Methylene blue pa matenda a mitsempha ndi ululu: ndi mavuto ati amene afufuzidwa?

Kodi methylene blue imachepetsa ululu ndi matenda a mitsempha ya minyewa? Funso limeneli likumveka ngati funso limodzi, koma zolemba za kafukufuku zimayankha mafunso angapo osiyana. Utoto wobayidwa mkati mwa disc ya msana, utoto wobayidwa pansi pa khungu lozungulira potulukira chimbudzi, utoto wolowetsedwa mumtsempha wa magazi, ndi utoto wotsukira m'kamwa zili ndi dzina limodzi koma zimayesa mfundo zosiyana zogwira ntchito. Zotsatira za njira imodzi sizikutanthauza kuti njira zinazo zidzakhala ndi zotsatira zomwezo.

Ganizirani kuti ndi mfundo zinayi zokhala ndi dzina limodzi. Mfundo yoyamba imawononga kapena kuchepetsa mphamvu yozindikira ya mathero ang'onoang'ono a mitsempha ya minyewa amene akukula kulowa mu disc yowonongeka. Mfundo yachiwiri imachititsa kuti mitsempha ya minyewa ya khungu pamalo obayidwa isamve kapena ichepetse ntchito yake. Mfundo yachitatu imagwira ntchito pa dongosolo la mitsempha ya minyewa kudzera m'kayendedwe ka magazi m'thupi lonse. Mfundo yachinayi imakuta malo ovulala kuti ichepetse ululu pamalopo. Mukamvetsetsa kusiyana kumeneku, umboni umasiyanitsidwa mosavuta, ndipo kusowa kwake kumaonekera: zonena zotchuka zimakhudza mfundo yachitatu pogwiritsa ntchito madzi omezedwa, ndipo ndi pamene umboni wa mwa anthu uli wochepa kwambiri.

Tebulo la umboni malinga ndi vuto ndi njira yogwiritsira ntchito

Tebuloli likufupikitsa nkhani yonseyi. Mzere uliwonse umasunga pamodzi vuto, njira yogwiritsira ntchito, ndi chithandizo chimene chinayesedwa, chifukwa kulekanitsa zimenezi ndi kumene kumakulitsa zonena za kuchepetsa ululu kuposa umboni wake.

Werengani kaye mzati wa njira yogwiritsira ntchito musanawerenge mutu uliwonse. Chizindikiro chilichonse cha zotsatira zabwino mwa anthu chili pamzere wokhudza kugwiritsa ntchito pamalo enaake kapena pochita njira yachipatala. Mizere yokhudza kugwira ntchito m'thupi lonse ili ndi kafukufuku woyambirira mmodzi wochepa kwambiri ndiponso mipata yopanda umboni.

Ululu wa msana wochokera ku disc: kafukufuku mmodzi wa zotsatira zazikulu, ndi kuyesa kubwereza kumodzi komwe sikunapambane

Nkhani ya kugwiritsa ntchito mkati mwa disc imayamba ndi kafukufuku woyambirira wa 2007 wopanda gulu loyerekezera nawo mwa odwala 24 omwe ululu wawo unatsimikiziridwa ndi kufufuza disc pogwiritsa ntchito utoto woonekera pa zithunzi, ndipo sunayankhe chithandizo chosachita opaleshoni. Pambuyo pa jekeseni imodzi mkati mwa disc ya 10 mg ya methylene blue, 21 mwa 24 ananena kuti ululu unatha kapena unachepa kwambiri pa nthawi yowatsatira ya pafupifupi miyezi 18. Popeza panalibe gulu loyerekezera nawo, zotsatira zimenezi zikanachokera pa kusankha odwala, kusintha kwachibadwa kwa vutolo, kapena lidocaine yomwe inaperekedwa limodzi nayo. Choncho zinalimbikitsa kufufuza funso la kugwira ntchito kwake, osati kuliyankha.

