Methylene blue don lalacewar jijiyoyi da ciwo: waɗanne yanayi aka yi nazari a kansu?

Shin methylene blue yana rage lalacewar jijiyoyi da ciwo? Wannan tambayar tana kama da tambaya ɗaya, amma wallafe-wallafen bincike suna amsa tambayoyi daban-daban. Rini da aka yi wa allura cikin faifan kashin baya, rini da aka yi wa allura ƙarƙashin fatar da ke kewaye da dubura, rini da aka zuba cikin jijiyar jini, da rini da aka kurkura baki da shi duk suna da suna ɗaya, amma suna gwada dabaru daban-daban masu hanyoyin aiki daban-daban. Sakamakon ɗaya ba ya zama na sauran.

Ka ɗauke su a matsayin dabaru huɗu masu lakabi ɗaya. Dabara ta farko tana lalata ko rage jin ƙananan ƙarshen jijiyoyi da suka tsiro cikin faifan kashin baya da ya lalace. Dabara ta biyu tana hana ji ko rage aikin jijiyoyin fata a wurin allurar. Dabara ta uku tana aiki a tsarin jijiyoyi ta hanyar zagayawar jini a duk jiki. Dabara ta huɗu tana lulluɓe saman wurin da ya ji rauni don rage ciwo a wurin. Da zarar an fahimci wannan bambanci, ana iya rarrabe shaidar cikin sauƙi, kuma gibin ya bayyana: da'awar da ta shahara ta shafi dabara ta uku a matsayin ruwan da ake haɗiyewa, wanda shi ne wurin da shaidar bincike a mutane ta fi ƙaranci.

Jadawalin shaida bisa yanayi da hanyar amfani

Wannan jadawalin taƙaitaccen bayanin wannan maƙala ne. Kowane layi yana haɗa yanayin, hanyar amfani, da abin da aka yi tare, domin raba su ne ke sa a wuce gona da iri a da'awar rage ciwo.

Karanta ginshiƙin hanyar amfani daga sama zuwa ƙasa kafin ka karanta kowane kanun labari. Duk alamar tasiri mai kyau a mutane tana cikin layin amfani a wani wuri na jiki ko yayin aikin likita. Layukan amfani a duk jiki sun ƙunshi ƙaramin gwajin farko guda ɗaya da wasu gurabe marasa shaida.

Ciwon baya daga faifan kashin baya: gwaji ɗaya mai sakamako na ban mamaki, da maimaitawa ɗaya da ta gaza

Labarin allura cikin faifan kashin baya ya fara da gwajin farko na 2007 ba tare da rukunin kwatanci ba a marasa lafiya 24 da aka tabbatar da tushen ciwonsu ta gwajin discography, kuma ciwon ya ƙi kulawar da ba ta buƙatar tiyata. Bayan allura ɗaya cikin faifan kashin baya ta methylene blue 10 mg, 21 cikin 24 sun ba da rahoton cewa ciwon ya gushe ko ya ragu sosai a tsawon kusan watanni 18 na bibiyar su. Ba tare da rukunin kwatanci ba, wannan sakamakon zai iya kasancewa saboda yadda aka zaɓi mahalarta, yadda yanayin ya sauya da kansa, ko lidocaine da aka ba tare da shi. Saboda haka, ya ƙarfafa yin bincike kan inganci maimakon ya amsa tambayar.

Binciken da ya biyo baya shi ne gwajin 2010 da aka ɓoye rabon rukunoni ga ɓangarori biyu tare da rukunin kwatanci na placebo a marasa lafiya 72, yana kwatanta methylene blue tare da lidocaine da ruwan gishiri tare da lidocaine. Bayan watanni 24, bambance-bambancen da aka ruwaito sun yi yawa ƙwarai: matsakaicin raguwar maki na ciwo 52.5 idan aka kwatanta da maki 0.7, da gamsuwa 91.6% idan aka kwatanta da 14.3%. Wani sharhin edita da ya raka binciken ya tambaya a fili ko wannan maganin warkar da ciwon baya ne, abin da ke nuna yadda ƙwararru suka ga da'awar a matsayin abin mamaki a lokacin.

