Zaɓuɓɓuka na magani ga Osteopenia (Ƙananan Ƙasa Kashi)
Idan an gano ku da osteopenia (ƙananan ƙananan kashi) likitanku na iya bada shawarar yin magani. Mene ne za'a iya samun maganin magani idan baku da "cike da zubar da ciki" osteoporosis, kuma wane lokaci ya fi kyau a yi la'akari da magani?
Osteopenia: Ƙananan Ƙarƙashin Bone
Osteopenia yana nufin ƙananan ƙananan kashi, amma menene wannan yake nufi? Zai fi sauƙi mu fahimci Osteopenia lokacin da muka kwatanta shi da ƙananan ƙarancin kashi da osteoporosis (ƙananan ƙananan kashi).
Girman kashi kashi yana nufin cewa yawancin da ginewar kasusuwanku na al'ada ne. A kan gwajin gwaji mai yawa , lambar da za ku gani idan yawancin kashinku na al'ada zai fi girma -1.0. A wasu kalmomi, ƙananan kashiwanku zai kasance a mafi kyau ko fiye da daidaitattun daidaituwa guda ɗaya a ƙasa al'ada.
Osteoporosis wani yanayin ne wanda kasusuwa suka zama raguwa kuma suna iya karya, ko da tare da raunin rauni. Kwararrun gwaji mai yawa da osteoporosis yana ba da T-score -2.5 ko mafi muni, ma'ana cewa kashi kashi kashi kashi 2.5 ne a tsakanin kasa da kashi kashi mai kyau na yarinyar lafiya ko muni.
Osteopenia ya kasance tsakanin waɗannan lambobi, tare da T-score na mafi alhẽri daga -2.5 amma mafi muni fiye da -0.1. Samun cewa osteopenia zai ci gaba zuwa osteoporosis ya dogara da shekarunka, wasu yanayin kiwon lafiya da kake da shi, magunguna kake ɗauka, da sauransu.
Yin maganin Osteopenia
Akwai dalilai masu yawa da za suyi la'akari kafin yin maganin osteopenia, kuma wannan a halin yanzu yana da rikici da zafi.
Idan an haɗa darajar osteopenia tare da fractures, akwai yiwuwar magani zai iya haifar da bambanci. Ba shi da cikakken bayani ko yin maganin osteopenia ba tare da fractures yana da amfani.
Akwai magungunan likita na FDA don maganin osteoporosis (sabili da haka don osteopenia). Wadannan magunguna suna da tasiri amma wasu daga cikinsu suna da mummunar tasiri.
Wasu likitoci suna da jinkirin yin bayani akan maganin osteoporosis don osteopenia yayin da wasu ke da matukar ƙoƙari wajen ƙoƙarin rage hasara. Manufar ainihin magance duka osteopenia da osteoporosis suna hana fractures, musamman na hip da kashin baya. Likitoci na iya ƙididdige yawan haɗarin shekaru 10 da ke tattare da ƙananan ma'adinai da sauran abubuwan haɗari. Wannan haɗarin shekaru 10 shine mafi girma a yayin da yake tunani game da shan magunguna don osteopenia.
Bayanan martaba, ko da yake yana da mahimmanci, shine yawancin kamfanonin inshora na kiwon lafiya ba su yarda da osteopenia a matsayin yanayin da ke buƙatar magani kuma saboda haka bazai iya ɗaukar kudin (wani lokaci) na waɗannan kwayoyi.
Yaya Ya kamata A Yi Maganar Osteopenia?
Kamar yadda muka gani a baya, maganin osteopenia yana da rikici. Wannan ya ce, lokacin da aka fara maganin wannan mataki a cikin mutanen da aka sa ran su cigaba da ciwon osteoporosis, ko kuma suna da wasu yanayi masu mahimmanci, maganin osteopenia na iya hana ci gaban osteoporosis da fractures. Yanayin da yakamata mai yaduwa ya fi tsanani shine:
- Osteopenia samuwa a cikin wani saurayi, alal misali, mutumin da yake da shekaru 50 kawai.
