Shuɗin methylene da HBOT: shin oxygen mai matsin lamba yana ƙara fa'ida?

Wani shafin asibiti yana tallata shuɗin methylene tare da HBOT don kuzari, fahimta, ko farfaɗowa. Wani lokaci ana ƙara allon jan haske, a kuma kira kunshin shuɗin methylene da jan haske da oxygen mai matsin lamba. Shafin yana ambaton mitochondria, isar da oxygen, da wasu takardun bincike kaɗan. Ana biyan kuɗi ga kowane zama. Tambayar da mai karatu yake buƙata ta fi takaita fiye da tambayar ko kowane ɓangare yana da hujjar da ta yi kama da mai yiwuwa. Ita ce ko wani ya gwada wannan takamaiman haɗin kuma ya auna ƙarin fa'idarsa idan aka kwatanta da kowane ɓangare shi kaɗai.

Wannan tambayar ita ce batun wannan bita. Kunshin ya ƙunshi har zuwa matakai huɗu da za a iya sauya kowannensu da kansa: matsin ɗaki, adadin oxygen, tsarin haɗa magani da lokacin ba da shi, da fallasa ga haske. Shaidar wani ɓangare ba shaida ce ga dukan kunshin ba, kuma sakamakon gwajin haɗin kai tsaye mafi ƙarfi yana nuna ƙaruwa a kashe ƙwayoyin halitta ta aikin haske da magani, maimakon ƙarin ƙarfin mitochondria gaba ɗaya.

Matakai huɗu suna tafiya ƙarƙashin suna ɗaya

Matsin lamba shi ne batu na farko. Maganin oxygen mai matsin lamba a asibiti, wanda aka fi kira HBOT, yana nufin shaƙar oxygen mai yawa a matsin da ya fi na muhalli, yawanci kusan 1.9 zuwa 3.0 atmospheres na cikakken matsin lamba, tare da lokutan shaƙar oxygen na kusan mintuna 90 zuwa 120 waɗanda suka haɗa da hutun shaƙar iska. A ɗaki na mutum ɗaya, oxygen ne ake amfani da shi wajen ƙara matsin ɗakin; a ɗaki na mutane da yawa, iska ce ake amfani da ita wajen ƙara matsin yayin da majiyyaci yake shaƙar oxygen ta murfin kai ko abin rufe fuska. Matsin lamba da rabon oxygen suna sauyawa dabam-dabam, don haka ambaton matsin lamba mai sauƙi ba tare da lambobin biyu ba ba ya fayyace ko ɗaya.

Isar da oxygen shi ne batu na biyu. A 2 atmospheres yayin shaƙar tsantsar oxygen, oxygen da ya narke a plasma yana ƙaruwa sosai sama da yadda aka saba, ban da oxygen da ke ɗaure da hemoglobin. Wannan rabon da ya narke ne yake tallafa wa amfanin da aka amince da su, kamar toshewar jijiyoyin jini da iskar gas da dashen nama da ke cikin matsala, a jerin dalilan amfani na Undersea and Hyperbaric Medical Society. Haka kuma shi ne yake haifar da illolin: raunin kunne da sinus saboda matsin lamba, illar oxygen ga huhu, rashin iya ganin nesa na ɗan lokaci, da farfaɗiya idan matsin oxygen ya yi yawa.

Tsarin haɗa magani shi ne batu na uku. A cikin duhu, rinin yana aiki a zagayen redox kuma a matsayin madadin mai ɗaukar electron, yana karɓar electrons don samar da leucomethylene blue sannan yana miƙa su gaba yayin da yake sake zagayawa, kamar yadda aka bayyana a yadda shuɗin methylene yake aiki wajen miƙa electron. Nau'in samfur, hanyar ba da shi, adadi a mg ga kowane kg, da lokacin ba da shi dangane da zaman ɗaki duk suna cikin wannan batu. Bayanin maganin allura na Amurka ya ƙunshi methemoglobinemia da aka samu bayan haihuwa, da adadin 1 mg ga kowane kg bisa bayanin rubuta maganin ProvayBlue, wanda ba adadi ne da aka tabbatar da ingancinsa ga zaman haɗin da aka zaɓa ba.

