Tuhinga
Te puru metilīni mō ngā pokenga Candida o te waha: ngā kitenga o ngā rangahau haumanu hihiko-ā-rama
Ka titiro tētahi tūroro ki te whakaata, ka kite kua ngaro ngā papanga mā, ā, ka whakatau kua ngaro hoki te harore. He whakatau māori noa tēnā. I ngā whakamātautau o te puru metilīni e whakahohehia ana e te rama mō te mate Candida o te waha, koirā hoki te whakatau e tino puta ai te rangirua.
E toru ngā wāhanga o te maimoatanga, ā, he mahi rerekē tā tēnā, tā tēnā. Ka uhia te pāpaka ki te puru metilīni, ka whakaongaongatia te waikano e te rama whero, ā, ka tukuna e te waikano kua whakaongaongatia he pūngao ki te hāora kia hangaia ai he momo matū tauhohe e poto ana te oranga, e tūkino ana hoki i ngā pūtau moroiti e tata ana. He mea nui ngā taipitopito o te mahi a te puru metilīni hei matū tairongo ki te rama, nā te mea, ki te kore he rama, he tino ngoikore ake te kaha patu moroiti o taua waikano. He whāiti ake te pātai ā-haumanu: ina whakamahia tēnei raupapa mō te mate Candida o te waha, he aha te mea ka pai ake, ko te āhua o te waha, ko te ahurea harore rānei, ā, mō te pēhea te roa?
Ko taua wehewehenga te tūāpapa o ngā kōrero katoa i raro nei. Ko te urupare ā-haumanu, he iti ake ngā pāpaka e kitea ana, he iti ake te wherotanga, te kiriuhi rūpahu rānei, he iti ake hoki te mamae, te wera rānei. Ko te urupare ā-harore, he iti ake ngā waeine hanga koroni i te ahurea, he whakakorenga katoa rānei. Ka tutuki pea i tētahi waha te whakamāramatanga tuatahi, engari kāore e tutuki te tuarua.
Ngā mea i whakamātauria e ngā whakamātautau matua e rua
Ko te whakamātautau e tino hāngai ana ki ngā pakeke whai mate Candida whero o te waha i tohatoha matapōkere i ngā kaiuru 41 ki te haumanu hihiko-ā-rama mā te puru metilīni, ki te rongoā nystatin whakatārewatia rānei. I whakahaerehia he wātū ia wiki mō te 4 wiki te mōrahi i te rōpū rama. Ko te kukū o te waikano he 0.1 percent, me te wā whakapā 15 meneti, kātahi ka whakamahia te rama taiaho 660 nm, he 4 joules ki ia ira mō te 40 hēkona ki ia ira. I whakaritea te maha o ngā ira i runga i te whānuitanga o te pāpaka. Ko te maimoatanga whakataurite he rongoā nystatin whakatārewatia mō te waha, he 100,000 IU hei horoi waha ia rā mō te 21 rā pea. I aroturukihia ngā kaiuru ia wiki i te wā o te maimoatanga, ā, kāore i pūrongotia he wā aroturuki roa mō te hokinga mai o te mate. E ai ki te whakarāpopototanga kua whakaputaina, i ngaro katoa ngā pāpaka i te 16 o ngā kēhi nystatin 17 i aromatawaitia, me te 16 o ngā kēhi hihiko-ā-rama 19 i aromatawaitia. He taipitopito mō te tau o raro e tika ana kia mōhiotia, nā te mea he rerekē ēnei i ngā tāngata 18 me te 23 i tohaina matapōkeretia. Kāore hoki te whakamātautau i kite i te pai ake o te rōpū rama. He iti ake te tūponotanga ka ngaro ngā pāpaka tino kino i ngā rōpū e rua. I heke ngā tatau harore i muri i te wātū rama tuatahi, engari e tautoko ana te pūrongo i te hekenga wawe, kaua i te whakakorenga kua whakaūngia. Kei te whakamātautau matapōkere o te haumanu hihiko-ā-rama mō te mate Candida whero te pūrongo katoa.