Kafukufuku wotsatira anali wa 2010, wobisira odwala ndi ofufuza magulu ochizira ndiponso wokhala ndi gulu lolandira mankhwala onyengezera, mwa odwala 72, woyerekezera methylene blue limodzi ndi lidocaine ndi madzi amchere limodzi ndi lidocaine. Pa miyezi 24, kusiyana komwe kunanenedwa kunali kwakukulu kwambiri: avareji ya kuchepa kwa muyezo wa ululu inali 52.5 poyerekeza ndi mfundo 0.7, ndipo kukhutira kunali 91.6% poyerekeza ndi 14.3%. Ndemanga ya akonzi yomwe inatsagana nawo inafunsa mosapita m'mbali ngati ichi chinali chithandizo chothetsa ululu wa msana, zomwe zikusonyeza mmene akatswiri anaonera zonenazo kukhala zapadera pa nthawiyo.

Zonena zapadera zimafunika kuyesedwa mobwerezanso, ndipo kuyesa kubwereza kumeneku sikunapeze zotsatira zomwezo. Kafukufuku wa IMBI wotsatira wa m'malo angapo unayesa methylene blue mkati mwa disc m'malo osiyanasiyana ndipo sunatsimikizire zotsatira za Peng. Kafukufuku wina wodziimira payekha wa magulu ang'onoang'ono opanda magulu oyerekezera nawo nthawi zambiri unanena kuti anthu omwe anapeza phindu anali ochepa kapena kuti phindulo linkachepa pakapita nthawi. Chidule choona n'chakuti umboni sukugwirizana: kupambana kwakukulu kumodzi kumalo amodzi, koma kuyesa kubwereza m'malo angapo sikunapambane. Zotsatira zotere sizitsimikizira chithandizo, ndipo sizikunena chilichonse chokhudza kumeza methylene blue, yomwe siifika mu disc pa kuchuluka kofanana. Chidule chathu cha umboni wa ululu wokhalitsa chimayika mkangano umenewu limodzi ndi njira zina zachipatala.

Jekeseni wozungulira potulukira chimbudzi: zizindikiro zenizeni, koma pa zinthu zochepa zokha

Methylene blue yobayidwa mkati mwa khungu pochiza kuyabwa kosayankha chithandizo potulukira chimbudzi ili ndi mbiri yaitali kwambiri ya kafukufuku wotsatira magulu a odwala, kuyambira mu 1990 mpaka magulu a odwala 25, 30, 49, ndi 103. Chiwerengero cha omwe amapeza phindu chimaoneka chachikulu, ndipo nthawi zambiri ambiri amakhala opanda zizindikiro pambuyo pa jekeseni imodzi kapena ziwiri, koma kafukufuku aliyense alibe gulu loyerekezera nawo. Kuyabwa komwe kumachititsa munthu kufuna njira yolowerera m'thupi kungasinthe, ndipo kulandira jekeseni kokha kungakhudze zotsatira chifukwa cha zimene wodwala akuyembekezera. Choncho kuchepa kwa zizindikiro popanda gulu loyerekezera nawo sikungatsimikizire kugwira ntchito kwa mankhwalawo.

Umboni wamphamvu kwambiri woyerekezera uli pa nkhani yofanana nayo ya ululu pambuyo pa opaleshoni. Kafukufuku awiri wogawa anthu m'magulu mwamwayi, wogwiritsa ntchito methylene blue mkati mwa khungu lozungulira potulukira chimbudzi panthawi ya opaleshoni yochotsa zotupa za mitsempha ya magazi ya kuthako, anapeza miyezo yochepa ya ululu ndi kugwiritsa ntchito mankhwala owonjezera ochepetsa ululu kochepa pa masiku 1 mpaka 3 mu kafukufuku wa odwala 67 ndiponso pa masiku 1 mpaka 7 mu kafukufuku wa odwala 97. Umenewu ndi umboni weniweni wa kuchepetsa ululu pa njira yachipatala yodziwika bwino, mlingo wodziwika, ndi sabata imodzi. Si umboni wa matenda okhalitsa a mitsempha ya minyewa, ndipo mmene imagwirira ntchito zomwe zikukambidwa ndi kuchepetsa mphamvu yozindikira ya mitsempha pamalo a chilonda. Dontho lomezedwa silingachite chimodzimodzi pamalopo. Mfundo zofotokozera mmene methylene blue imagwirira ntchito pa mitsempha ya minyewa ndi mitochondria zimafotokoza chifukwa chake kusintha kwa mankhwala pamalo enaake kumangokhala pamalopo.