Fallasa ga haske shi ne batu na huɗu, kuma yana cikin wasu tayin kawai. Jan haske a 630 zuwa 680 nm yana haɗuwa da zangon tsawon igiyar da rinin yake sha kusa da 664 nm, kuma yana iya kunna aikin sinadarin da haske ke motsawa; hasken kusa da infrared na 810 nm ba ya kunna rinin kai tsaye sosai, kamar yadda aka yi bita a shuɗin methylene da maganin jan haske. Tsawon igiyar haske, ƙarfin hasken da ke isa ga kowane yanki, jimillar makamashin hasken da ke isa ga kowane yanki, da tazarar lokaci tsakanin magani da haske su ne ke ƙayyade yanayin aikin, bisa jagorar tsawon igiyar haske, ƙarfin haske, da tsarin matsayi. Jan haske ba tare da waɗannan lambobin ba daidai yake, a fannin haske, da ambaton matsin lamba ba tare da bayyana matsin ba.

Abin da wallafe-wallafen haɗin suka gwada a zahiri

Babu gwajin ɗan Adam mai rukunin kwatance da aka samu don wannan bita da ya nuna ƙarin fa'ida ga tsarin jiki gaba ɗaya daga shuɗin methylene tare da ainihin HBOT, idan aka kwatanta da kowannensu dabam. Abubuwan da ake da su sun kasu gida uku, kuma kowanne yana amsa wata tambaya dabam.

Gwajin haɗin da ya fi zama kai tsaye an yi shi ne a wajen jiki. Bisland da abokan aikinsa sun fallasa S. aureus da P. aeruginosa, waɗanda suke yawo da waɗanda suke cikin biofilm, ga rini tare da jan haske da aka tace a 600 zuwa 800 nm, tare da kuma ba tare da tsantsar oxygen a 2 atmospheres ba, kamar yadda aka ruwaito a wannan binciken oxygen da aikin haske da magani. Ƙarin oxygen mai matsin lamba ya ƙara kashe ƙwayoyin da fiye da mataki ɗaya na log a 5 J ga kowane cm mai murabba'i, da fiye da matakai biyu na log a 10 J ga kowane cm mai murabba'i. Wannan ƙarin fa'ida ne na gaske da oxygen ya kawo ga maganin da haske ke kunnawa a kwanon gwaji, ba shaida ce cewa oxygen mai matsin lamba tare da rini yana inganta fahimta ko kuzari a mutane ba.

Gwajin dabbobi mafi kusa da ya kwatanta haɗuwar abubuwa ya yi amfani da yawan oxygen a matsin lamba na al'ada, ba HBOT ba. Rodriguez da abokan aikinsa sun rarraba berayen da aka toshe wa jijiyar artery na mintuna 60 zuwa iska ko oxygen, sannan suka haɗa wannan rabon da rukunin sinadarin ɗaukar magani ba tare da rini ba ko rini na 1 mg ga kowane kg, a wannan binciken farfaɗowa bayan bugun jini. Haɗin ya inganta farfaɗowar ayyukan jiki fiye da kowane ɓangare shi kaɗai, ko da yake girman naman da ya mutu saboda katsewar jini ya yi kama da na rini shi kaɗai. Domin ba a ƙara matsin komai ba, wannan yana tallafa wa hulɗar oxygen da rini ba tare da bayyana ko 2 zuwa 3 atmospheres suna ƙara wani abu fiye da oxygen ba.

Rahotannin mutane sun tsaya ne a matakin rahoton mutum ɗaya. Wani mai shekaru 52 da ke da matsananciyar methemoglobinemia da aka samu bayan haihuwa ya karɓi oxygen tare da rini ta jijiya na 1 mg ga kowane kg, sannan HBOT a kusan 2.2 atmospheres na mintuna 90, kamar yadda aka bayyana a wannan rahoton lamarin gaggawa. Ba da matakan ceto ɗaya bayan ɗaya ba zai iya raba tasirin yanayin cutar da kanta, rini, oxygen, da matsin lamba ba. Wani rahoton dapsone da ya nuna akasin haka ya gano cewa 2.5 atmospheres na awa 2 sun yi ɗan tasiri kaɗan kafin rini na 1.5 mg ga kowane kg ya yi aiki da sauri, kamar yadda aka ruwaito a wannan rahoton magani ɗaya bayan ɗaya. Wannan yana nuna rashin goyon bayan HBOT a matsayin madadin rini, ba tare da gwada ba da magungunan a lokaci ɗaya ba. Takardun binciken mice na 810 nm da ake yawan ambato sun gwada rini tare da haske ne ba tare da wani ɗaki ba kwata-kwata, kuma an jera su a PMID 35059872 da PMID 31372913, don haka ba za su iya tabbatar da tsarin amfani da ɗaki ba.