Ko te whakamātautau matua tuarua he whakamātautau tōmua iti hei tūhura, e whakaatu mārama ana i te wehenga o te urupare ā-haumanu me te urupare ā-harore. Tekau mā waru ngā pakeke kua whakaūngia te mate Candida o te waha mā te aromatawai ā-haumanu, ā-harore hoki, i tohaina matapōkeretia mā ngā poraka, he 9 ki ia rōpū, ā, 16 i whakaoti. I āhei ngā tāngata whai mate huka, mau niho horihori, kua pā ki ngā rongoā paturopi, he ngoikore rānei te akuaku ki te whakauru, engari i aukatia te hunga kua whakaūngia he pokenga HIV. He tino iti ake te kukū waikano i whakamahia e te rōpū rama, he 0.1 mg ki ia mL, me te wā whakapā 1 meneti. I whakamahia te rama diode 660 nm, he 1.2 ki te 3.3 joules ki ia cm2 mō te 60 hēkona pea ki ia wāhi, e ono ngā wātū i roto i te rua wiki. Ko te maimoatanga whakataurite he papa ngote nystatin, he 500,000 IU e toru ngā wā ia rā mō te 14 rā. I mutu te aroturuki i te rā 14, kāore hoki he tirotiro i muri mai mō te hokinga mai o te mate. I puta te urupare ā-haumanu i te 6 o te 9 whai haumanu hihiko-ā-rama, ki te 8 o te 9 whai nystatin. Ko te urupare ā-harore he 5 o te 9 ki te 8 o te 9, ā, ko te whakakorenga katoa o te harore he 4 o te 9 ki te 8 o te 9. Kāore tētahi o ngā rerekētanga i eke ki te taumata whai tikanga ā-tatauranga, he mea e tūmanakohia ana mō tēnei rahinga. Ko te kitenga whai hua ko te āputa i roto tonu i te rōpū rama: he 66.7 percent te urupare ā-haumanu, ki te 44.4 percent te whakakorenga katoa. He maha ake ngā wā i pai ake ai ngā pāpaka i ngā wā i kore ai te harore i ngā ahurea. Kāore he takahanga kino taumaha i puta. Kei te whakamātautau tōmua mō te whaihua o te whakahaere maimoatanga i te tūru niho mō te mate Candida o te waha te hoahoa me ngā tau.
Me maumahara ngā kaipānui e rapu ana i te puru metilīni mō te mate Candida o te waha ki taua āputa i mua i te pānui i tētahi auau whakaora kei te upoko kōrero. Mā tētahi inenga whakaora hanumi e whakakotahi ana i ngā tohu me ngā ahurea ka huna tonu ngā mōhiohio e hiahiatia ana e te tūroro e hoki mai ana ōna tohu mate.
Ngā putanga ā-haumanu me ngā putanga ā-harore
| Te whakamātautau me te taupori | Te hoahoa, te maimoatanga whakataurite, te aroturuki | Te putanga ā-haumanu o ngā pāpaka | Te putanga ā-harore | Ngā herenga matua |
|---|---|---|---|---|
| Medeiros 2023, ngā pakeke whai mate Candida whero o te waha, 41 i tātarihia | He matapōkere, he rongoā nystatin whakatārewatia 100,000 IU hei horoi waha ia rā mō te 21 rā pea, he aroturuki ia wiki tae noa ki te 4 wiki | I ngaro katoa ngā pāpaka i te 84 percent pea whai haumanu rama, ki te 94 percent pea whai nystatin, kāore i whakaaturia te pai ake o tētahi | I heke ngā tatau Candida i muri i te wātū tuatahi, kāore i whakaūngia te whakakorenga | He tauira iti, he aroturuki poto, kāore ngā tau o raro mō te ngaronga pāpaka i ōrite ki ngā tapeke i tohaina matapōkeretia, he iti rawa te wāhi o ngā pāpaka tino kino ki ngā pāpaka i ngaro |
| Zhou 2026, ngā pakeke kua whakaūngia te mate Candida o te waha, 18 i tohaina matapōkeretia | He whakamātautau tōmua matapōkere, he papa ngote nystatin 500,000 IU e toru ngā wā ia rā mō te 14 rā, he aroturuki tae noa ki te rā 14 | He urupare i te 6 o te 9 ki te 8 o te 9, ko p he 0.576 | He whakakorenga katoa i te 4 o te 9 ki te 8 o te 9, ko p he 0.131 | Ko n he 18, kāore he tātaitanga mana ā-tatauranga, kāore he wā aroturuki hokinga mai, kāore te nui me te hōtaka maimoatanga i whakaritea kia tino pai |
