Tuhinga
Te kikorangi metilīni mō ngā mate harore o ngā maikuku me te kiri: ngā kitenga o ngā whakamātautau whakaora mā te whakahohe ki te mārama
He maha ngā hua rapu mō te kikorangi metilīni mō te harore maikuku e whakahanumi ana i ngā mea e rua e tino rerekē ana. Ko tētahi he pounamu waikano kikorangi ka pania ki te kāinga. Ko tētahi atu he tukanga i te whare haumanu: ka pania te waikano, ka waiho mō tētahi wā poto, kātahi ka whakahohea ki tētahi horopeta mārama whero kua inea. Nō te tukanga tuarua tata katoa ngā taunakitanga haumanu. Ka whakataurite hāngai tēnei tuhinga i ngā rangahau e toru mō te whakaora mā te whakahohe ki te mārama, kia kitea ai e koe he aha tonu i whakamātauria, ā, he aha i whakaūngia e ia rangahau.
He māmā te tukanga mahi e whakamahia ana e aua rangahau katoa. He kaha te ngongo a te kikorangi metilīni i te mārama whero, ā, ka tuku te rāpoi ngota kua whakaihiihihia i taua pūngao ki te hāora. Ka hua mai te hāora singlet me ētahi atu momo matū hohe e tūkino ana i ngā pūtau harore. Ki te kore he mārama, ka tino ngoikore ake te pānga. Koia ia rangahau i raro nei e hono ai i te waikano ki tētahi rama, tētahi roangaru, me tētahi horopeta kua tautuhia, ā, koia hoki ngā hua o ngā tikanga whai mārama e kore ai e whakamārama i te pānga o te pani waikano noa ki tētahi maikuku i te awatea. Ka whakamāramatia whānuitia ake te tukanga mahi whānui i te whakamārama mō te whakaora mā te whakahohe ki te mārama, ā, kei te tirohanga whānui ki te kikorangi metilīni hei matū patu moroiti te horopaki whānui ake o ngā rangahau patu harore.
Te mate harore o ngā maikuku waewae: te waikano me te mārama ki te fluconazole ia wiki
Ko te whakamātautau nui rawa he whakataurite matapōkere i ngā tūroro 80 whai mate harore maikuku waewae, i whakaputaina i te tau 2014. I whiwhi te haurua i te maimoatanga whakahohe ki te mārama, ā, i whiwhi te haurua i te fluconazole 300 mg mā te waha kotahi i ia wiki, mō ngā wiki 24 i ia rōpū.
I āta tautuhia te tikanga mārama. I pania tētahi wairewa wai kikorangi metilīni 2% ki te maikuku, kātahi, i muri i tētahi wā poto kia uru ai te waikano, ka whakamāramatia ki tētahi LED whero kore-kōherente i te 630 nm, e tuku ana i te 18 joules mō ia henemita pūrua. I whakahokia ngā wā maimoatanga ia 15 rā, tekau mā rua ngā wā i roto i te ono marama. I ngā rōpū e rua, i waruhia ā-miihini i te tuatahi ngā maikuku whai paparanga para mātotoru i raro i te maikuku, whai rārangi roa, whai pūkai harore rānei e kīia nei he dermatophytoma, nā te mea e kore te mārama, te rongoā rānei e whai hua ina āraia e tētahi pakitara keratin.
I pai ake te hua matua mō te rōpū mārama, ā, he hiranga ā-tauanga tō taua rerekētanga. E ai ki ngā raraunga i tangohia i muri mai i te tuhinga katoa, tata ki te 90% te urupare i muri i te akoranga ono marama, ki te 45% mō te fluconazole. I heke te urupare o te rōpū mārama ki te 80% pea i te tekau mā rua marama i muri i te mutunga o te maimoatanga. I tētahi tātaritanga anō, he kaha ake ngā paearu: me noho tahi ngā mea e toru, arā, kāore he harore i te tirohanga karu whakarahi, kāore he harore i te whakatipu taiwhanga, ā, kua tipu anō te maikuku katoa me te kore tohu mate. Nā aua paearu i puta ai ngā tatauranga whakamutunga mō te whakaora katoa, arā, 50% ki te 25%. E whakaahua ana ēnei huinga tau e rua i ngā paearu putanga rerekē; kāore ngā kitenga e taupatupatu ana. Ko te rerekētanga i waenganui i aua tau te kaupapa o te wāhanga e whai ake nei. I pūrongotia he pai te whakamanawa o ngā tūroro ki te maimoatanga, ā, kotahi te pānga mamae me te rongo wera i tuhia.
