Sabuwar sani game da ilmin halitta a bayan hare-haren na motsa jiki yana nufin inganta hanyoyin kwantar da hankali
Migraine wata cuta ne mai rikitarwa wadda ta haifar da masana kimiyya mai zurfi da kuma masu bincike a wasu lokutan da ke kan kawunansu. Ba kamar sauran sha'anin likita ba, bambance-bambance na hare-haren ƙaura ba a bayyana duk da haka ba tukuna.
Gaskiyar ita ce, masu bincike suna kusa da fahimtar "yadda" a baya bayan hare-haren migraine - ma'anar ilimin su, ko yadda suke nunawa.
Wannan ilimin ne wanda ya sauya hanyoyin kwantar da hanzarin ƙwayar cuta, ya kafa wani abu mai kyau na nazari da sababbin jiyya.
Abubuwa uku na ci gaba a cikin farfadowa na ƙaura sun haɗa da:
- Hanyoyin da ba za a iya ba da su ba, da maganin rigakafi mai ƙaura.
- Magunguna masu magungunan ƙwayoyi masu magungunan ƙwayoyi don magunguna da kuma rigakafi.
- Magunguna don magance magunguna.
An ba da Kyautattun Ƙungiya ta musamman
Triptans ɗaure masu karɓar sakonni a cikin kwakwalwa kuma suna amfani dasu don magance matsalolin hawan ƙaura mai tsaka-tsaka. Ana amfani da su don biyan ƙwayar migraines mai sauƙi wanda bai dace da NSAID ba .
Kyawawan ƙarancin shi ne cewa ana iya samarda su da hanyoyi daban-daban-Allunan, allunan lalacewa ta murji (wafer), foshin hanci, injection subcutaneous (ƙarƙashin fata), da kuma zato.
Tare da dukan waɗannan zaɓuɓɓuka, mutumin da ke da ƙaura da likitanta zai iya zaɓar mai kyauta, bisa la'akari da bukatunta da bukatunta.
Waɗannan ƙididdiga na iya haɗawa da:
- Sakamako na gefen
- Farawa na aikin
- Kira ga wasu ƙauyuka na masu hijira-misali, waɗanda suka fuskanci tashin hankali da kuma zubar da ƙaurarsu kuma basu iya jure wa magunguna da baki
- Kudin
- Aminci
Har ila yau, yana da farin ciki don sanin cewa ana iya gudanar da jarrabawa a wasu hanyoyi mafi mahimmanci a nan gaba.
Alal misali, a halin yanzu ana bunkasa wani shinge mai kwakwalwa, kamar yadda zolmitriptan inhaler da rizatriptan baki yake narkewa.
Ka tuna cewa sabon tsarin ba koyaushe ke aiki ba. Alal misali, sumatriptan da aka yi amfani dashi a matsayin mai amfani da ƙananan transdermal wanda ake kira batir (wanda ake kira Kashi) wanda aka yi amfani da shi a hannun babba ko cinya. Ya shiga cikin fata ta amfani da tsarin kayan aikin lantarki, yana kawo 6.5mg na sumatriptan a tsawon awa hudu. Duk da haka, a halin yanzu yana kasuwa a kasuwa saboda rahotanni na ƙonawa da scars da suke hade da shi.
Babban hoto a nan shi ne cewa tare da sababbin magungunan da magunguna sun zo da alkawuran, amma har da wasu jinkirtawa kamar yadda aka samu nuances.
Ka tuna kuma, cewa tsarin da yake aiki ga mutum ɗaya bazai aiki ba don wani-don haka magana da likitanka na likita don fitar da ƙananan ƙwararru da ƙananan hanyoyin da za a ci gaba da ƙaura.
Magunguna na maganin rigakafi na anti-Migraine
Kamar yadda masana kimiyya suka bayyana ilmin halitta a kan yadda hare-haren ƙirar hare-haren ke ci gaba a cikin kwakwalwa, suna iya tsara sababbin hanyoyi da masu karɓa. Abun ci gaba uku a cikin magungunan ƙwayoyi sun hada da:
- Lasmiditan: Wani magani kamar kamanni ne amma yana da dangantaka mai mahimmanci ga wani mai karɓa na serotonin.