Kugwiritsa ntchito m'thupi lonse pa ululu wochokera ku mitsempha ya minyewa: kafukufuku woyambirira mmodzi wochepa kwambiri

Pa zonena zomwe ogula ambiri amazisamala, zakuti methylene blue yogwira ntchito m'thupi lonse imachepetsa ululu wochokera ku mitsempha ya minyewa, umboni wonse wa kafukufuku wa anthu wokhala ndi gulu loyerekezera nawo ukuoneka kuti ndi kafukufuku woyambirira mmodzi wa 2015 mwa odwala 10 omwe anali ndi ululu wokhalitsa wa zifukwa zosiyanasiyana, wochokera ku mitsempha ya minyewa komanso wosayankha chithandizo. Methylene blue yoperekedwa mumtsempha wa magazi pa 2 mg/kg inachepetsa miyezo ya ululu kuposa mlingo wochepa kwambiri wa gulu loyerekezera nawo pa tsiku la chithandizo ndi tsiku lotsatira, ndipo phindulo linatsala pang'ono kutha m'masiku ochepa. Odwala atatu anasonyeza kuchepa kwa ululu woyambitsidwa ndi kukhudzidwa komwe nthawi zambiri sikupweteka.

Odwala khumi a mavuto osiyanasiyana ndi kuchepa kwa ululu kwa masiku awiri ndi chifukwa chochitira kafukufuku wina, osati maziko operekera chithandizo. Munthu mmodzi yekha mwa otenga nawo mbali anali ndi ululu wa mitsempha pambuyo pa herpes zoster, choncho uwu si kafukufuku wa vuto limenelo. Palibe kafukufuku wa anthu wokwaniritsa zofunikira amene anapezeka wokhudza methylene blue yogwira ntchito m'thupi lonse pa matenda a mitsempha ya minyewa ya kunja kwa ubongo ndi msana chifukwa cha shuga, ululu wa mtsempha wa trigeminal, kapena vuto lovuta la ululu wa gawo lina la thupi. Kafukufuku wa ululu wa mitsempha pambuyo pa herpes zoster womwe nthawi zina umaonekera pa makina osakira, wokhudza kugwiritsa ntchito pafupi ndi msana, unaphatikiza methylene blue ndi mankhwala ochititsa dzanzi pamalo amenewo. Umenewo ndi wa njira yachipatala pamalo enaake, osati wa kugwira ntchito m'thupi lonse.

Kutsukira m'kamwa, zilonda, ndi mfundo: umboni wa pamalo enaake womwe sungagwiritsidwe ntchito pa njira ina

Zizindikiro zotsala za zotsatira mwa anthu zonse ndi za pamalo enaake. Kafukufuku wa 2022 wa gawo 2 wogawa anthu m'magulu mwamwayi unapeza kuti madzi otsukira m'kamwa a methylene blue a milingo itatu ya kuchuluka kwake anachepetsa ululu wa kutupa kwa nembanemba za m'kamwa chifukwa cha chithandizo cha khansa kuposa chithandizo chozolowereka pofika tsiku 2. Madzi otsukira amakuta nembanemba zovulala ndipo amalavulidwa. Kuwatchula ngati umboni wa madontho omezedwa kumasokoneza kukhudza pamalo enaake ndi kupereka mlingo wogwira ntchito m'thupi lonse.