E rua ngā taipitopito e whai take ana mō te tangata e ui ana me pēhea te whakamahi i te kikorangi metilīni mō te harore maikuku waewae. Tuatahi, ko te fluconazole te rongoā whakataurite, he rongoā he āhua iti tōna whai huatanga ki te mate maikuku, kāore ko te terbinafine e kaha ake ana. Tuarua, he 2% te kukū o te waikano, he tino teitei ake i ngā mea e hokona ana mō te whakamahi whakarākei ki te kāinga. I whakamahia i raro i te tirotiro ngaio, me te tango kiko para me tētahi rama kua whakatikahia kia tika tōna putanga.
Te mate taumaha o ngā maikuku waewae: te waikano me te mārama hei tāpiritanga ki te terbinafine
Ko te rangahau maikuku tuarua, he whakamātautau matapōkere mō te mate taumaha o ngā maikuku waewae nā ngā harore dermatophyte, i whakaputaina i te tau 2020, e whakautu ana i tētahi pātai whāiti ake. E rua tekau ngā tūroro kua pā te mate ki te neke atu i te 60% o te maikuku o te matimati waewae nui. I whiwhi katoa rātou i te terbinafine 250 mg mā te waha ia rā mō ngā wiki tekau mā rua, me te whakangāwari i te papa maikuku ki te urea. Hei tāpiritanga ki taua maimoatanga matua, i whiwhi te tekau i te maimoatanga whakahohe kikorangi metilīni ki te mārama, ā, i whiwhi te tekau i te maimoatanga whakahohe ki te mārama mā tētahi atu matū whakararongo ki te mārama.
I whakamahia e te rōpū kikorangi metilīni te wairewa wai 2%, me te waiho mō te toru meneti pea kia uru ai. Kātahi ka whakamahia he LED 635 nm e tuku ana i te 37 joules mō ia henemita pūrua i roto i te tekau meneti. E iwa ngā wā maimoatanga, me te rua wiki i waenganui, i roto i ngā wiki tekau mā ono. I whakamahia he pani urea 40% i ngā ahiahi i mua i ia wā maimoatanga, me te tango ā-miihini i ngā para.
I te wiki 52, tata ki te iwa marama i muri i te wā maimoatanga mārama whakamutunga, kua heke te taupū taumaha o te mate i te rōpū kikorangi metilīni mai i te 24 pea ki raro iho i te 1. Kua heke te wāhanga o te maikuku e pāngia ana mai i te 65% pea ki raro iho i te 2%, ā, he 70% te whakaora katoa, arā, he maikuku e rite ana te āhua ki te maikuku māori, me te kore harore i ngā whakamātautau. Ko te whakakorenga harore anake i eke ki te 100% i te rōpū kikorangi metilīni, ki te 90% mō te matū whakararongo kē. Kāore i pūrongotia he pānga taha ā-rohe nā te waikano me te mārama; e rua ngā tūroro i pāngia e te hūhi o te pūnaha kūnatu, i whakaarotia nā te terbinafine e kainga ana hoki e rāua.
Ki te āta pānui pono, kāore tēnei whakamātautau e taea te wehe i te takoha o te waikano. I whiwhi ia tūroro i tētahi akoranga katoa o te rongoā ā-tinana tino whai hua, me te āta whakarite i ngā maikuku. Kāore he rōpū i whiwhi rongoā anake, ā, he ōrite ngā putanga o ngā rōpū mārama e rua. Ko tāna e whakaatu ana, nā tētahi tikanga mārama kikorangi metilīni i tāpirihia ki te maimoatanga paerewa i puta ai te taumata tiketike o te whakakorenga harore i te mate taumaha, me te aroturuki roa. I tēnei rōpū iti, kāore hoki ngā wā maimoatanga mārama i tāpiri mai i tētahi pānga tāoke ā-rohe. Ka matapakihia ngā pāhekoheko rongoā me ngā mōrea ā-tinana o ngā huinga maimoatanga i te aratohu haumaru me ngā pāhekoheko.
