Duk da yake babu maganin warkar da kwayar cutar ta asibiti (AS), tsarin kulawa wanda ya ƙunshi maganin jiki da magani zai iya inganta lafiyar mutum ta hanyar haɗin gwiwa, haɓaka, da kumburi, da kuma inganta aikin yau da kullum.
A shekara ta 2015, Kwalejin Kwalejin Rheumatology (ACR) ta Amurka ya kafa jagororin magance zubar da jini spondylitis.
Wadannan jagororin sun kasance don taimaka wa likitoci su inganta kula da marasa lafiya tare da AS a hanyar da ta dace, bisa ga binciken bincike.
A matsayin mutumin da ke da AS (ko kuma idan kana da ƙaunatacciyar tare da AS), sanin game da jagororin kulawa zai taimaka maka kawo da wannan cuta da ciwo mai tsanani da tabbaci.
Anti-inflammatory marasa ciwon steroidal (NSAID) Far
Mafi magungunan maganin spondylitis ne wanda ba mai maganin cututtukan steroid ne (NSAID) ba. HASUMIYAR TSARO sun kasance a cikin lokaci mai tsawo kuma suna da matukar tasiri a rage rage kumburi a jiki. Suna aiki ta hanyar hana wasu enzymes da ake kira cyclooxygenase enzymes (COX enzymes).
Ta hanyar hana wadannan enzymes, matakan prostaglandin sun rage a jiki. Tun da prostaglandins suna taka muhimmiyar rawa a cikin kumburi, ta hanyar rage su, an rage minuttuka na kumburi kamar zafi da kumburi.
Sakamako na NSAIDs shine cewa ba zasu iya karɓar su ba, saboda yiwuwar cutar su.
Wannan shine dalilin da ya sa yana da matukar muhimmanci a dauki NSAID karkashin jagorancin likitan ku.
Alal misali, wata mummunar cutar da cutar NSAID ita ce ta haifar da lalacewar ciki, ulcers, da zub da jini. Hannun NSAIDs na iya kara yawan haɗarin zuciya, rashin zuciya, ko bugun jini. Hakanan suna iya tayar da cutar jini da kuma haifar da matsalolin koda.
Bugu da ƙari ga waɗannan ƙananan halayen, NSAIDs na iya hulɗa da magunguna. Wannan shine dalilin da ya sa yana da muhimmanci a gaya wa likita dukkanin magunguna da kake dauka, ciki har da herbals, bitamin, ko kari.
Misalan NSAIDs
Akwai da dama NSAID daban-daban da za a iya bi da AS, ciki har da wadanda aka yi amfani da su da NSAIDs masu mahimmanci. Misalan sun haɗa da:
- Ƙididdiga masu mahimmanci NSAIDs: Advil ko Motrin (ibuprofen) da Aleve (naproxen)
- Dokar NSAIDs: Voltaren (diclofenac), Mobic (muni), ko Indocin (indomethacin).
Ana iya samun takaddun shaida na NSAID irin su ibuprofen tare da takaddama a wani ƙarfin da ya fi ƙarfin.
Wani nau'in NSAID wanda aka tsara don magance AS shine Celebrex (celecoxib) , wanda zai iya taimakawa wajen magance matsalolin ciki da na ciki. Celebrex wani zaɓi ne-NSAID saboda ƙaddamar da enzyme na COX-2 (wasu NSAIDs toshe COX-1 da COX-2 enzymes). Ta hanyar kiyaye COX-1 kuma kawai ana hana COX-2, an rage raunin ciki da na ciki. Wannan shi ne saboda COX-1 yana taimaka wajen kula da gastrointestinal rufi.
Ma'aikata Necrosis Factor Masu Hana (TNFi)
Idan mutum tare da AS ba zai iya daukar NSAID ba, ko kuma idan ba a inganta alamun su kamar ciwo da haushi ba tare da farfadowar NSAID, an bada shawarar mai amfani da TNF .