Da'awa irin wannan tana buƙatar maimaita gwaji, amma maimaitawar ba ta tabbatar da ita ba. Gwajin IMBI na cibiyoyi da yawa da aka yi daga baya ya gwada methylene blue cikin faifan kashin baya a cibiyoyi daban-daban, kuma bai tabbatar da tasirin da Peng ya samu ba. Ƙananan bincike masu zaman kansu da ba su da rukunin kwatanci galibi sun ruwaito ƙarancin yawan waɗanda suka amfana ko raguwa da lokaci. Taƙaitawa ta gaskiya ita ce shaida mai saɓani: nasara ɗaya mai ɗaukar hankali a cibiya ɗaya, amma maimaita gwaji a cibiyoyi da yawa ya gaza. Wannan yanayin ba ya tabbatar da magani, kuma ba ya faɗin komai game da haɗiye methylene blue, wanda ba ya shiga faifan kashin baya a kaurin da ya yi kama da na allurar. Bitar mu ta shaidar ciwo mai ɗorewa tana sanya wannan takaddama tare da sauran hanyoyin da ake yi yayin aikin likita.

Allura a kewaye da dubura: alamun tasiri na gaske, amma iyakantattun amfani

Amfani da methylene blue cikin fata don ƙaiƙayin dubura da ya ƙi magani yana da tarihin jerin rahotannin marasa lafiya mafi tsawo, tun daga 1990, har zuwa rukunonin marasa lafiya 25, 30, 49, da 103. Yawan waɗanda suka amfana yana da yawa a gani, sau da yawa mafi rinjaye ba sa da alamomi bayan allura ɗaya ko biyu, amma duk jerin binciken ba su da rukunin kwatanci. Ƙaiƙayin da ya sa mara lafiya neman hanyar da ke buƙatar allura zai iya ƙaruwa ko raguwa, kuma tsammanin amfani daga allurar kansa na iya shafar abin da mara lafiya yake ji. Saboda haka, yawan waɗanda suka sami sauƙi a bincike marasa rukunin kwatanci ba zai iya tabbatar da inganci ba.

Shaidar kwatanci mafi ƙarfi tana cikin ciwo bayan tiyata. Gwaje-gwaje biyu da aka raba mahalarta bisa bazuwar zaɓe na methylene blue cikin fatar da ke kewaye da dubura a lokacin tiyatar cire basur sun gano raguwar maki na ciwo da ƙarancin amfani da ƙarin maganin rage ciwo a kwanaki 1 zuwa 3 a gwajin marasa lafiya 67, da kuma a kwanaki 1 zuwa 7 a gwajin marasa lafiya 97. Wannan shaida ce ta gaske ta rage ciwo ga takamaiman aikin likita, adadin magani, da mako. Ba shaida ba ce ga lalacewar jijiyoyi mai ɗorewa, kuma hanyar aikin da ake magana a kai ita ce rage jin jijiyoyi a wurin rauni, wanda ɗigon da aka haɗiye ba zai iya maimaitawa ba. Bayani kan yadda methylene blue yake aiki a jijiyoyi da mitochondria yana bayyana dalilin da ya sa aikin sinadari a wani wuri yake takaita ga wurin.

Amfani a duk jiki don ciwon lalacewar jijiyoyi: ƙaramin gwajin farko guda ɗaya

Ga da'awar da yawancin masu saya suka fi damuwa da ita, cewa methylene blue da ke aiki a duk jiki yana rage ciwon lalacewar jijiyoyi, duk tarihin gwaje-gwajen mutane masu rukunin kwatanci ya bayyana yana takaita ga gwajin farko guda ɗaya na 2015 a marasa lafiya 10 masu ciwon lalacewar jijiyoyi mai ɗorewa daga sabubba daban-daban wanda ya ƙi magani. Methylene blue 2 mg/kg da aka zuba cikin jijiyar jini ya fi adadi ƙanƙani sosai da aka ba rukunin kwatanci wajen rage maki na ciwo a ranar magani da washegari, amma kusan duk amfanin ya gushe cikin 'yan kwanaki. Marasa lafiya uku sun nuna raguwar ciwon da taɓawa ko matsin da ba ya saba haifar da ciwo yake jawowa.

