Methylene blue da POTS: dalilin da ya sa hanyoyin aikin jijiyoyin jini ba su tabbatar da magani ba

Methylene blue ba magani ne da aka tabbatar da shi ga ciwon saurin bugun zuciya yayin tsayuwa, wato POTS ba. A binciken wallafe-wallafen da aka yi don wannan maƙala, ba a gano wani gwajin asibiti mai rukunin kwatantawa da ya nuna cewa yana inganta alamomin POTS ko ayyukan yau da kullum ba. Nazarin shokin kamuwa da cuta da na jijiyoyin jini a gwaje-gwaje suna amsa wasu tambayoyi daban.

Hujjar da ke jan hankali ita ce POTS yana da alaƙa da zagayawar jini, methylene blue na iya hana wasu saƙonnin da ke sassauta jijiyoyin jini, don haka ya kamata methylene blue ya inganta POTS. Kowane mataki na wannan hujja yana buƙatar nazari. Tasirin wani magani a wata hanyar aikin jijiyoyin jini ba ya tabbatar da cewa wannan hanyar ce sanadin alamomin wani mutum, ko cewa canza ta zai taimaka masa ya tsaya ba tare da wahala ba.

Abubuwan da ya kamata a fara bambantawa

Rashin jure tsayuwa yana nufin alamomin da ke da alaƙa da kasancewa a tsaye. POTS wata takamaiman ƙungiyar alamomi ce cikin wannan matsala mai faɗi. Dysautonomia ya fi wannan faɗi, domin yana nufin matsalolin daidaitawar tsarin jijiyoyin da ke sarrafa ayyukan jiki kai tsaye; ba sunan wani takamaiman tsarin matsin jini ba ne.

Bayanin yarjejeniyar ƙwararrun NIH game da POTS ya bayyana ƙaruwa mai ɗorewa a bugun zuciya da aƙalla bugun 30 a minti ɗaya cikin minti 10 na kasancewa a tsaye, ko aƙalla 40 ga masu shekaru 12–19. Wannan yana tare da alamomin tsayuwa masu daɗewa, sauƙi yayin kwanciya, da rashin saukar matsin jini mai ɗorewa yayin tsayuwa. Dole ne alamomin su kasance sun ɗauki aƙalla watanni uku, kuma a kawar da wasu abubuwan da za su iya bayyana saurin bugun zuciyar. Karatun agogon hannu kaɗai ba zai iya tabbatar da haɗuwar waɗannan abubuwan ba.

Nau'in gargajiya na saukar matsin jini yayin tsayuwa yana da wata ma'aunin tantancewa dabam: ma'anar da ƙungiyoyin tsarin jijiyoyi masu sarrafa ayyukan jiki kai tsaye suka amince da ita ta ƙayyade sauka mai ɗorewa da aƙalla 20 mmHg a matsin jini na lokacin matsewar zuciya ko 10 mmHg a na lokacin sassautawar zuciya, cikin minti uku bayan tsayuwa ko karkatar da jiki da kai zuwa sama. Shokin vasoplegia kuwa yana nufin rasa ƙarfin matsewar jijiyoyin jini cikin gaggawa, har ya kai ga barazana ga zagayawar jini. Ba a gano shi ta gwajin tsayuwa.

Kwatantawa: yanayi, sakamako, da gibin shaidu

Wannan kwatantawa tana ware tambayoyin bincike; ba takardar tantance cuta ba ce. Sauke kwatantawar yanayin da tambayoyin tattaunawa don ajiye bambance-bambancen a wuri guda. Suna da muhimmanci kuma wajen fassara methylene blue da sauye-sauyen matsin jini.

Abin da gwajin shoki ya gwada a zahiri

A gwajin Ibarra-Estrada da abokan aikinsa na 2023 wanda aka raba mahalarta zuwa rukuni bisa bazuwar zaɓi, manya masu shokin kamuwa da cuta sun karɓi methylene blue ta jijiya ko ruwan gishiri a matsayin maganin bogi, tare da kulawa ta musamman. Binciken sakamakon ya ƙunshi marasa lafiya 91, 45 sun karɓi methylene blue, 46 kuma maganin bogi. An ba da maganin ta ɗigon jijiya a tsawon kwanaki uku, sannan aka tantance sakamako har zuwa kwanaki 28.