| Te whakamātautau mō te mate Candida e pā ana ki te HIV, 21 ngā tūroro, he 7 pea ki ia rōpū | He matapōkere, e toru ngā rōpū, he fluconazole 100 mg ia rā mō te 14 rā me tētahi rōpū rama anake, he aroturuki tae noa ki te rā 30 | I pūrongo ngā kaituhi kāore te mate i hoki mai i te rōpū rama tae noa ki te rā 30, engari i hoki wawe mai i te rōpū fluconazole | I pūrongo ngā kaituhi i whakakorea ngā koroni i muri i te haumanu rama, ā, i mau tonu tēnei tae noa ki te rā 30 | He tino iti ngā tatau ki ia rōpū, kei te taumata whakarāpopototanga anake te pūrongo takahanga kino, nā te kawa wātū kotahi ka herea te whakawhānui i ngā kitenga |
| Te mumura waha e pā ana ki ngā niho horihori Momo II, 40 ngā kaiuru | He matapōkere, he pia miconazole e whā ngā wā ia rā mō te 15 rā, he tirotiro hokinga mai i te rā 30 pea | He whakataunga hanumi ā-haumanu, ā-moroiti hoki i te 40 percent whai rama me te taiaho taumata iti, ki te 80 percent whai miconazole | I pūrongotia hei inenga hanumi, kāore i āta wehea | Kotahi te wātū hihiko-ā-rama me ngā wātū taiaho, nā te paearu mutunga hanumi kāore e taea te wehe i ngā pānga ki ngā pāpaka me ngā pānga ki ngā ahurea |
E whakaatu ana te ripanga i te ia. Ina wehe ngā whakamātautau i ngā paearu mutunga e rua, ka nui ake te urupare o ngā pāpaka i te whakakorenga i te ahurea. Ina whakakotahitia ēnei, kāore te kaipānui e mōhio ko tēhea i hua ai te putanga. Ka whakamārama ngā mea e whakahaerehia ana e te nui o te rama whero i tētahi wāhanga o te rerekētanga, nā te mea he rerekē te kukū, te wā whakapā, te roangaru, te pūngao ki ia horahanga, me te maha o ngā wātū i ia rārangi.
He aha i tino rerekē ai ngā kawa
Kei waenganui i te 0.01 me te 0.1 percent te kukū i ngā whakamātautau waha matua. Mai i te 1 meneti ki te 15 meneti te wā whakapā. Kotahi noa te maimoatanga i ētahi kawa, e ono ngā maimoatanga i roto i te rua wiki i ētahi atu. Ka rerekē hoki te pūngao e tukuna ana i runga i te nui o te rama, te maha o ngā ira, me te whakamāramatanga, kāore rānei, o te niho horihori tonu ki te rama. Nā tēnei kanorau, kāore he nui kotahi o te puru metilīni mō te Candida hei whakarāpopoto. Ka hanumi tētahi tau whakakotahi i ngā maimoatanga rerekē i raro i te tapanga kotahi.
Ka tāpiri ngā rerekētanga o ngā taupori i tētahi paparanga tuarua. He rerekē te whanonga o te mate Candida whero, o te mate whai kiriuhi rūpahu, o te mumura waha e pā ana ki ngā niho horihori, me te mate Candida e pā ana ki te HIV, ā, he rerekē hoki ngā take e hoki mai ai. Ka pā ki te hunga mau niho horihori te whakakoronitanga anō mai i te mata o te niho horihori. He rerekē ngā take e akiaki ana i te hokinga mai o te mate mō te hunga whai waha maroke, whai mate huka, whakamahi pūtaiaki whakangā, kua whakamahi rongoā paturopi rānei inā tata nei. Kāore e whakawhiti aunoa tētahi kitenga o tētahi rōpū ki tētahi atu, ā, kāore tētahi o ēnei whakamātautau waha e whakamātau ana i ngā kerēme mō te Candida puta noa i te tinana, i te whēkau rānei.
