuti mukhale ndi moyo wabwino.

Kukonzanso

Cholinga chokhazikitsira ndikukonzanso ndikusunga magwiridwe antchito ndikuchepetsa kutopa. Izi zingaphatikizepo:

• chithandizo chamankhwala
• chithandizo pantchito
• kukonzanso kuzindikira
• matenda olankhula
• kukonzanso ntchito

Funsani dokotala wanu kuti akutumizireni akatswiriwa.

Tengera kwina

PPMS si mtundu wamba wa MS, koma ofufuza angapo akufufuzabe njira zochizira vutoli.

Kuvomerezeka kwa 2017 kwa ocrelizumab kudawonetsa gawo lalikulu patsogolo chifukwa kuvomerezedwa ndikuwonetsa kwa PPMS. Mankhwala ena omwe akutuluka, monga anti-inflammatories ndi biotin, apeza zotsatira zosakanikirana mu PPMS pakadali pano.

Ibudilast yawerengedwanso pazotsatira zake pa PPMS ndi SPMS. Zotsatira zaposachedwa pakuyesedwa kwa gawo lachiwiri zikuwonetsa kuti zimayambitsa zovuta zina, kuphatikizapo kukhumudwa. Komabe, zimaphatikizidwanso ndi kuchepa kwa ubongo wa atrophy.

Lankhulani ndi dokotala wanu ngati mukufuna zambiri zazomwe mungachite posamalira PPMS yanu.