Te kahurangi metilīni mō te mate io me te mamae: ko ēhea āhuatanga kua rangahaua?

Ka whakamauru rānei te kahurangi metilīni i te mate io me te mamae? Ki te whakarongo, he pātai kotahi tēnei, engari he maha ngā pātai rerekē e whakautua ana e ngā tuhinga rangahau. He ingoa kotahi tō te waikano ka werohia ki roto i tētahi kōpae o te tuaiwi, tō te waikano ka werohia ki raro i te kiri huri noa i te nono, tō te waikano ka whāngaihia ki roto i tētahi ia toto, me tō te waikano ka whakakorikoria ki te waha hei wai horoi. Heoi, he ariā rerekē ēnei e whakamātautau ana, ā, he rerekē hoki ngā mātāpono whakahaere. Kāore te hua o tētahi e whakawhiti ki ērā atu.

Whakaarohia he ariā e whā e mau ana i te tapanga kotahi. Ko te ariā tuatahi, he whakangaro, he whakaiti rānei i te tairongo o ngā pito io ririki e tipu ana ki roto i tētahi kōpae kua whara. Ko te ariā tuarua, he whakamoe, he whakaheke rānei i te mahi a ngā io kiri i te wāhi werohanga. Ko te ariā tuatoru, he mahi puta noa i te tinana mā te rere toto, ka pā ki te pūnaha io. Ko te ariā tuawhā, he whakakapi i tētahi mata kua whara hei whakamauru i te mamae o taua wāhi. Kia mārama koe ki taua wehewehenga, ka tere te whakarōpū i ngā taunakitanga, ā, ka kitea te āputa: ko te whakapae e horapa ana e pā ana ki te ariā tuatoru, engari mā tētahi wai ka horomia. Koinei tonu te wāhi e tino iti ana ngā taunakitanga ki te tangata.

Te ripanga taunakitanga mā te āhuatanga me te ara tuku

He whakarāpopototanga tēnei ripanga o te tuhinga. Ka herea e ia rārangi te āhuatanga, te ara tuku, me te maimoatanga ki a rātou anō, nā te mea mā te wehe i aua mea ka whakanuia kinotia ngā whakapae mō te mamae.

Pānuitia whakararo te tīwae ara tuku i mua i te pānui i tētahi upoko. Kei tētahi rārangi ā-wāhi, ā-tukanga haumanu rānei, ia tohu pai ki te tangata. Kei ngā rārangi mō te mahi puta noa i te tinana tētahi whakamātautau tuatahi tino iti me ētahi pūtau kāore he raraunga.

Mamae tuarā nā te kōpae: kotahi whakamātautau whai hua nui, kotahi whakamātautau tārua kāore i angitu

Ka tīmata te kōrero mō te tuku ki roto i te kōpae ki tētahi whakamātautau tuatahi kāore he rōpū whakataurite o 2007 ki ngā tūroro 24. Kua whakaūngia te pūtake o tō rātou mamae mā te whakaahua kōpae, ā, kāore te mamae i aro ki ngā maimoatanga māmā ake. Whai muri i tētahi werohanga kotahi ki roto i te kōpae o te 10 mg kahurangi metilīni, i pūrongo te 21 o te 24 kua ngaro te mamae, kua tino mauru rānei, i te āhua 18 marama o te aroturuki. Nā te kore rōpū whakataurite, tērā pea nā te kōwhiringa tūroro, nā te whanaketanga māori o te āhuatanga, nā te lidocaine i tukuna ngātahitia rānei taua hua. Nō reira, i whakakipakipa taua rangahau i te pātai mō te whai hua, engari kāore i whakautu.

Ko te rangahau o muri mai he whakamātautau matapō-rua, whai rōpū whakataurite rongoā horihori, o 2010 ki ngā tūroro 72. I whakatauritea te kahurangi metilīni me te lidocaine ki te wairewa tote me te lidocaine. I te 24 marama, he tino nui ngā rerekētanga i pūrongotia: ko te hekenga toharite o te kaute mamae he 52.5 ira, ki te 0.7 ira, ā, ko te makona he 91.6%, ki te 14.3%. I pātai mārika tētahi tuhinga ētita i puta tahi mehemea he rongoā whakaora tēnei mō te mamae tuarā. E whakaatu ana tēnei i te tino rerekē o taua whakapae ki ngā mātanga i taua wā.

