Wata binciken zai iya samun amsar
Magungunan anti-inflammatory marasa cututtuka ( NSAIDs ) suna daya daga cikin mahimmancin magani don osteoarthritis na wuka da gwiwoyi. Sassan NSAID suna aiki ta hanyar kulle kwayoyin, wanda ake kira cyclooxygenase wanda ke biye da ƙwayar yawan kwayoyi masu alamar da ake kira prostaglandins. Prostaglandins suna da alhakin ayyuka da yawa a jikinmu, ɗaya daga cikinsu shine ƙonewa.
Ta wurin hana kira na prostaglandins NSAIDs rage ƙonawa a cikin jikinmu, kuma tare da wannan ya kawo ragu mai tsanani a cikin zafi.
Har ila yau, Prostaglandins suna da alhakin ƙananan wasu ayyuka a cikin jiki kamar fargabawar ciki na ciki, saboda haka wasu daga cikin mummunan sakamakon NSAID sun zo ne daga hana ayyukan nan; musamman NSAIDs zai iya zama da wuya a cikin ciki, da kuma amfani da tsawo na NSAIDs zai iya haifar da ciki ko duodenal (ƙananan ciwo) ulcers. Wadannan kwayoyi sunyi nazari da yawa kuma suna wajabta wa mutane da osteoarthritis. Yin amfani da NSAIDs a cikin wannan tsari yana daya daga cikin shawarwarin da suka dace wanda Cibiyar Nazarin Orthopedic Surgeons ta Amurka (AAOS) ta yi a cikin jagororin su game da maganin gwiwar osteoarthritis.
Magunguna suna bayar da shawarar NSAID a matsayin maganin farko na OA. Akwai magungunan kwayoyi a ƙarƙashin wannan magungunan ƙwayoyi wanda shahararrun sune aspirin, ibuprofen (Advil), da naproxen (Aleve).
Acetaminophen wanda aka fi sani da paracetamol ko Tylenol wani magani ne wanda ke kusa da ƙungiyar NSAID, ana amfani dasu ne kawai don irin wannan manufa, amma ba shi da magungunan ƙananan kumburi mai karfi kuma ba a la'akari da shi sosai na ƙungiyar NSAID.
Duk da yake muna da bayanai masu yawa waɗanda suka goyi bayan yin amfani da NSADs a wurin OA, muna da ƙananan bayanai don gaya mana, wanda NSAID ya fi tasiri fiye da sauran.
Wannan shi ne har zuwa wani bita na baya-bayan nan da ya zo a Lancet wannan Maris. Kafin mu ci gaba, bari muyi magana game da asalin wannan bincike. Lancet wata jarida ce ta likita a Birtaniya da ta kasance tun daga shekarun 1820, daya daga cikin mujallolin da aka fi sani da ita, kuma ya kasance dandamali ga wasu daga cikin mafi girman tasiri mafi mahimman bayanai a cikin tarihin magani.
A matsayin misali na wasu batutuwa da aka buga a farkon Lancet sune littafin Lister a shekara ta 1870 akan sakamakon fasaha mai dorewa a sakamakon sakamako wanda ya kasance farkon littafin da ya haifar da likitoci don busa hannayensu da kayan aiki kafin aikin tiyata . Har ila yau, Ronald Ross ya wallafa bincikensa cewa masallaci yana watsa malaria, McBride ya wallafa cewa thalidomide (wani maganin maganin maganin rigakafin da ake amfani dashi a cikin ciki) yana haifar da lahani na haihuwa.
Lancet yana wallafa abubuwan da ke da kyau kuma a cikin tarihin su na yanzu sunyi aiki na buga wallafe-wallafe masu kyau inda suka haɗa bayanai daga nazarin da yawa don kokarin gwada tambaya mai mahimmanci. A cikin fitowar su, jaridar ta yi ƙoƙari ta amsa tambayar "Wanne NSAID shine mafi kyawun magance cutar da ke da alaka da osteoarthritis na gwiwa da hip?"
Bari mu tsaya a nan don na biyu kuma muyi sanarwa sosai. Wannan binciken ba YA KASA SAFETI. Don haka babu wani bayanan wannan bayanan da ya shafi tasirin tasiri na gefe ko yadda cututtuka suke da illa, suna kallon tasiri na taimako mai zafi.
Binciken ya samo rahotanni 8,973, 74 daga cikinsu akwai nazarin karatun bazuwar karatu wanda ya kwatanta sababbin NSAIDs da Tylenol guda bakwai. Wannan shi ne mafi yawan shaidar da za a tattara a kan batun. Daga cikin waɗannan gwaje-gwaje kusan kusan mutane 60,000 ne ke tare da daban-daban na NSAID da daban-daban na jin zafi. Sai suka yi nazarin maganganu, wanda ke rufe dukkan waɗannan marasa lafiya a cikin ƙungiya daya don ganin wane daga cikin NSAIDs da kuma amfani da aka yi amfani da ita sun fi tasiri a inganta ciwo.