Marasa lafiya goma masu yanayi daban-daban da sauƙi na kwanaki biyu dalili ne na ƙarin bincike, ba tushen amfani da shi a matsayin magani ba. Mahalarta ɗaya ne kawai yake da ciwon jijiyoyi bayan shingles, don haka wannan ma ba gwajin ciwon jijiyoyi bayan shingles ba ne. Ba a gano gwajin methylene blue da ke aiki a duk jiki a mutane wanda ya cika ƙa'idodin da ake nema don lalacewar jijiyoyin gaɓoɓi saboda ciwon sukari, ciwon jijiyar trigeminal, ko ciwo mai sarƙaƙiya a wani yanki na jiki ba. Binciken ciwon jijiyoyi bayan shingles da aka yi kusa da kashin baya, wanda injinan bincike sukan nuna, ya haɗa methylene blue da maganin sa barcin wuri a kashin baya. Wannan ya shiga cikin dabarar aikin likita a wurin, ba ta amfani a duk jiki ba.

Kurkure baki, raunuka, da haɗin gwiwa: shaidar amfani a wuri da ba za a ɗauka zuwa wani amfani ba

Sauran alamun tasiri a mutane duk na amfani ne a wani wuri na jiki. Wani gwajin mataki na 2 na 2022 da aka raba mahalarta bisa bazuwar zaɓe ya gano cewa kurkure baki da methylene blue a matakan kauri guda uku ya rage ciwon kumburin rufin baki saboda maganin kansa fiye da kulawar da aka saba zuwa rana ta 2. Ruwan kurkura yana lulluɓe rufin baki da ya ji rauni, sannan a tofar da shi. Ambatonsa a matsayin shaida ga ɗigon da ake haɗiyewa yana gauraya amfani a saman wani wuri da ba da magani don ya yi aiki a duk jiki.

Haka kuma, lulluɓe naman wurin tiyata da methylene blue da aka tsarma yayin tiyatar cire faifan kashin bayan ƙugu ya rage maki na ciwon baya a wani gwajin marasa lafiya 115 da aka ɓoye rabon rukunoni ga ɓangarori uku, yayin da wani gwajin allura cikin haɗin gwiwar facet ya ruwaito raguwar maki na ciwo da gazawar yin ayyuka bayan watanni 3 da 6. Kowane sakamako yana da alaƙa da wurin da aka sanya maganin. Babu ɗayansu da za a ɗauka a matsayin sakamakon samfurin da ake sha ta baki.

Abin da binciken dabbobi ya nuna, da inda hanyar aikin take da tasiri biyu masu saɓawa

Samfuran ciwon lalacewar jijiyoyi a beraye suna samar da yiwuwar hanyar aiki da aka fi yawan ambata. Methylene blue da aka sanya cikin ruwan da ke kewaye da lakar kashin baya ya hana yawan jin ciwo daga zafi da ya riga ya samu na kusan sa'o'i 4 bayan ɗaure jijiyar sciatic a wani gwajin farko na 1992. Wannan ya yi daidai da yiwuwar gudummawar hanyar nitric oxide zuwa cGMP a lakar kashin baya. Binciken da aka yi daga baya kan raunin jijiyar da aka matse na dogon lokaci ya gano cewa methylene blue shi kaɗai yana rage amsar ciwo, kuma yana iya hana ƙarin yawan jin ciwo da sildenafil ya jawo. Wannan ya sake nuna rawar isar da saƙon nitric oxide. Wani binciken 2021 ya ƙara wata hanyar aiki ta biyu: danne aika saƙonnin jijiyoyi kai tsaye, irin tasirin da ake samu a tashoshin sodium, tare da dannewa mai tsawo fiye da lidocaine a samfurin da aka gwada.