Me pēhea te pānui i tētahi whakamātautau mate Candida o te waha i roto i te rua meneti
Tuatahi, tirohia te rerenga kōrero mō te taupori. He rerekē ngā pātai ka whakautua e ngā pakeke mau niho horihori, e ngā tāngata whai HIV, me ngā kāhui whānui whai mate Candida o te waha. Tuarua, tuhia te maimoatanga whakataurite me te rahinga tauira. Kāore e taea te whakawhiti noa i te rongoā nystatin whakatārewatia, ngā papa ngote nystatin, te pia miconazole, me te fluconazole hei maimoatanga whakahaere, ā, ko ngā whakamātautau he 7 ki te 23 ngā kaiuru ki ia rōpū ka tautoko noa i ngā whakatau mō te āhei ki te whakahaere. Tuatoru, kimihia te rā aroturuki. Ka ine te paearu mutunga i te rā 14, i te rā 30 rānei i te urupare wā poto, ehara i te ārai i te hokinga mai o te mate. Tuawhā, tonoa he tau motuhake mō ngā pāpaka me ngā ahurea. Ki te pūrongo te pepa i tētahi whakaora hanumi anake, me whakaaro he taunakitanga kāore anō kia oti mō te pātai ā-harore.
He iti ngā pūrongo haumaru i ēnei whakamātautau, engari he āhuatanga whakamārie kei roto i tō rātou whānuitanga. I pūrongotia e te whakamātautau tōmua tētahi kēhi o te wherotanga me te mamae o te pae niho, i whakatauria kāore i pā ki te maimoatanga whai muri i te kitenga o tētahi mate niho. I pūrongotia hoki tētahi tangohanga nā te reka me te whakapōrearea o te nystatin, me tētahi tangohanga nā te whakaaro kāore he pānga o te haumanu rama. Ko ngā pātai whānui ake mō te āhei o te kiriuhi ki te kawe i te maimoatanga me whai wāhi ki ngā raraunga haumaru mō te whakamahinga ki te kiriuhi o te waha, kaua ki ngā ripanga whaihua.
Te tikanga o tēnei mō ngā tūroro me ngā mātanga haumanu
Mō te mate e pā ana ki ngā niho horihori, me whakahaere te niho horihori i te taha o te kiriuhi. Koia te take he whakatau motuhake te āhua o te whakahaere i te mate Candida e pā ana ki ngā niho horihori, i te whakatau ko tēhea rongoā patu harore, kawa rama rānei ka kōwhiria. Mō te mate Candida o te waha e hoki mai ana, he tika ake tētahi mahere e tirotiro ana i te whakaata me te ahurea i tētahi e tirotiro ana i tētahi anake. Mā ngā tohu mate me te taumata o ngā pāpaka e ārahi ngā mahi mō te noho pai me te mahi o te waha. Mā ngā ahurea tukurua, ngā tatau koroni rānei e ārahi te whakatau mēnā kei te mau tonu te whakakoronitanga i muri i te memehatanga o ngā pāpaka.
Ko tēnei tētahi whakarāpopototanga pono o te āhua o nāianei. Ka taea e te haumanu hihiko-ā-rama mā te puru metilīni te whakaiti i ngā pāpaka me ngā tatau harore i te mate Candida o te waha i roto i ngā rā ki ngā wiki. He iti ake te ōritetanga o ngā taunakitanga mō te whakakorenga katoa, mauroa hoki i te ahurea, ā, he iti rawa, he poto rawa hoki ngā whakataurite tika ki te nystatin, ki te miconazole rānei hei tautoko i ngā kerēme ōritetanga. I kitea e tētahi tātari whānui ake i te tau 2025 o ngā whakamātautau hihiko-ā-rama 16, e kapi ana i ngā matū tairongo ki te rama rerekē, kāore he rerekētanga whai tikanga ā-tatauranga o te urupare whānui ki ngā rongoā patu harore. He nui hoki te kanorau me ngā māharahara mō te rītaha. He horopaki tēnei, ehara i te whakatau tata motuhake mō te puru metilīni.
He tohu iti tēnā, engari he tohu tūturu. E tautoko ana i te rangahau anō me ngā tawhā waikano, rama hoki kua whakatauritea, ngā paearu mutunga kua wehea, me te aroturuki mō te hokinga mai o te mate. Kāore e tautoko ana i ngā whakatau mō te whakamahi i te kāinga, ā, kāore tēnei arotake e toro atu ki te whēkau, ki te ia toto rānei. Ka taea e ngā kaipānui e hiahia ana ki te tirohanga whānui ake o ngā rangahau waikano e whakahohehia ana e te rama te whakamahi i te tirohanga whānui o ngā mate waha kua rangahaua mā ngā waikano e whakahohehia ana e te rama, i te taha o ngā whakamātautau matua e rua kua honoa i runga ake nei.