Me tārua ngā whakapae tino rerekē, ā, kāore te hua i mau i te tāruatanga. I whakamātautau te whakamātautau IMBI ā-pokapū maha o muri mai i te kahurangi metilīni ki roto i te kōpae puta noa i ngā pokapū, ā, kāore i whakaū i te pānga i kitea e Peng. Ko ngā rangahau motuhake iti ake ki ngā rōpū tūroro kāore he rōpū whakataurite, i pūrongo i te nuinga he iti ake ngā reiti urupare, he memeha haere rānei. Ko te whakarāpopototanga pono, he taunakitanga taupatupatu: kotahi angitu tino nui nō te pokapū kotahi, ki tētahi tāruatanga ā-pokapū maha kāore i angitu. Kāore taua tauira e whakaū i tētahi maimoatanga. Kāore hoki he kōrero o roto mō te horomi kahurangi metilīni, nā te mea kāore e tae ki roto i te kōpae i tētahi kukūtanga ōrite. Ka whakatakotoria tēnei taupatupatu ki te taha o ētahi atu maimoatanga ā-tukanga haumanu i tā mātou tirohanga whānui ki ngā taunakitanga mō te mamae mauroa.

Werohanga huri noa i te nono: he tohu pānga tūturu, he whāiti te whānuitanga

Ko te kahurangi metilīni ki roto i te kiri mō te māngeongeo o te nono kāore e aro ki te maimoatanga te whakamahinga kua roa rawa ngā pūrongo rangahau raupapa take. I tīmata i 1990, ā, i haere tonu ki ngā rōpū tūroro 25, 30, 49, me te 103. He āhua teitei ngā reiti urupare, ā, i te nuinga o te wā kāore he tohumate o te nuinga whai muri i te kotahi, e rua rānei ngā werohanga. Heoi, kāore he rōpū whakataurite o tētahi o aua rangahau raupapa. Ka rerekē haere te māngeongeo e akiaki ana i te tūroro kia whai i tētahi tukanga e kuhu ana ki te tinana. Ka pā hoki ngā tūmanako ki ngā hua o ngā werohanga. Nō reira, kāore e taea e ngā reiti whakamaurutanga kāore he rōpū whakataurite te whakaū i te whai hua.

Kei te mamae whai muri i te pokanga, he āhuatanga pātata, ngā taunakitanga whakataurite kaha ake. E rua ngā whakamātautau matapōkere o te kahurangi metilīni ki roto i te kiri huri noa i te nono, i te wā o te pokanga tango puku haemorrhoid. I kitea he iti ake ngā kaute mamae me te whakamahinga rongoā āwhina i ngā rā 1 ki te 3 i te whakamātautau ki ngā tūroro 67, ā, i ngā rā 1 ki te 7 i te whakamātautau ki ngā tūroro 97. He taunakitanga whakamauru mamae tūturu tēnei mō tētahi tukanga, tētahi horopeta, me tētahi wiki kua tautuhia. Ehara i te taunakitanga mō te mate io mauroa. Ko te tikanga mahi e kōrerohia ana, he whakaiti ā-wāhi i te tairongo o ngā io i te patunga, ā, kāore tētahi pata ka horomia e taea te whakaputa anō i taua pānga. Ka whakamārama ngā kōrero mō te mahi a te kahurangi metilīni ki ngā io me ngā pūngaoiti i te take ka noho ā-wāhi tonu te matū e mahi ā-wāhi ana.

Whakamahinga puta noa i te tinana mō te mamae nā te mate io: kotahi whakamātautau tuatahi tino iti

Mō te whakapae e tino whai take ana ki te nuinga o ngā kaihoko, arā, te whakamauru a te kahurangi metilīni i te mamae nā te mate io mā te mahi puta noa i te tinana, te āhua nei ko te katoa o ngā rangahau ki te tangata whai rōpū whakataurite he whakamātautau tuatahi kotahi o 2015 ki ngā tūroro 10. He mamae mauroa nā te mate io tō rātou, he maha ngā pūtake, ā, kāore i aro ki te maimoatanga. I pai ake ngā kaute mamae o te kahurangi metilīni i tukuna ki te ia toto i te 2 mg/kg i ērā o te rōpū whakataurite horopeta tino iti, i te rā maimoatanga me te rā o muri mai. Kua tata ngaro te painga i roto i ētahi rā. E toru ngā tūroro i whakaatu i te hekenga o te mamae nā te pā ā-tinana kāore e tika kia mamae.