- Magunguna da ke niyyar kirkirar Peptide na Calcitonin Gene-Related Peptide (CGRP)
- Magunguna kange Glutamate
Lasmiditan: Wani dan kallo na Serotonin 5-HT1F
Ana cigaba da Lasmiditan a matsayin madadin maganin maganin wariyar launin fata. Me yasa ake bukatar madadin? Akwai dalilai uku:
- Bincike ya nuna cewa kimanin kashi 35 cikin dari na mutane ba sa samun gudun hijirar daga cikin bakar fata.
- Yawancin mutane ba za su iya ɗaukar samfurori ba saboda suna iya haifar da rikice-rikice na jini (vasoconstriction) -so, an haramta wa wadanda ke da tarihin cututtukan zuciya, bugun jini, ciwo na jijiyoyin jini , ƙin jini, da kuma wasu nau'o'in ƙaura kamar lalata ko ƙaurawar ƙaura.
- Wasu mutane ba sa son yadda masu cin nasara suka sa su ji, kamar yadda zasu iya haifar da kullun kullun kamar jaw, wuyansa, da kuma kirji, damuwa, da tingling (musamman ma fuskar).
Labarin mai ladabi game da lasmiditan shi ne cewa yana ɗauka ta musamman ga wasu masu karɓar sakonta na serotonin a cikin kwakwalwa, ba tare da ƙarancin zumunci ga sauran masu karɓar sakonni ba idan an ɗaure shi, zai iya haifar da vasoconstriction maras so.
Labari mai dadi shine a cikin wani nazari na lokaci na 2, an gano lasmiditan a wasu nau'o'in maganganu don inganta jin zafi daga matsanancin ciwon ciwon ƙaurar ƙananan migraine zuwa babu (ko m) a sa'o'i biyu. Nishaɗin ciwo shine ragewa-dogara, ma'anar mahimmancin kashi, mafi girma da taimakon jin zafi.
Babban mawuyacin sakamako shine rashin hankali (yana faruwa a cikin kashi 38 cikin dari na masu halartar).
Sabili da haka, ba kamar sabbin 'yan gudun hijirar yanzu ba, ƙaddamar da ƙwayar lasmiditan na iya kauce wa sakamakon illa na vasoconstrictive, amma zai iya haifar da tsarin jin dadin jiki, wanda zai iya iyakance ga wasu mutane. A takaice dai, ana buƙatar darajar karatu da kuma karin bayani game da ingancin bayan lasmiditan.
Calcitonin Gene-Related Peptide (CGRP)
Kamfanin peptide na kwayoyin Calcitonin (CGRP) yana taka muhimmiyar rawa wajen maganin ƙwayar cuta. Bugu da ƙari musamman, bincike yana nuna cewa a lokacin haɗari na ƙaura, ana amfani da tsarin da ke faruwa, wanda zai haifar da sakin CGRP daga ƙarshen ciwon nadama. Bayanan CGRP yana aiki don kwantar da jini a kusa da kwakwalwa da kuma haifar da wani abin da ake kira flammation neurogenic, kuma waɗannan matakai guda biyu ne wadanda suka haifar da ciwon kai na ƙaura.
Don haka, magunguna da za su iya toshe ko dai CGRP kanta ko kuma masu karɓa (shafin yanar gizo a kwakwalwa) na CGRP ana binciken yanzu. Abin takaici, wasu nazarin nazarin magungunan CGRP-receptor antagonists (magungunan da ke kange aikin CGRP) an dakatar da su na farko don dalilai da dama, ciki har da damuwa game da haɗari hanta. Amma wata magani, mai ciki, an yi haƙuri sosai kuma yana da tasiri a wani nazarin lokaci na biyu.