Yayinda wannan ya kasance a kan sauƙaƙe hanyoyin su, cikakkun bayanai game da hanya bai wuce ikon wannan labarin ba.
Daga cikin jigilar kwayoyi 22 da aka bincika, 5 ba su yi wani abu mafi kyau fiye da placebo (kwayar sukari) ba. Wadannan 5 sun kasance Tylenol a kasa da 2 grams kuma ƙasa da 3 grams kowace rana dosing, diclofenac (Voltaren) a 70mg a rana, Naproxen a 750mg kowace rana, da kuma ibuprofen a 1200mg a rana. Yana da mahimmanci a lura da cewa waɗannan sunyi amfani da wasu ƙayyadaddun sakamako, kuma mafi magungunan wadannan magunguna a wasu lokuta sun tabbatar da tasiri. Hanya shida sun tsaya a matsayin mafi tasiri: diclofenac (aka Voltaren) 150 MG / day, etoricoxib (aka Arcoxia) 30 mg / rana, 60 mg / rana, da 90 MG / day, da kuma rofecoxib (Vioxx) 25 MG / rana da 50 MG / rana.
Ƙarin binciken gwagwarmaya masu kwarewa sun nuna cewa diclofenac 150 mg / rana da etoricoxib 60 MG / rana sunyi mafi kyau a game da taimakon jin zafi idan aka kwatanta da sauran kwayoyi da kuma kwayoyi. Lokacin da aka kwatanta daban-daban na NSAID dangane da tasirin da suka shafi inganta aikin, yana kama da diclofenac (Voltaren) 150mg / day kuma rofecoxib (Vioxx) 25mg / day.
Kafin mu cigaba da ci gaba zamu yi hankali kan Vioxx (rofecoxib). Duk da yake a cikin wannan gwaji an nuna shi magani ne mai mahimmanci don taimakawa jin zafi da ingantaccen aiki, Vioxx ba lafiyar miyagun ƙwayoyi ba ne. FDA ta cire shi daga kasuwar da ke damu da damuwa akan ciwon zuciya da bugun jini wanda ke da alaka da amfani da dogon lokaci. Yana da tasiri a matsayin mai sauƙi mai sauƙi ba shi da mahimmanci saboda haɗarin haɗari masu haɗari. Bai kamata a dauki shi azaman zaɓin mai yiwuwa ba.
To, me ake nufi? Wannan cikakkiyar bayanai ne don warwarewa ta kuma fassara. A ganina akwai wasu mahimman matakai da suka fito daga wannan mahimmancin ma'auni. Na farko, paracetamol (wanda aka fi sani da acetaminophen ko Tylenol) na iya zama da tasiri sosai wajen sarrafa ciwo fiye da yadda muke tunani. Yanzu yana da mahimmanci a lura cewa wannan binciken yana da mahimmanci ga osteoarthritis na hip da gwiwa. Saboda haka watakila Tylenol yana da kyau a kan sarrafa ciwo a wasu saituna, kamar ciwon kai, wannan binciken ba ya magance wannan. Har zuwa OA na kunya da gwiwoyi sun tafi, yana kama da Tylenol wani zabi mara kyau. Diclofenac a 150mg / rana shi ne mafi tasiri a sarrafa iko da inganta aikin.
Wannan ya dubi sakamako akan gajeren lokaci da tsakiyar lokaci na kimanin watanni 3 a matsakaici. Shin wadannan kwayoyi za su yi daban a kan tsawon lokaci kamar shekaru masu yawa? Zai yiwu, muna buƙatar ƙarin nazarin lokaci mai tsawo don tabbatar da tabbacin. Abu mafi wuya akan fassara wannan bayanan shi ne cewa ba ya magance alamar kare lafiyar waɗannan kwayoyi. An nuna matakan NSAI don kara yawan ciwon jini na ciki (ciki da ƙananan hanji), da kuma kara haɗarin ciwon zuciya. Kuma matakan da kowane NSAID, da kuma kowace NSAID suka gabatar, ya kawo halayen na iya bambanta. Dole ne a shawarci shawarar da za a fara sabon magani don maganin OA na hip da gwiwa da kyau tare da likitanka, don haka ɗayanku biyu na iya nauyin nauyin wadata da ƙwararruwar kowanne magani a kowanne ɗayan kuma zaɓi shawarar da ya dace a gareku .