Ko ngā tūroro 10 he rerekē ō rātou āhuatanga, me te whakamaurutanga mō ngā rā e rua, he take mō te rangahau anō, ehara i te tūāpapa mō tētahi maimoatanga. Kotahi anake te kaiuru i whai mamae io whai muri i te mate herpes zoster. Nō reira, ehara hoki i te whakamātautau mō taua mamae io. Kāore i kitea he whakamātautau ki te tangata e tutuki ana i ngā paearu mō te kahurangi metilīni e mahi puta noa ana i te tinana mō te mate io taiao nā te mate huka, mō te mamae o te io trigeminal, mō te mate mamae ā-rohe matatini rānei. Ko ngā rangahau mō te mamae io whai muri i te mate herpes zoster e whakamahi ana i te tuku ki te taha o te tuaiwi, ka puta i ētahi wā i ngā pūkaha rapu, i whakakotahi i te kahurangi metilīni me te rongoā whakamoe ā-wāhi i te tuaiwi. Nō te ariā ā-tukanga haumanu tēnei, ehara i te ariā mahi puta noa i te tinana.

Ngā wai horoi, ngā patunga, me ngā hononga: he taunakitanga ā-wāhi kāore e taea te whakawhiti

He ā-wāhi katoa ngā tohu pānga ki te tangata e toe ana. I kitea e tētahi whakamātautau matapōkere wāhanga 2 o 2022 he nui ake te whakaiti a te wai horoi waha kahurangi metilīni, i ngā kukūtanga e toru, i te mamae nā te mumura o te kiriuhi hūpē o te waha i te maimoatanga mate pukupuku, i tā te tiaki tikanga noa i te rā 2. Ka whakakapi te wai horoi i te kiriuhi hūpē kua whara, ā, ka tuwhaina. Mā te whakamahi i taua rangahau hei tautoko i ngā pata ka horomia ka rangirua te pānga ki te mata me te tuku horopeta hei mahi puta noa i te tinana.

Waihoki, i heke ngā kaute mamae tuarā i te whakakapi i te kiko pokanga ki te kahurangi metilīni kua waimehatia i te wā o te pokanga tango kōpae o te tuarā whakararo, i tētahi whakamātautau matapō-toru ki ngā tūroro 115. I pūrongo hoki tētahi whakamātautau werohanga ki ngā hononga iti o te tuaiwi i te hekenga o ngā kaute mamae me te hauātanga i te 3 me te 6 marama. Ka herea ia hua ki te wāhi i tukuna ai. Kāore tētahi o aua hua e whakawhiti ki tētahi hua ka horomia.

Ngā mea e whakaaturia ana e ngā kararehe, me ngā pānga tauaro o te tikanga mahi

Ko ngā tauira mamae nā te mate io ki ngā kiore e whakarato ana i te whaitake ā-tikanga mahi e tino whakahuahia ana. I tētahi whakamātau tōmua o 1992, i ārai te kahurangi metilīni i tukuna ki roto i te wāhi wai huri noa i te aho tuaiwi i te tairongo mamae nui ki te wera kua mau kē, mō te āhua 4 hāora whai muri i te here i te io sciatic. E hāngai ana tēnei ki te whai wāhi o te ara tohu mai i te nitric oxide ki te cGMP i te aho tuaiwi. I ngā mahi o muri mai mō te wharanga nā te whakawhāiti mauroa i te io, i kitea ka whakaiti te kahurangi metilīni anake i te tukanga rongo mamae, ā, ka āhei hoki ki te ārai i te tairongo mamae nui i whakakaha ake ai te sildenafil. I tohu anō tēnei ki te whai wāhi o te tuku tohu nitric oxide. I tāpirihia e tētahi rangahau o 2021 tētahi tikanga mahi tuarua: te pēhi tika i te tuku tohu hiko a ngā io, he rite ki ngā pānga ki ngā hongere konutai. He roa ake taua pēhitanga i tā te lidocaine i te tauira i whakamātautauria.