Kwayoyin anti-CGRP guda uku (magungunan da ke daura da kamfanonin CGRP da kuma toshewa ko kuma ba su da shi) an kuma gina su don hana ƙwayar migraines, tare da ra'ayin kawar da ƙananan CGRP da aka samu ta hanyar jijiyoyin cututtuka a lokacin haɗari na ƙaura. Wadannan kwayoyi suna nuna alamun sakamako a farkon farkon gwaji 1 da 2.
A ƙarshe, erenumab shi ne wanda ya saba da shi wanda ya ɗaure shi ba zuwa CGRP ba, amma ga mai karɓarta, kuma an ba shi a karkashin fata (wani injection subcutaneous). Ta jingina ga mai karɓa, erenumab ya katange shi daga sigina. An bincike shi a matsayin magungunan rigakafi na migraine kuma ya nuna haƙuri cikin nazarin lokaci na biyu.
Gaba ɗaya, ƙaddamar da hanyoyi na CGRP yana nuna alamar wariyar launin fata ga waɗanda ke da wata cuta ko cuta ta rashin ciwo.
Glutamate Receptor Antagonists
Glutamate ne mai neurotransmitter, ko sinadaran a cikin kwakwalwa, cewa bisa ga duka dabbobi da na ɗan adam, ya bayyana yana taka muhimmiyar rawa a yadda ake nuna magunguna. Da dama magunguna da suka shafi kwashewa ko musanya masu karɓar gwaninta sunyi nazari, wasu don magance matsalolin hawan ƙaura da wasu don hana ƙaura.
Kuna iya ɗaukar ko sun saba da magani mai mahimmanci kamar topamax (topiramate) da kuma maganin botulinum A wanda ya kaddamar da shinge mai yaduwa, tare da sauran sunadarai.
Abin sha'awa, ketamine (wani maganin rigakafi), wanda ke kaddamar da mai karɓa na glutamate a cikin kwakwalwa da aka kira mai karɓar NMDA, an samo shi don kula da ƙwayar motsi ta hanyar kawar da ƙwayar cuta ta ciki, wani nau'i na ayyukan ciwon gurguwar da ke ɓarke a cikin ɓacin kwakwalwa.
A cikin karami, binciken mutum biyu da ruwaye na tsawon lokaci, 25mg na intranasal ketamine (aka ba ta hanci) aka kwatanta da midazolam, wanda shine magungunan magani. Nazarin ya gano cewa ketamine din ya rage girman amma ba tsawon lokaci ba. Hanyoyi na ciki sun hada da:
- Jin dadin rashin kuskure
- Euphoria
- Kyakkyawan gidan gidana mai daraja
Wadannan sakamako sun ragu a cikin minti 30 zuwa 45. A takaice dai, rawar da ake amfani da shi da kuma hanyoyinsa a cikin ƙaura na ci gaba da ci gaba da ci gaba da kasancewa tushen bincike, tare da wannan, bege ga sababbin hanyoyin kwantar da hankali.
Gidan juyin juya halin FDA-Kyautattun na'urori don Cibiyar Nazarin Hoto
Halittar na'urori don kulawa da hana ƙwayar cutar migraines sun canza tsarin farfadowa na migraine. Wadannan na'urorin sune mafi sauki don amfani, dace, kuma suna danganta da ƙananan tasiri. Sakamakon farashi shi ne kudin da gaskiyar cewa wasu na'urori ba su aiki ga kowa ba.
Duk da haka, zuba jarurruka a cikin na'urar zai iya zama wani zaɓi mai kyau don wasu ƙwararrun migraineurs, musamman idan magunguna ba su aiki, ko ga mutanen da suka saba wa ciwon kai na ciwon magunguna .
Ɗaya daga cikin na'ura mai hana ciwon daji wanda ake kira Cefaly yayi kama da ciwon suturar jiki (tSNS) wanda ke cikin ɓangaren goshinsa, kunya da fatar ido. Yana da na'ura mai sarrafa baturi wanda aka sawa kamar sutura wanda aka yi amfani dashi kullum don zaman minti ashirin.