- Mutanen da ke fama da ciwon daji, musamman ma wadanda ke fama da ciwon nono ko ciwon daji wanda zai yi amfani da hanyoyin maganin hormonal.
- Mutane da suka kasance a cikin dindindin lokaci don maganganun irin su asma, COPD, ko ƙwararrun ciwon jini.
- Wadanda ke da yanayin da ke haɗuwa da haɗarin osteoporosis da yawa kamar lupus, rheumatoid arthritis, da sauransu.
- Wadanda suka fi dacewa su fadi saboda yanayin kiwon lafiya irin su cututtuka ko wasu cututtuka masu cutar daji.
- Wadanda suke da tarihin iyali mai kyau na osteoporosis.
- Wadanda suka yi fama da rauni kuma suna da ƙananan kashi.
Magunguna don hana Osteoporosis (Jiyya na Osteopenia)
Akwai wasu magunguna daban-daban da aka yarda don maganin osteoporosis , amma kaɗan ne kawai aka yarda don rigakafin ciki har da Actonel da Evista.
Za mu lissafa zaɓuɓɓuka don maganin osteoporosis, kamar yadda wasu magunguna wasu banda waɗanda aka yarda da osteopenia (rigakafin osteoporosis) za'a iya nunawa. Ana rarraba nau'o'in magunguna daban-daban a ƙasa.
Bisphosphates
Bisphosphonates su ne magunguna waɗanda ke aiki ta hanyar rage jinkirin rashi kashi kuma inganta yawan kashi. Yawancin waɗannan suna rage hadarin lalacewa, amma ba duk an nuna su rage haɗarin ɓarna na hanzari ba. Wasu daga cikin wadannan magunguna suna ɗauke da maganin yayin da wasu suka ba da allura. Actonel, musamman, an yarda don rigakafin osteoporosis. Zometa ya rigaya an yarda ya yi amfani da shi tare da mai maganin aromatase don maganin cutar kanjamau.
Magunguna a wannan rukuni sun haɗa da:
- Fosomax (alendronate): Fosomax yana bayyana ragewa biyu da ɓacin hanji.
- Actonel (risedronate): Actonel na iya rage haɗari na ramuka da finesures.
- Boniva (ibandronate): Boniva yana rage hadarin cututtuka amma ba ɓarna.
- Zometa ko Reclast (zoledronic acid): Baya da allurar, Zometa ta rage hadarin duka ramuka da kashin baya.
Hanyoyi na bisopsphonates sun bambanta bisa ga ko ana amfani da su ta hanyar magana ko inuwa. Tare da bisphosphonates na baki, ana buƙatar mutane su dauki magani tare da cikakken gilashin ruwa kuma su kasance a tsaye na tsawon minti 30 zuwa 60. Wadannan kwayoyi na iya haifar da ƙwannafi ko farfadowa. Magungunan injectable na iya haifar da mura-kamar bayyanar cututtuka na kwana ɗaya ko biyu bayan allura kuma zai iya haifar da tsoka da haɗin gwiwa.
Wani abu ne wanda ba a sani ba amma mai tsanani shi ne osteonecrosis na jaw. Mutanen da ke da cututtukan cututtuka ko tsabtace hakori, suna da na'urar kwantar da hankula ko kuma buƙatar hanyoyin kamar yaduwar hakori mafi girma. Sauran cututtukan da ba a sani ba sun haɗu da fibrillation da ƙananan mata.
Mai sauƙi mai sauƙi masu sauƙi (Evista da Tamoxifen)
Masu amfani da isrogen receptor (SERMS) za su iya samun magungunan isrogen-like da kuma anti-estrogen dangane da ɓangaren jiki da suke aiki. An yarda da Evista (raloxifene) don kare rigar osteoporosis a cikin mata masu auren mata kuma anyi tunanin rage cututtukan nono. Ana amfani da Tamoxifen ga mata masu fama da ciwon ƙirjin nono wanda ke da karfin mai karɓar isrogen don ya rage hadarin komawa. Ana iya amfani da Tamoxifen don rage hadarin bunkasa ciwon nono.