Te mate kiri ātete: kotahi te tūroro, kotahi te harore uaua ki te whakakore
He tino iti ake ngā taunakitanga mō te kiri. Ko tētahi rangahau o te tau 2026 mō te maimoatanga mārama kikorangi metilīni ki te Trichophyton indotineae ātete ki te rongoā e pā ana ki tētahi tūroro kotahi, 25 ōna tau, he whānui ōna wharanga kiri. Kua mau tonu aua wharanga mō ngā marama e waru, ahakoa i whakamahia te terbinafine ā-tinana 250 mg ia rā mō ngā wiki e ono. I whakaatu ngā whakamātautau taiwhanga he 8.0 micrograms mō ia miririta te kukū iti rawa o te terbinafine hei aukati i te tupu o te harore, ki te 1.0 mō te kikorangi metilīni. E hāngai ana tēnei ki te mate harore dermatophyte ātete e horapa ana ināianei i ngā rohe maha.
I maimoatia ngā wharanga ki te kikorangi metilīni 1% ka pania ki te kiri, me te mārama whero i te 630 nm pea, e tuku ana i te 100 joules mō ia henemita pūrua, kotahi i ia wiki mō ngā wiki e whā. I muri i ngā wiki e rua, kua kore te unahi kiri i ngā wharanga i maimoatia, ā, kāore he harore i te tirohanga karu whakarahi. I te wiki tuawhā, i whakaahuatia kua ora katoa aua wharanga, he paku rerekētanga tae anake e toe ana. Engari, i kitea tonutia ngā whenu harore i ngā wharanga i maimoatia ki te kirīmi terbinafine. Kāore i pūrongotia he tauhohenga taumaha, he mamae rānei.
He urupare tūturu tēnei e kitea ana i ngā whakamātautau harore mō te mate ātete, engari he tūroro kotahi anake, e whā wiki noa te mātakitaki. Kāore i tuhia he huringa ki te hua whakatipu taiwhanga kore harore i muri i te maimoatanga, i tua atu i te tirohanga karu whakarahi. Kāore he aroturuki mō te hokinga mai o te mate i te toru, te ono, te tekau mā rua marama rānei, ā, kāore he taupori hei tātai i tētahi ōrau urupare. E tautoko ana tēnei i te rangahau anō, kāore i tētahi tūtohutanga maimoatanga. Ka āta tirohia ngā momo ātete me ngā whakamātautau tairongo ki te rongoā i te aratohu mō te ātete ki ngā rongoā patu harore.
Ngā rangahau e toru e whakatauritea ana
| Souza 2014, maikuku waewae | Alberdi me Gomez 2020, mate taumaha o te maikuku waewae | Xu 2026, wharanga kiri ātete | |
|---|---|---|---|
| Hoahoa me te rahi | Matapōkere, 40 i ia rōpū | Matapōkere, 10 i ia rōpū i tātaritia | Kotahi te tūroro, ko ōna wharanga tonu hei whakataurite |
| Rauropi | He ranunga harore dermatophyte, rewena, me ngā harore puruhekaheka | T. rubrum, T. mentagrophytes rānei | T. indotineae, kāore e urupare ki te terbinafine |
| Waikano me te wā tuku kia uru | Wairewa wai 2%, he meneti | Wairewa wai 2%, tata ki te 3 meneti | 1% ka pania ki te kiri, he uhi ārai mārama e ai ki te tikanga o te tuhinga tōmua |
| Mārama | 630 nm LED, 18 J mō ia cm2 | 635 nm LED, 37 J mō ia cm2 | Tata ki te 630 nm, 100 J mō ia cm2 |
| Ngā wā maimoatanga | 12, ia 15 rā i roto i te 6 marama | 9, ia 2 wiki i roto i te 16 wiki | 4, ia wiki |
| Maimoatanga tāpiri | Te waru maikuku ina tika; he kāpene rongoā horihori | Terbinafine 250 mg ia rā mō te 12 wiki, urea 40%, te tango kiko para | Kāore i ngā wharanga i maimoatia; he kirīmi terbinafine ki ngā wharanga whakataurite |
| Putanga haumanu | Tata ki te 90% te urupare i te mutunga o te maimoatanga, tata ki te 80% i te 12 marama | Te taupū taumaha o te mate mai i te 24 pea ki raro iho i te 1; 70% te whakaora katoa i te wiki 52 | Kua kore te unahi kiri i te wiki 2, kua ora i te wiki 4 |