Babban sakamakon da aka auna shi ne lokacin da aka ɗauka kafin a iya dakatar da magungunan ɗaga matsin jini. Waɗannan magunguna ne da ake amfani da su don tallafa wa matsin jini yayin shoki. Lokacin tsakiya ya kasance sa'o'i 69 ga methylene blue da sa'o'i 94 ga maganin bogi. Mutuwar marasa lafiya da tsawon lokacin amfani da na'urar taimakon numfashi sun yi kama tsakanin rukunonin.

Wannan shaida ce game da ƙarin magani a lokacin gazawar zagayawar jini mai faruwa cikin gaggawa saboda kamuwa da cuta. Ba ta nuna cewa methylene blue da ake sha yana rage saurin bugun zuciya yayin tsayuwa, hana jin kamar za a suma, ko inganta halartar makaranta ga masu POTS ba. Marasa lafiyar, hanyar ba da magani, sauran magungunan da aka bayar tare da shi, tsawon lokacin, da babban sakamakon da aka auna duk sun bambanta. Wani nazari dabam na gwaje-gwajen methylene blue a vasoplegia da shokin kamuwa da cuta yana bincika wannan shaida ta kulawa ta musamman a yanayin da ta dace da shi.

Dalilin da ya sa bayanin nitric oxide bai cika ba

Nitric oxide yana taka rawa wajen sassautawar jijiyoyin jini, ciki har da isar da saƙonni ta soluble guanylate cyclase da cyclic GMP. Methylene blue na iya tsoma baki cikin wannan tsarin halittu, amma bayyana shi kawai a matsayin mai toshe nitric oxide yana ɓoye bambance-bambancen gwaje-gwaje.

Misali, gwajin jijiyoyin jini da Wolin da abokan aikinsa suka yi a 1990 ya shafa methylene blue kai tsaye a ƙananan jijiyoyin jinin tsokokin ƙasusuwan berayen da aka yi wa maganin sa barci, bayan an buɗe wurin. Ya rage faɗaɗawar jijiyoyin da acetylcholine da nitric oxide suka haifar. Superoxide dismutase ya hana wannan toshewar, abin da ya goyi bayan hanyar aikin superoxide a wajen ƙwayoyin halitta a wannan shirin gwaji. Wannan gwaji ne na ƙananan jijiyoyin da ke kai jini daga zuciya a wani takamaiman wuri, ba nazarin maganin sha ga masu POTS ba. Sakamakonsa ba zai iya tabbatar da fa'idar magani ko raunin jijiyoyin sadarwa a waɗannan marasa lafiya ba.

Zaton da ya shafi cutar ma ba shi da tabbas. Wani nazarin amsoshin ƙananan jijiyoyin jini a POTS na 2005 ya kwatanta mahalarta 15 masu POTS na ƙarancin gudanawar jini, 17 masu POTS na gudanawar jini ta al'ada, da mahalarta masu lafiya 13 na kwatantawa, masu shekaru 14–22. Masu binciken sun auna gudanawar jini a fata yayin gwaje-gwajen da ke tayar da amsar jijiyoyin jini a wurin. Abubuwan da suka gano sun nuna yiwuwar raguwar sakin nitric oxide da ya dogara da gudanawar jini a rukunin ƙarancin gudanawa. Ba su gwada methylene blue a matsayin magani ba.

Wannan abin da aka gano yana ƙalubalantar ra'ayin cewa duk POTS yana nufin yawan nitric oxide da ya kamata a danne. Haka kuma ba ya tabbatar da cewa kowane mai POTS yana da ƙarancin nitric oxide. Kamar yadda nazarin asibiti na Mar da Raj ya bayyana, raunin wani ɓangare na jijiyoyin da ke sarrafa ayyukan jiki kai tsaye, ƙarancin yawan jinin da ke zagayawa, da ƙarin ayyukan tsarin adrenergic na iya ba da gudummawa ta hanyoyin da ke haɗuwa. Bambance-bambancen NOS, cGMP, da isar da saƙonni a jijiyoyin jini suna da muhimmanci domin sunan wata hanyar aiki ba tantance cutar wani mutum ba ne.