Kamar estrogen (kamar yadda a cikin sauya maye gurbin hormone) aikin su a kan kasusuwa yana ƙaruwa da yawa na ma'adinai kuma yana rage hadarin cututtuka (spinal) fractures. Sabanin HRT, duk da haka, Evista yana da ciwon haɓocin ciwon estrogen akan ƙwayoyin nono kuma zai iya rage hadarin bunkasa ciwon nono. Duk da yake SARIN ba ta ƙara yawan kashi zuwa matakin da bisphosphonate keyi ba, zasu iya rage haɗarin fractures (amma ba raunin fatar jiki) da inganta yawan kashi.
Sakamakon sakamako na SERMS sun hada da walƙiya mai zafi, haɗin gwiwa, da suma. Hakanan kuma suna iya ƙara haɗarin jini kamar yatsun ganyayyaki mai zurfi, ƙwaƙwalwar ƙwayar jini (jini a cikin ƙafa wanda ya rabu da tafiya zuwa ga huhu), da kuma ɓoye na ɓoye na ciki.
Hanyoyin Sauya Hormone (HRT)
Yayinda ake maye gurbin warkar hormone (HRT) a matsayin kusan wata magungunan miyagun kwayoyi don hana osteoporosis a cikin mata, ba a yarda da wannan nuni ba. Bugu da ƙari, binciken binciken wani ƙari na ciwon nono, cututtukan zuciya, da kuma shan ciwo a cikin mata masu shan HRT sun haifar da amfani da waɗannan magunguna sosai da yawa.
Tabbas, akwai sauran mutane da suke amfani da HRT don bayyanar cututtukan mazaopausal, kuma zai iya aiki da kyau ga waɗannan bayyanar cututtuka. Ɗaya daga cikin muhimman dalilai na asarar asarar mace a cikin mata mazaopausal shine rage yawan adadin estrogen da jiki ya samar. Ya zama ma'anar haka cewa tsarin maye gurbin hormone (HRT) zai taimaka wajen rage asarar kasusuwa.
Kamar yadda yake tare da kowane magani, dole ne ku yi la'akari da hadarin da amfanin kowane magani da kuke amfani da su. Ga matasan da suka yi wa mazajen aure kuma suna fama da mummunar zafi, Hakan na iya zama wani zaɓi mai kyau. Duk da haka, har ma a wannan wuri, manufar kulawa tare da HRT ba zai zama raguwa a hadarin osteoporosis ba.
Denosumab (Prolia da Xgeva)
Ana amfani dasu mafi yawanci tare da ciwon daji, denosumab wata kwayar cutar guda daya ce wadda ta hana jigilar osteoclasts, kwayoyin da ke haifar da raunin kashi.
Ga matan da ke kan maganin aromatase (magungunan ƙwayar ciwon nono) wanda ya kawo hadarin osteoporosis, ko maza da ke kan maganin cututtukan cututtukan asrogen don cutar cancer (wanda zai kara haɗarin osteoporosis), zai iya rage hadarin fractures. Denosumab kuma ana amfani dashi ga mutanen da ke dauke da kowane irin ciwon daji wanda ya yada ga ƙasusuwan su don rage haɗarin fractures.
Ba da by allurar, denosumab yana da sakamako mai tasiri kamar bisphosphonates kuma zai iya ƙara haɗarin osteonecrosis na muƙamuƙi.
Calcitonin (Miacalcin, Ƙarshe, Kira)
Calcitonin shine tsarin mutum ne na hormone a cikin jikinmu wanda ke sarrafa ƙwayar cin nama kuma yana taimakawa canza canjin da jikin ke ɗauke da kashi. Ana samuwa duka biyu a matsayin mai laushi na hanci da inuwa kuma zai iya rage hadarin fractures. Maganin na Miacalcin, mai mahimmanci, na iya zama wani zaɓi ga mata masu auren mata da ba za su iya jure wa maganin sauran magunguna ba.
Parathyroid Hormone da Dabbobi
Forteo (teriparatide) wani nau'i ne na jikin jikin jikin jikin mutum na jikin parathyroid kuma yawanci ana amfani dashi ne kawai ga mutanen da ke fama da matsananciyar osteoporosis wanda ke cikin haɗari na fractures. Abin sani kawai magani ne wanda zai iya motsa jiki don yayi sabon ƙashi. An yi amfani da amfani yanzu don kawai shekaru 2. Tymlos (abaloparatide) yana kama da shi kuma wani sashi ne na ɓangaren parathyroid hormone.