Mofananamo, kukuta mbali za thupi zomwe zikuchitidwa opaleshoni ndi methylene blue yochepetsedwa mphamvu panthawi yochotsa disc ya m'munsi mwa msana kunachepetsa miyezo ya ululu wa msana mu kafukufuku wa odwala 115 wobisira magulu atatu magulu ochizira omwe odwala anali nawo, pamene kafukufuku wa jekeseni mu mfundo zolumikiza mafupa a msana unanena kuti miyezo ya ululu ndi kulephera kuchita zinthu inali yochepa pa miyezi 3 ndi 6. Zotsatira zilizonse zimadalira malo omwe mankhwalawo anaikidwa. Palibe zimene zingatanthauzidwe kuti zimagwiranso ntchito pa mankhwala omezedwa.

Zomwe kafukufuku wa zinyama amasonyeza, ndi pamene mmene mankhwala amagwirira ntchito kungabweretse zotsatira zotsutsana

Kafukufuku woyerekezera ululu wochokera ku mitsempha ya minyewa mu makoswe ndi amene amapereka chifukwa chomveka cha mmene mankhwalawa angagwirire ntchito, chomwe chimatchulidwa kawirikawiri. Methylene blue yoikidwa m'madzi ozungulira msana inaletsa kumva ululu wowonjezereka chifukwa cha kutentha kwa pafupifupi maola 4 pambuyo pomanga mtsempha wa sciatic mu kuyesa koyambirira kwa 1992. Izi zinagwirizana ndi mfundo yakuti njira ya nitric oxide kupita ku cGMP mu msana imathandizira ululuwo. Kafukufuku wotsatira wa kuvulala chifukwa cha kukanikizidwa kokhalitsa anapeza kuti methylene blue yokha inachepetsa kuyankha ku zinthu zoyambitsa ululu ndiponso inatha kuletsa kuwonjezeka kwa kumva ululu komwe sildenafil inkayambitsa. Zimenezi zinasonyezanso udindo wa kutumiza zizindikiro kwa nitric oxide. Kafukufuku wa 2021 anawonjezera njira yachiwiri yogwirira ntchito: kupondereza mwachindunji kutumiza zizindikiro za mitsempha ya minyewa, mofanana ndi zotsatira pa njira zolowera za sodium, ndipo kuponderezako kunatenga nthawi yaitali kuposa kwa lidocaine pa zomwe zinayesedwa.

Mfundo ina yofunika siyenera kuiwalika chifukwa ogulitsa saitchula. Kafukufuku wa nitric oxide wochitika asanayesedwe mwa anthu sakusonyeza nthawi zonse kuti methylene blue imachepetsa ululu. M'njira zina zoyesera, kutumiza zizindikiro kwa nitric oxide kokha kumathandiza kuchepetsa ululu, ndipo methylene blue imalepheretsa kuchepa kumeneko. Mu kuyesa matenda a mitsempha ya minyewa chifukwa cha shuga, methylene blue inalepheretsa kuchepa kwa kuyankha ku zinthu zoyambitsa ululu komwe kunali kogwirizana ndi sildenafil, ndipo yokha inawonjezera kumva ululu mopitirira muyeso. Zotsatira za mmene imagwirira ntchito zimadalira mtundu wa kuyesa ndi njira ya m'thupi yomwe ikukhudzidwa. Ichi ndi chifukwa china chomwe zotsatira za zinyama sizingatengedwe ngati malangizo a mlingo wogwiritsira ntchito.