| Putanga whakamātautau harore | He 50% ki te 25% te whakaora katoa i raro i ngā paearu kaha i te aroturuki whakamutunga | 100% kāore he harore i te PAS me te whakatipu taiwhanga i te wiki 52 | Kāore he harore i te tirohanga karu whakarahi i te 2 wiki; kāore i pūrongotia he whakatipu taiwhanga i muri i te maimoatanga |
| Aroturuki | 12 marama i muri i te maimoatanga | Tata ki te 9 marama i muri i te wā maimoatanga mārama whakamutunga | 4 wiki, kāore he raraunga mō te hokinga mai o te mate |
| Pānga kino | Kotahi te pānga mamae me te rongo wera | Kāore he pānga ā-rohe; he hūhi kūnatu nā te terbinafine i te 2 o te 10 | Kāore he tauhohenga taumaha, kāore he mamae |
He rerekē te whakaora haumanu i te whakaora kua whakaūngia e ngā whakamātautau harore
Me mārama ki tētahi rerekētanga hei pānui i ēnei tuhinga rangahau. Ko te whakaora haumanu te tikanga, he māori te āhua o te maikuku, o te kiri rānei. Ko te whakaora kua whakaūngia e ngā whakamātautau harore te tikanga, kāore e kitea he harore i te tirohanga karu whakarahi me te whakatipu taiwhanga. Ko te whakaora katoa te tikanga, kua tutuki tahi ēnei mea e rua. He pōturi te tipu anō o ngā maikuku, nō reira ka pai ake pea te āhua o tētahi maikuku mō ētahi marama i mua i te ngaronga o te harore. Waihoki, ka mau tonu pea tētahi hua whakamātautau e tohu ana he harore kei reira nā ngā toenga harore mate, ahakoa kua mutu te pokenga. E whakaatu hāngai ana te whakamātautau a Souza i te hua o tēnei: mā ngā paearu urupare ngāwari ka puta te 80 ki te 90%, engari mā te tono kia kore he tohu mate i te maikuku me ngā whakamātautau kore harore ka puta te 50%. Kāore tētahi o aua tatauranga i te hē. He rerekē ngā mea e inea ana e rāua, ā, me tautuhi e tētahi kerēme mō te whai huatanga ko tēhea tatauranga tāna e whakamahi ana.
Te tikanga o ēnei kitenga mō ngā whakatau maimoatanga
E toru ngā whakatau e mau tonu ana i muri i te pānui tino āta. Tuatahi, kua puta he whakakorenga harore tūturu i ngā maikuku waewae mā te kikorangi metilīni me te mārama whero kua whakatikahia kia tika tōna putanga, i ngā whakamātautau matapōkere e rua. I tētahi, i whakatauritea ki te fluconazole anake; i tētahi atu, i tāpirihia ki te terbinafine me te whakarite maikuku ki te urea. Tuarua, he whakatenatena te pūrongo kotahi mō te kiri ātete, engari he iti rawa ngā mea ka whakaūngia e taua pūrongo anake; kāore anō he taunakitanga matapōkere mō te mate harore dermatophyte o te kiri e maimoatia ana ki te waikano me te mārama. Tuatoru, i puta ia hua pai i tētahi huinga maimoatanga i raro i te tirotiro ngaio: he waikano kounga rongoā i te 1 ki te 2%, he wā kua whakaritea kia uru ai, he horopeta mārama kua inea, ā, i te nuinga o te wā he tango kiko para, he rongoā ā-tinana rānei hei tāpiritanga.
Kāore tētahi o ēnei kitenga e hāngai atu ki te pani waikano hokohoko ki te kāinga. I te pani ki te kāinga, kāore he horopeta mārama kua inea, kāore he whakahaere i te wā tuku kia uru, kāore he tango kiko para, kāore he whakamātautau harore, kāore hoki he aroturuki. Nō reira kua ngaro katoa ngā wāhanga i whakawhirinaki ai ngā whakamātautau. Me kawe e te tangata e whakaaro ana ki te maimoatanga mā te mārama ēnei tikanga ki tētahi mātanga kiri, me te ui mēnā e wātea ana te maimoatanga whakahohe ki te mārama i raro i te tirotiro ngaio, kaua e tārua noa i te tae me te whakarere i te tukanga.