Me pupuri tētahi āhuatanga motuhake, nā te mea ka waiho e ngā kaihoko. Kāore ngā tuhinga rangahau nitric oxide i mua i ngā whakamātautau haumanu e whakaatu ōrite ana he whakamauru mamae te kahurangi metilīni. I ētahi tauira whakamātau, mā te tuku tohu nitric oxide tonu e puta ai te whakamaurutanga mamae, ā, ka ārai te kahurangi metilīni i taua whakamaurutanga. I ngā whakamātau mate io nā te mate huka, i ārai te kahurangi metilīni i te whakaiti rongo mamae e pā ana ki te sildenafil, ā, māna anake i whakakaha ake te tairongo mamae nui. Ka whakawhirinaki ngā pānga o te tikanga mahi ki te tauira me te ara tohu. He take anō tēnei kia kaua ngā kitenga ki ngā kararehe e pānuitia hei tohutohu horopeta.

Ngā mea kāore anō kia rangahaua, me te rohe haumaru

Kāore i kitea he whakamātautau matapōkere, he rangahau raupapa haumanu pono rānei, mō te kahurangi metilīni ka horomia mā te waha mō te mamae mauroa nā te mate io, mō te mate io nā te mate huka, mō te mamae o te io trigeminal, mō te mate mamae ā-rohe matatini, mō te mamae io whai muri i te mate herpes zoster rānei. Ko te whakamātautau kotahi e pā tika ana ki te mamae nā te mate io me te mahi puta noa i te tinana, ko te whakamātautau tuatahi ki ngā tūroro 10 mā te ia toto, me tētahi tohu pānga mō te 1 ki te 2 rā. Kāore e taea, i runga i ngā mātāpono rongoā, te whakawhānui i ngā hua o te tuku ki roto kōpae, ki roto kiri, ki roto hononga, ki te taha o te tuaiwi, me te horoi waha, ki ngā pata hokohoko. He maha ngā taumata whakarea o te rerekētanga o te kukūtanga i te wāhi whāinga, ā, kāore hoki aua pata e whakatakotoria mā tētahi tukanga haumanu.

He whakatūpato haumaru anō kei te rangirua o ngā ara tuku. Kāore ngā wāhi o te tuaiwi e taea te whakakapi tētahi ki tētahi: he rerekē ngā pānga rongoā me ngā pānga paitini o te tuku ki roto kōpae, ki te taha o te tuaiwi, ki waho i te kiriuhi dura, me te tuku ki roto i te wāhi wai huri noa i te aho tuaiwi. Nā te paitini tino kino ki ngā io whai muri i te pānga o te kahurangi metilīni i taua wāhi wai, i puta ai tētahi whakatūpato mōrearea mārama. He take motuhake anō, ka taunekeneke te kahurangi metilīni ki ngā rongoā e pā ana ki te serotonin, ā, kāore e whakaaetia tōna whakamahinga mēnā he ngoikoretanga G6PD. Nō reira, ko tētahi tūroro mamae e whakaaro ana ki te whakamahi me pānui tuatahi i te tirohanga whānui ki ngā pānga taha me ngā āhuatanga e kore ai e tika te whakamahi, me kōrero hoki ki tētahi mātanga haumanu, mā ēnei pātai hei ui mō te kahurangi metilīni.

Me pēhea te whakamahi i ēnei taunakitanga

Me ui te tangata e aromātai ana i te kahurangi metilīni mō te mamae i ngā pātai e toru mō ia tohutoro. Ko tēhea āhuatanga tonu, nā te mea kāore te whakaoranga whai muri i te pokanga tango puku haemorrhoid e rite ki te mate io nā te mate huka. Ko tēhea ara tuku tonu, nā te mea kāore te tuku ki roto kōpae, ki roto kiri rānei, e rite ki tētahi horopeta ka horomia. Ā, ko tēhea putanga i inea, mō te wā pēhea te roa, nā te mea kāore ngā rā whakamaurutanga ā-tukanga haumanu e rite ki ngā marama whakahaere mate io.

I runga i ngā taunakitanga o nāianei, ko ngā tohu whakamauru mamae ki te tangata mō te kahurangi metilīni e herea ana ki te tuku ā-wāhi, ā-tukanga haumanu rānei, ā, he rerekē te whai hua i waenga i ngā take whakamahinga. Ko ngā taunakitanga mō te mahi puta noa i te tinana e herea ana ki tētahi whakamātautau tuatahi kotahi tino iti mā te ia toto. Kāore he taunakitanga haumanu e tautoko ana i te kahurangi metilīni hokohoko ka tukuna mā te waha mō te mamae nā te mate io, mō te mamae mauroa rānei.