Zomwe sizinafufuzidwe, ndi malire a chitetezo

Palibe kafukufuku wogawa anthu m'magulu mwamwayi kapena kafukufuku wodalirika wotsatira magulu a odwala amene anapezeka wokhudza methylene blue yomezedwa pa ululu wokhalitsa wochokera ku mitsempha ya minyewa, matenda a mitsempha chifukwa cha shuga, ululu wa mtsempha wa trigeminal, vuto lovuta la ululu wa gawo lina la thupi, kapena ululu wa mitsempha pambuyo pa herpes zoster. Kafukufuku yekhayo wachindunji wa kugwiritsa ntchito m'thupi lonse pa ululu wochokera ku mitsempha ya minyewa ndi kafukufuku woyambirira wa odwala 10 wopereka mankhwalawo mumtsempha wa magazi, wokhala ndi chizindikiro cha phindu cha masiku 1 mpaka 2. Malinga ndi mmene mankhwala amagwirira ntchito m'thupi, zotsatira za kugwiritsa ntchito mkati mwa disc, mkati mwa khungu, mkati mwa mfundo, pafupi ndi msana, ndi potsukira m'kamwa sizingatanthauzidwe kuti zikugwiranso ntchito pa madontho ogulitsidwa. Kuchuluka kwa mankhwala ofika pamalo omwe akufuna kukhudza kumasiyana kwambiri pakati pa njira zimenezi, ndipo madonthowo saikidwa pamalopo kudzera mu njira iliyonse yachipatala.

Kusokoneza njira zogwiritsira ntchito kulinso ndi chenjezo la chitetezo. Malo osiyanasiyana a msana sangasinthanitsidwe: kugwiritsa ntchito mkati mwa disc, pafupi ndi msana, kunja kwa nembanemba yolimba yozungulira msana, ndi m'madzi ozungulira msana kumasiyana pa mmene mankhwalawo amagwirira ntchito ndi mmene angawonongere thupi. Kuwonongeka kwakukulu kwa mitsempha ya minyewa pambuyo poika methylene blue m'madzi ozungulira msana kunachititsa kuperekedwa kwa chenjezo lomveka bwino la ngozi. Payokha, methylene blue imakhudzana ndi mankhwala okhudza serotonin ndipo siyenera kugwiritsidwa ntchito kwa anthu omwe ali ndi kusowa kwa G6PD. Choncho wodwala ululu aliyense amene akuganiza zoigwiritsa ntchito ayenera kuwerenga kaye chidule cha zotsatira zosafunika ndi mikhalidwe yomwe imaletsa kugwiritsa ntchito ndi kukambirana ndi katswiri wa zachipatala, pogwiritsa ntchito mafunso awa okhudza methylene blue.

Mmene mungagwiritsire ntchito umboni umenewu

Aliyense amene akuwunika methylene blue pa ululu ayenera kufunsa mafunso atatu pa gwero lililonse lotchulidwa. Ndi vuto liti lenileni, chifukwa kuchira pambuyo pa opaleshoni yochotsa zotupa za mitsempha ya magazi ya kuthako si matenda a mitsempha chifukwa cha shuga. Ndi njira iti yeniyeni yogwiritsira ntchito, chifukwa kuika mkati mwa disc kapena mkati mwa khungu si chimodzimodzi ndi mlingo womezedwa. Ndipo ndi chotsatira chiti chomwe chinayesedwa, pa nthawi yaitali bwanji, chifukwa kuchepa kwa ululu kwa masiku ochepa pambuyo pa njira yachipatala si kuwongolera matenda a mitsempha kwa miyezi.

Malinga ndi umboni womwe ulipo, zizindikiro za kuchepetsa ululu mwa anthu pogwiritsa ntchito methylene blue zimangokhala pa kupereka pamalo enaake kapena pochita njira zachipatala, ndipo kugwira ntchito kwake sikugwirizana pa mavuto osiyanasiyana. Umboni wa kugwira ntchito m'thupi lonse umangokhala pa kafukufuku woyambirira mmodzi wochepa kwambiri wa kupereka mumtsempha wa magazi, ndipo palibe umboni wa kafukufuku wa odwala womwe umathandiza kugwiritsa ntchito methylene blue yogulitsidwa kuti imezedwe pa ululu wochokera ku mitsempha ya minyewa kapena ululu wokhalitsa.