Matsayin necrosis na Tumor (TNF) wani hade ne a cikin tsarin mai kumburi, don haka ta hana shi samarwa, ƙonewa a cikin jiki an rage.
Tana da labarai game da masu tarin firin TNF akwai hujjojin kimiyya don tallafawa amfanin su wajen rage yawan cututtukan cututtuka a cikin wasu kwayoyin maganin cutar, wanda ya rage jinin jiki a jiki. Duk da haka, masu tarin magunguna na TNF ba su da magunguna. Suna da haɗari, kuma dole ne a auna wannan a hankali ga kowane mutum.
Saboda gaskiyar cewa masu tayar da TNF sun kawar da tsarin kwayoyin cuta na mutum (duk da haka wani abu mai mahimmanci a cikin wadanda ke da wutsiyar spondylitis), zasu iya ƙara haɓakar mutum da rashin ciwo mai tsanani da kamuwa da cuta mai tsanani.
Misali na rashin lafiya mai sauƙi shine sanannen sanyi. A wani ɓangare kuma, ƙwayar cuta mai tsanani wadda likitoci ke damu sosai a yayin da mutum yake daukar mai hana TNF shine tarin fuka. Dangane da hadarin da tarin fuka take da shi, ana buƙatar gwaji ta TB kafin a fara farfadowa na TNF. A takaice, ana danganta maƙerun TNF da karin damar da za a iya inganta wasu ciwon daji.
Yana da mahimmanci a san cewa wasu mutane ba su da 'yan takarar daukar matakan TNF kamar wadanda suke da:
- Magunguna da yawa (masu mahimmanci na TNF sunyi hasara sosai a kan kwakwalwa da kwakwalwa)
- Zuciyar zuciya
- Hanyar kamuwa da cuta kamar ciwon huhu
Mata masu juna biyu ko masu shayarwa ba ma 'yan takara ne ba na TNF.
Misalai na TNF Blockers
A shekara ta 2010, binciken na SpondyloArthritis International Society (ASAS) ya wallafa wani shiri na amfani da masu amfani da TNF a marasa lafiya da spondylitis. Wadannan jagororin sun taimaka wa likitoci su gane ko wane ne dan takara mai kyau don TNF blocker far.
Alal misali, bisa ga ka'idojin ASAS, dole ne kawai a yi la'akari da mutum ga mai tsaron gidan TNF idan cutar ba ta inganta tare da akalla iri daban-daban na NSAID (a matsakaicin iyakar haƙuri).
Masu haɗin TNF da suke amfani da su a cikin spondylitis ankylosing sune:
- Enbrel (tsinkaya)
- Remicade da Renflexis (infliximab)
- Humira (adalimumab)
- Simponi (Golimumab)
- Cimzia (certolizumab)
Rikicin da Renflexis (infliximab) an ba su a matsayin jiko ta hanyar kwayar halitta yayin da Enbrel (Etanercept), Humira (adalimumab), Simponi (golimumab), da Cimzia (certolizumab) an ba su a matsayin subcutaneous (a cikin mai nama) injections.
Cosentyx (Secukinumab)
Idan mutum bai amsa da kyau ga TNFi ba, likita zasu iya la'akari da Cosentyx (secukinumab). Cosentyx an amince da shi ta Cibiyar Abinci da Druggun Amurka (FDA) a shekara ta 2016 don kula da spondylitis.
Yana aiki ne ta hanyar kulle IL-17A, wanda yake shi ne cytokine mai ba da labari (manzon kwayoyin halitta wanda ke jawo martani a cikin jiki). IL-17A an san shi da taka muhimmiyar rawa wajen bunkasa AS.
Ana ba Cosentyx sau ɗaya a mako don makonni huɗu, sannan kuma kowane mako hudu bayan haka. Bincike ya nuna cewa yana da haƙuri, tare da sakamakon da yafi rinjaye shine sanyi bayyanar cututtuka, kamar hanci da ciwon ƙwayar cuta.