Abin da rahotannin marasa lafiya masu saɓani za su iya gaya mana

Wata tattaunawa a Phoenix Rising ta ƙunshi rahoton tsanantar POTS sosai yayin amfani da methylene blue. A ɗaya ɓangaren kuma, wata tattaunawar POTS a Reddit ta ƙunshi rahoton ingantar bugun zuciya nan take da aka danganta da methylene blue. Waɗannan bayanai suna bayyana abubuwan da mutane suka fuskanta da tambayoyinsu; ba sa tabbatar da sanadin ingantawa ko tabarbarewa.

Tambayoyin da za su taimaka suna da takamaiman ma'ana. An auna alamomin yayin da jiki yake a matsayi ɗaya? Matsin jini ya canza tare da bugun zuciya? An canza magunguna ko wasu abubuwan ƙarin abinci? Mutumin ya ji sauƙi ne na ɗan lokaci kawai, ko ya dawo da damar kasancewa a tsaye domin yin ayyuka a kwanakin da suka biyo baya? Rahoton da ba shi da waɗannan bayanai ba zai iya ware tasirin magani daga sauran sauye-sauyen da suka faru a lokaci guda ko sauyin alamomi na yau da kullum ba.

Ga mutanen da kuma suke da ME/CFS, jin kuzari nan take ba ya amsa ko yin aiki ya haifar da tabarbarewa daga baya. ME/CFS, methylene blue, da tabarbarewar lafiya bayan yin ƙoƙari yana magana kan wannan sakamako dabam. Rahotannin farin ciki ko na firgici ba su ba da hujjar tsarin gwada maganin a gida ba.

Me zai sa ikirarin maganin POTS ya zama mai gamsarwa?

Nazari mai amfani zai ɗauki marasa lafiya da aka rubuta tabbataccen ganewar cutarsu, ya ƙayyade yadda aka haɗa maganin da hanyar ba da shi, ya yi amfani da abin kwatantawa mai inganci, kuma ya auna alamomi da iya yin ayyuka. Ya kamata a tantance bugun zuciya da matsin jini tare. Dole ne bibiyar marasa lafiya ta daɗe yadda za a iya bincika fa'ida mai ɗorewa da illoli, maimakon ɗaukar karatu guda ɗaya mai kyau a matsayin murmurewa. Waɗannan sharuɗɗa ne na gwada ikirarin, ba shaidar cewa maganin yana aiki ba.

Aminci yana da muhimmanci ga wannan shawara ta musamman. Bayanin rubuta maganin ProvayBlue na jijiya a Amurka yana gargaɗi game da ciwon serotonin da zai iya zama sanadin mutuwa idan an haɗa shi da magungunan da ke yin mu'amala da shi, kuma ya hana amfani da shi ga masu ƙarancin G6PD saboda haɗarin ƙarancin jini sakamakon rushewar jajayen ƙwayoyin jini. An amince da amfani da shi ga methemoglobinemia da aka samu daga baya, ba POTS ba. Wannan bayanin maganin ba ya tabbatar da ingancin wani tsarin shan maganin don alamomin tsayuwa.

Kai takamaiman ikirarin, samfurin, jerin magungunan da kake amfani da su yanzu, da sakamakon da kake nema ga ƙwararren ma'aikacin lafiya wanda ya san alamomin da kake fuskanta yayin tsayuwa. Tambayoyin da za a yi kafin yin la'akari da methylene blue suna taimakawa wajen tsara wannan tattaunawa. Tambayar da ba a warware ba ita ce ko yana samar da fa'ida mai ma'ana kuma mai ɗorewa ga masu POTS, ba ko yana iya canza jijiyoyin jini a wani yanayi dabam ba.