Akwai wani muhimmin bambanci da ya kamata a riƙe domin masu sayarwa suna barinsa. Wallafe-wallafen nitric oxide na binciken kafin gwaji a mutane ba duka suke nuna cewa methylene blue yana nufin rage ciwo ba. A wasu tsarin gwaji, isar da saƙon nitric oxide da kanta tana kawo sauƙin ciwo, kuma methylene blue yana hana wannan sauƙin. A gwajin lalacewar jijiyoyi saboda ciwon sukari, methylene blue ya hana rage amsar ciwo da ke da alaƙa da sildenafil, kuma shi kaɗai ya ƙara yawan jin ciwo. Tasirin hanyar aiki ya danganta da samfurin gwaji da hanyar sinadarai, wanda wani ƙarin dalili ne da ya sa ba za a ɗauki sakamakon dabbobi a matsayin shawarar adadin magani ba.

Abin da ba a yi nazari ba, da iyakar aminci

Ba a gano gwajin da aka raba mahalarta bisa bazuwar zaɓe ko sahihin jerin binciken asibiti na methylene blue da ake haɗiyewa ta baki don ciwon lalacewar jijiyoyi mai ɗorewa, lalacewar jijiyoyi saboda ciwon sukari, ciwon jijiyar trigeminal, ciwo mai sarƙaƙiya a wani yanki na jiki, ko ciwon jijiyoyi bayan shingles ba. Gwajin kai tsaye guda ɗaya na ciwon lalacewar jijiyoyi da ke amfani da maganin da zai yi aiki a duk jiki shi ne gwajin farko na marasa lafiya 10 da aka ba shi cikin jijiyar jini, tare da alamar tasiri na kwanaki 1 zuwa 2. Ba za a ɗora sakamakon allura cikin faifan kashin baya, cikin fata, cikin haɗin gwiwa, kusa da kashin baya, da kurkure baki kan ɗigon da ake sayarwa bisa ilimin magunguna ba. Kaurin ɗigon a wurin da ake nufi ya bambanta da waɗannan sosai, kuma ba a sanya su a wurin ta hanyar aikin likita.

Rikicewar hanyoyin amfani tana kuma ɗauke da gargaɗin aminci. Ba a iya musanya sassan da ke kusa da kashin baya: sanya magani cikin faifan kashin baya, kusa da kashin baya, a sararin epidural, da cikin ruwan da ke kewaye da lakar kashin baya suna bambanta wajen aikin magani da guba. Mummunan lahani ga tsarin jijiyoyi bayan sanya methylene blue cikin ruwan da ke kewaye da lakar kashin baya ya sa aka bayar da gargaɗin haɗari a fili. Baya ga haka, methylene blue yana yin mu'amala da magungunan da ke shafar serotonin, kuma bai dace da masu ƙarancin G6PD ba. Saboda haka, duk mai ciwo da ke tunanin amfani da shi yana buƙatar bitar illoli da yanayin da bai dace a yi amfani da shi ba da tattaunawa da ƙwararren ma'aikacin lafiya da farko, tare da amfani da waɗannan tambayoyin da za a yi game da methylene blue.

Yadda za a yi amfani da wannan shaida

Duk wanda yake tantance methylene blue don ciwo ya kamata ya yi tambayoyi uku game da kowane binciken da aka ambata. Wane yanayi ne takamaimai, domin murmurewa bayan tiyatar cire basur ba lalacewar jijiyoyi saboda ciwon sukari ba ce. Wace hanyar amfani ce takamaimai, domin sanya magani cikin faifan kashin baya ko cikin fata ba daidai yake da adadin da aka haɗiye ba. Kuma wane sakamako aka auna, a tsawon wane lokaci, domin sauƙin ciwo na kwanaki bayan aikin likita ba watannin shawo kan lalacewar jijiyoyi ba ne.

Bisa shaidar da ake da ita yanzu, alamun rage ciwo da methylene blue yake nuna a mutane sun takaita ga amfani a wani wuri na jiki ko yayin aikin likita, tare da rashin daidaiton inganci tsakanin yanayin da ake amfani da shi. Shaidar amfani a duk jiki ta takaita ga ƙaramin gwajin farko guda ɗaya na zuba shi cikin jijiyar jini, kuma babu shaidar asibiti da ta goyi bayan methylene blue da ake sayarwa don sha ta baki saboda ciwon lalacewar jijiyoyi ko ciwo mai ɗorewa.