Bincike yana ci gaba a kan Cosentyx. Duk da haka, yana da ban sha'awa yanzu akwai wani zaɓi ga mutanen da cutar ta ci gaba da ci gaba a cikin mai hana TNF ko wanda ba zai iya daukar mai hana TNF ba.
Jiki na jiki
Bugu da ƙari, magani, Kwalejin Kwalejin Rheumatology na Amurka ya bada shawarar farfadowa na jiki don mutanen da ke da AS mai aiki (ma'anar bayyanar cututtuka kamar ciwon haɗin gwiwa da haɗari). Wannan shawarwarin yana dogara ne akan yawan binciken da suka samo farfadowa na jiki don amfani dasu wajen rage ciwo da kuma inganta yanayin motsa jiki, matsayi, sassauci, aiki na jiki, da zamantakewa.
Bishara mai kyau akwai ƙananan cututtuka da ke tattare da farfadowa na jiki. Har ila yau, mutum zai iya shiga cikin aikace-aikace kuma ya shimfiɗa a gida ko cikin ƙungiya. Wancan ya ce, bincike ya nuna cewa tsarin kula da lafiyar jama'a na iya zama mafi amfani fiye da yadda aka samu gida.
Abin da zai iya zama mafi mahimmanci (kuma mai marmari) ga wadanda ke tare da AS shine nau'in farfadowa da ake kira furotin-motsa jiki. Irin wannan farfadowa ya haɗa da yin amfani da ruwa mai dumi, jurewa daga jet jiragen ruwa, da shakatawa a cikin sauna. A gaskiya ma, bincike ya gano cewa maganin motsa jiki da aka haɗa tare da farfajiyar jiki na jiki ya fi na farfajiyar jiki kawai.
Tiyata
A lokuta da yawa, ana bukatar tiyata don yin maganin spondylitis. Hakanan ana adana wannan ne ga mutanen da ke lalata haɗin gwiwa da kuma ciwo. A cikin waɗannan lokuta, sau da yawa ana maye gurbin maye gurbin ba a taɓa yin tiyata ba. Rikicin daji na Riskier kamar wadanda suka hada da kashin baya ba su da yawa kuma an yi su yayin da akwai mai zurfi mai zurfi na kashin baya ("backchback posture").
Kalma Daga
Ankylosing spondylitis ne cuta na kullum, kuma babu magani duk da haka. Amma akwai hanyoyi don sarrafa shi. Tare da tsarin kula da lafiya (wanda zai buƙaci tweaking a tsawon lokaci a karkashin jagorancin likita), zaku iya zama tare da AS.
> Sources:
> Blair Ha, Dhillon S. Secukinumab: Binciken da ake yi a spondylitis. Drugs . 2016 Jul; 76 (10): 1023-30.
> Callhoff J et al. Amfani da magunguna na TNFa a cikin marasa lafiya tare da spondylitis wanda ba tare da yaduwa ba; Ann Rheum Dis . 2015 Yuni; 74 (6): 1241-8.
> Dagfinrud H, Kvien TK, Hagen KB. Jirgin aikin jiki don maganin spondylitis. Cochrane Database Syst Rev. 2008 Janairu 23; (1): CD002822.
> van der Heijde D et al. 2010 Sabuntawa na ƙasashen duniya ASAS shawarwari game da amfani da wakilan TNF masu tayar da hankali a marasa lafiya da spondyloarthritis. Ann Rheum Dis . 2011 Jun; 70 (6): 905-8.
> Ward MM et al. Cibiyar Harkokin Rheumatology na Amirka da Cibiyar Nazarin Harkokin Kasuwancin Amirka da Cibiyar Nazarin Harkokin Kasuwanci ta Spondylis 2015 Tababbin Guraben Nazarin Gizon Ankylosing Spondylitis da Magungunan Labaran Aikin Baƙaƙe. Arthritis Rheumatol . 2016 Feb, 68 (2): 282-98.