Dalilin da ya sa ƙarin oxygen tare da rinin redox ba lallai ne su ƙara wa juna tasiri ba

Zagayen redox na rinin kansa yana cinye oxygen: rini ta jijiya a matakin micromolar ya ƙara amfani da oxygen a dukan jikin beraye da kusan rabin adadin da ake amfani da shi, inda rinin da aka rage yake miƙa electrons kai tsaye ga oxygen, a wannan binciken aikin metabolism. Tasirinsa kan nau'ikan oxygen masu saurin amsa ya dogara da sinadarin da ake aiki da shi, yana ƙaruwa da sinadaran complex I kuma yana raguwa da succinate a mitochondria na zuciya da aka ware (binciken sinadaran da ake aiki da su). Ba tare da haske ba akwai zato biyu da har yanzu ake la'akari da su: ƙarin oxygen yana taimaka wa rinin ya sake shiga oxidation a inda jigilar ta samu matsala, ko kuma yana ƙara aikin oxidation da zagayen rinin yake haifarwa. Babu wata ƙa'ida da ta ce rinin yana ƙara zama mai hana oxidation yayin da matsin lamba yake ƙaruwa.

Ƙara jan haske yana sauya tsarin aikin. Rinin da haske ya kunna yana miƙa makamashi ko electrons ga oxygen kuma yana samar da nau'ikan sinadarai masu yin oxidation, ciki har da singlet oxygen; wannan ne ya sa ƙarin oxygen ya ƙara kashe ƙwayoyin bacteria a sakamakon kwanon gwajin. Wannan aikin sinadaran yana raunata abin da bai kamata a yi niyya gare shi ba: haskaka rini a mitochondria na hantar bera da aka ware ya haifar da samuwar sinadarai masu yin oxidation, ƙarewar glutathione, rabuwa tsakanin oxidation da samar da ATP, da raguwar samar da ATP, a wannan binciken illar haske ga mitochondria. Ƙara wa juna tasirin da aka nuna shi ne lalata ƙwayoyin halitta ta aikin haske da magani, wanda ya dace da kashe microbes maimakon ƙara kuzari ga nama mai lafiya.

Tsaro ya dogara da irin hidimar, ba da rini gaba ɗaya ba

Kowane batu yana buƙatar nasa binciken cancanta, kuma haɗin yana ƙara wuraren hulɗa da shafin tsaron rini na gama-gari ba zai iya rufewa ba.

Binciken cancantar shiga ɗaki yana farawa da haɗarin matsin lamba da oxygen: pneumothorax da ba a yi wa magani ba, cutar huhu mai toshe iska ko mai manyan kumfar iska, kasa daidaita matsin kunne, tarihin farfaɗiya, tiyatar ƙirji ko ido da aka yi kwanan nan, da na'urorin da aka dasa a jiki. Matakan kariya daga wuta suna buƙatar tsari. Wasiƙar FDA kan amfani da na'urorin matsin lamba cikin tsaro tana buƙatar bin umarnin masana'anta, haɗa na'ura da ƙasa don tsaron lantarki, horar da ma'aikata, kulawa a kowane lokaci, kula da na'urori, hana abubuwan lantarki da aka haramta, da tufafin da suka dace bisa NFPA 99 da ASME PVHO-1. Ba za a taɓa kawai shigar da allon haske cikin ɗaki mai yawan oxygen ba; dole ne a rubuta dacewarsa a umarnin ɗakin da shirin tsaron wuta.

Binciken cancantar magani yana bin bayanin rinin. An bayyana ƙarancin G6PD a matsayin dalilin da ya hana amfani; rinin yana hana monoamine oxidase aiki kuma yana da gargaɗi a cikin akwati game da haɗarin ciwon serotonin yayin amfani tare da magungunan da ke shafar serotonin da wasu opioids. Likitan da yake rubuta maganin ne ya kamata ya jagoranci duk wani sauyin magunguna, kuma ana buƙatar duba ciki da aikin koda da hanta. Rinin kuma yana kawo cikas ga auna oxygen ta pulse oximetry, don haka ana buƙatar wata hanyar auna yawan oxygen a jini idan daidaiton ma'auni yana da muhimmanci. Waɗannan bambance-bambancen suna da muhimmanci ga masu karatu da suke zuwa saboda ƙananan ma'aunin oxygen a cutar huhu ko yanayin gajiya kamar ME/CFS.