Yana da aminci, da haƙuri, da kuma na'urar haɗi mai amfani kamar yadda babban binciken yake a cikin Journal of Headache da Pain, tare da kasa da kashi 5 cikin dari na mutanen da ke bayar da rahoton ƙananan cututtuka. Yana iya zama wani zaɓi mai kyau ga mutanen da basu iya jurewa ko ba sa so suyi maganin magungunan ƙwayoyi na ƙaura na ƙira.
Wani na'ura ne na'urar motsa jiki (nVNS) mai banƙwane wanda ake kira GammaCore) wanda za'a iya amfani dashi don karewa da kuma magance matsalolin hawan ƙaura. Yana aiki ta hanyar motsawa jijiyoyin naman-don haka an yi shi a gefen wuyansa kamar kimanin minti biyu bayan anyi amfani da gel. An yi imani da aiki ta hanyar ƙaddamar da ƙananan matakan glutamate a cikin tsarin ɓarna.
A cikin binciken a cikin Journal of Headache da Pain, sakamakon ya nuna ci gaba a kan yawan ciwon kai a kowane wata, da kuma ciwo mai zafi, a cikin mahalarta tare da wata cuta ko kuma ciwo na ƙwayar cuta. An bayar da rahoton mummunan tasiri kuma babu wanda ke da tsanani. Wadannan sakamako sun haɗu da fata fata da wuyansa ƙuƙwalwa.
Na uku na'urar da ake kira Spring transcranial magnetic stimulator (sTMS) shi ne FDA-yarda don zalunta migraine tare da aura. An yi amfani da shi ta amfani da na'urar a bayan kanka kuma danna maɓallin, wanda ke haifar da hasken wutar lantarki cikin kwakwalwa. Ana iya amfani dashi sau ɗaya kowace rana 24 a matsayin magani. An yi imani da aikin aiki ta hanyar kwantar da hankalin ƙwayar cuta, ƙwaƙwalwar aiki na lantarki wanda ke rufe kwakwalwa.
Kalma Daga
Yayin da ƙaddamar da sababbin hanyoyin kwantar da hanzari da na'urori suna da ban sha'awa da kuma yin alkawarin, ku tuna cewa magancewa da hana hawan kai hare-haren ƙaura na iya zama tsari mai banƙyama da kuma mara kyau - daya daga gwaji da kuskure wanda zai canza kamar yadda ƙaurarin ku, salon rayuwa, da / ko zaɓin zaɓin ya canza.
Ci gaba da yin aiki ta hanyar biyo baya tare da likitancinka a kai a kai da kuma cigaban kwanan wata game da labarai na lalata, ba tare da yin la'akari da ka'idojin fasaha ba. Bari mu kasance masu begen cewa wannan cututtuka mai tsanani zai iya zama ba tare da bata lokaci ba don ku ko ƙaunataccenku.
> Sources:
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> Chan K, MaassenVanDenBrink A. Glutamate receptor antagonists a cikin gudanar da migraine. Drugs . 2014 Jul; 74 (11): 1165-76.
> Färkkilä M et al. Ƙarfafawa da kuma jurewa na lasmiditan, mai maganin mai karba 5-HT (1F) mai maganin ƙwaƙwalwar ƙwayar cuta: gajiyar lokaci na biyu mai gudanarwa, wanda yake aiki tare da shi, nazarin kashi-kashi. Lancet Neurol . 2012 May, 11 (5): 405-13.
> Magis D, Sava S, d / Elia TS, Baschi R, Schoenen J. Safety da kuma marasa lafiyar gamsuwa da ƙwayoyin cuta mai cike da jini (TSNS) tare da na'urar Cefaly a cikin maganin cutar ciwon kai: binciken da mutane 2,313 suka kamu da cutar a cikin jama'a. J Headache Pain . 2013 Dec 1; 14: 95.
> Sun H et al. Tsaro da inganci na AMG 334 don kare rigakafi na episodic: wani baƙi, mai makantar makafi, wuri mai sarrafawa, lokaci 2 gwaji. Lancet Neurol. 2016; 15 (4): 382-90.