Magungunan ƙwayoyi na ƙwayar cuta
Akwai muhawara game da yin amfani da magungunan maganin magunguna, kuma wasu sun yi jayayya cewa osteopenia wani bangare ne na tsufa. Duk da haka mun san cewa wasu mutane za su kasance mafi haɗari na ƙuntatawa, kuma duk abin da fashewar zai iya nufi idan an bar shi ba tare da izini ba. Idan kana da osteopenia, kai da likitanku zasu iya kwatanta matsalarku mai shekaru 10 na tasowa ta hanzari ko kashin baya ta hanyar amfani da sigogi da tebur da aka samo daga Ƙungiyar Lafiya ta Duniya ko kuma Osteoporosis Foundation.
Gudanar da Osteopenia Tare da Ba tare da Drugs ba
Ko dai ba za ka zabi amfani da magunguna don osteopenia ba, akwai abubuwa da za ka iya yi don rage yawan hadarin ka . Daga tabbatar da cewa matakanku ba su da kariya daga barin kuɓuta, akwai hanyoyi masu sauƙi waɗanda za ku iya rage damarku na fall.
Samun isasshen alli da kuma bitamin D yana da mahimmanci. Mutane da yawa suna samun cikakkun alli a cikin abincin su, amma bitamin D yana da wuya a zo, musamman ma a arewacin arewa. Yi magana da likitanka game da duba tsarin bitamin D naka (yawancin mutane basu raguwa). Idan matakinka ya kasance ƙananan ko a cikin ɓangaren ƙananan al'ada, tambayi ko yakamata ka dauki karin karin bitamin D3.
Aiki na yau da kullum da kuma guje wa shan taba yana da mahimmanci a cikin rigakafin osteoporosis.
Maganar Daga Daga Yankewar Osteopenia
Ba kamar osteoporosis ba, akwai cikakkun bayanai game da maganin osteopenia, kuma kowane mutum dole ne a kimanta shi a hankali don yanke shawarar ko magunguna zasu iya amfani. Ɗaya daga cikin manyan la'akari shine idan an sa mutum ya ci gaba da samun ciwon osteoporosis ko kuma yana samun haɗari na ƙananan ciwo saboda sakamakon wasu likitoci.
Akwai magunguna da yawa waɗanda zasu iya tasiri wajen rage asarar kasuwa, amma waɗannan duka suna tare da hadarin abubuwan lalacewa. A halin yanzu, kawai kwayoyi da aka amince don osteopenia (rigakafin osteoporosis) su ne Actonel da Evista. Wasu magunguna, duk da haka, ana iya la'akari da su bisa ga wasu mutane na musamman.
Idan an gano ku tare da osteopenia suna tattaunawa da likitanku sosai. Yi magana akan abin da za a iya sa ran a cikin shekaru masu zuwa. Yi magana game da hadarin cututtuka, da kuma abin da fashewar zai iya nufi game da motsa jiki da 'yancin kai. Sa'an nan kuma magana game da illa mai tasiri na duk wani magani kuma ku yi la'akari da duk wani amfanin da za ku iya hango ko hasashen. Yana da muhimmanci a zama mai ba da shawara a kula da ku, musamman ma a cikin halin da ake ciki kamar wannan da za a yi la'akari da yadda za a iya zaɓuɓɓukan kulawa.
> Sources:
> Eriksen, E. Jiyya na Osteopenia. Bayani a cikin Endocrinology da kuma Metabolic Disorders . 2012. 13 (3): 209-223.
> Kasper, Dennis L .., Anthony S. Fauci, da Stephen L .. Hauser. Ka'idodin Magungunan Hoto na Harrison. New York: Ilimin Mc Graw Hill, 2015. Print.
> Rosen, H. Ilimin likita: Tsarin rigakafi da jiyya na Osteoporosis (Baya Ƙananan Basira). UpToDate . Updated 03/26/17.