Ɗakin da FDA ta ba izinin amfani da shi ba yana nufin hukumar ta tantance shuɗin methylene tare da HBOT ko wani tsarin mitochondria, fahimta, ko tsawon rai ba. Gaba ɗaya, ɗakuna na'urori ne na Class II da ake ba izini ta hanyar 510(k) don dalilan amfani da aka ambata a nasu bayanan samfur. Wasiƙar FDA da ke sama sanarwa ce ta tsaro, ba amincewa da ingancin magani ba.

Jerin binciken shaidar haɗin: kayan aiki na asali na wannan labarin

Yi amfani da wannan jerin don tantance takardar bincike ko shafin asibiti. Tsari mai sahihanci yana bayyana kowane layi a rubuce. Idan wani layi ya ɓace, ba a fayyace ikirarin yadda ya kamata ba, maimakon a ɗauke shi a matsayin mai cike da alƙawari.

Abubuwan da aka haɗa: samfurin ɗaki tare da matsayin izininsa; na mutum ɗaya ko na mutane da yawa; ainihin atmospheres na cikakken matsin lamba; rabon oxygen da majiyyaci yake shaƙa; lokacin oxygen tare da hutun shaƙar iska; jimillar lokacin ɗaki; adadin zaman da yawan maimaitawarsu. Samfurin magani da tsarin haɗa shi; hanyar ba da shi; adadi a mg ga kowane kg; matsakaicin jimillar adadin da aka tara; tazarar lokaci tsakanin ba da magani da shiga ɗaki. Idan an haɗa haske: tsawon igiyar haske; ƙarfin hasken da ke isa ga kowane yanki; jimillar makamashin hasken da ke isa ga kowane yanki; tsawon lokaci; lokacin amfani dangane da rini; da ko tushen hasken yana ciki ko wajen ɗaki, tare da rubutacciyar shaidar dacewarsa da matsin lamba.

Rukunonin kwatance: a bincike, dole ne rukunonin su haɗa da haɗin, kowane ɓangare shi kaɗai, kuma idan zai yiwu rukunin maganin kwaikwayo ko na kulawar da aka saba, tare da rarrabawa bazuwar da babban sakamakon da aka ƙayyade tun farko. Jerin ma'aunai kafin da bayan amfani da cikakken kunshin ba zai iya jingina fa'ida ga haɗin ba. Ga shafin asibiti, tambayi waɗanne daga cikin waɗannan rukunoni takardun da aka ambata suka yi amfani da su a zahiri. Ambaton gwajin rini shi kaɗai tare da gwajin HBOT shi kaɗai haɗawa ne ta jerin takardun manazarta, ba shaidar ƙara wa juna tasiri ba.

Sakamako: bayyana sakamakon da ake aunawa, hanyar aunawa, da lokacin aunawa. Ma'aunan aikin jiki, girman wuraren rauni, ƙidayar microbes, da maki na alamomin rashin lafiya ikirari ne dabam-dabam masu kayan aunawa dabam-dabam. Sauye-sauyen ma'aunan madadin sakamako yayin zama, kamar ƙarin lambar na'urar sa ido yayin shaƙar oxygen, ba sa tabbatar da fa'ida mai ɗorewa.

Matakan tsaro: rubutaccen binciken cancanta game da cutar huhu, daidaita matsin kunne, tarihin farfaɗiya, matsayin G6PD, magungunan da ke shafar serotonin da opioids, ciki, da aikin koda da hanta; kulawa a kowane lokaci daga ma'aikatan da aka horar kan matsin lamba; hanyoyin kula da raunin matsin lamba da illar oxygen; shirin sauke matsin lamba a gaggawa; matakan kariya daga wuta da jerin abubuwan da aka haramta; rubuta abubuwan da suka jawo illa; da bayyana shirin sa ido kan oxygen saboda cikas da rinin yake kawo wa pulse oximetry.

Idan shafi ba zai iya samar da waɗannan layuka ba, yi amfani da irin tsarin tantancewa da za ka yi amfani da shi wajen bincika tsarin magani da aka samu a intanet. Nemi wallafar da ta gwada ainihin kunshin, karanta waɗanne rukunonin kwatance ta yi amfani da su, kuma kada ka ɗauki tsarin aiki mai yiwuwa a matsayin sakamakon da aka auna. Haɗin da yake da ma'ana zai iya kasancewa ba a gwada shi ba, kuma a wannan yanayin hulɗar ɗaya da aka gwada tana ƙara ƙarfin aikin sinadaran da ba za ka so a nufi nama mai lafiya da shi ba.