Ubururu bwa metilene na migrene: ibivugwa ku buvuzi ugereranyije no kuribwa umutwe nyuma yo kubukoresha

Ubururu bwa metilene si ubuvuzi bwemejwe bwa migrene. Inyandiko z'ubushakashatsi bwo kwa muganga zabonetse muri iri suzuma ntizitanga igerageza ririmo itsinda ryo kugereranya ryerekana ko ubururu bwa metilene buhagarika ibitero bya migrene, bubikumira, cyangwa buvura aura. Inkuru zivuga ko umutwe wagabanutse n'izivuga ko umutwe watangiye nyuma yo kubukoresha zishobora kubaho zombi, ariko ntizemeza uko ubururu bwa metilene bugira ingaruka kuri migrene yasuzumwe.

Imwe mu mpamvu zitera urujijo ni uko kuribwa umutwe bishobora kugabanuka iyo havuwe ikibitera. Mu bitaro, ubururu bwa metilene bukoreshwa mu kuvura methemoglobinemia itari iyavukanye. Iyo ndwara ubwayo ishobora gutera kuribwa umutwe bikabije bisa na migrene. Kuba ubwo buvuzi bwagenze neza muri iyo mimerere bisubiza ikibazo gitandukanye n'icyo kumenya niba umuntu ufite migrene akwiye gukoresha ubururu bwa metilene.

Shaka ubufasha bwihutirwa niba utangiye kuribwa umutwe bitunguranye kandi bikabije cyane, ugize intege nke utari usanganywe cyangwa ingorane zo kuvuga, utakaje ubwenge, cyangwa uribwa umutwe ufite n'ingorane zo guhumeka n'iminwa y'ubururu cyangwa y'ikijuju. Ntukibwire ko ibyo bimenyetso ari impinduka zisanzwe zitezwe igihe umubiri umenyera ubururu bwa metilene. Amabwiriza ya NHS ku kuribwa umutwe agaragaza ububabare bukabije butunguranye n'ibimenyetso bifitanye isano n'urwungano rw'imyakura nk'ibisaba ubufasha bwihutirwa.

Icyo ibivugwa kuri migrene byerekana koko

Ibiganiro byatanzwe byerekana ibyabaye bitandukanye: ikiganiro kimwe ku rubuga kivuga kuribwa umutwe nyuma yo gukoresha ubururu bwa metilene, mu gihe ikindi kirimo abavuga ko ububabare bwagabanutse hafi y'intangiriro y'igitero. Ibyo ni ibyabonywe n'abasomyi, si amakuru yo kwa muganga agaragaza imikorere y'ubuvuzi. Icyo kiganiro cya kabiri ndetse kivuga ko igipimo cy'ubururu bwa metilene mu muti w'amazi kitari kizwi neza, bigatuma bigorana gusobanura ibyo umuntu yakoresheje.

Ubushakashatsi ku buvuzi bwagira akamaro bwakwemeza ko umuntu afite migrene, bukagaragaza uko umuti uteguye n'uburyo utangwa, bukawugereranya n'itsinda ryo kugereranya, kandi bugapima umusaruro nko kutagira ububabare mu gihe cyagenwe cyangwa impinduka mu mubare w'iminsi umuntu agira migrene buri kwezi. Kuba umutwe w'umuntu umwe ugenda ugabanuka ntibishobora gusimbura iryo gereranya ribura. Migrene igenda ihindagurika, abantu bakunze gufata indi miti, kandi bashobora gukoresha ikintu mu gihe igitero cyamaze gutangira guhinduka.

Ubushakashatsi kuri nitric oxide butanga impamvu ishingiye ku mikorere y'umubiri yo gusuzuma uburyo kuribwa umutwe bibaho, ariko ntibwemeza ubururu bwa metilene nk'ubuvuzi. Mu bushakashatsi bwa Lassen na bagenzi be bwo mu 1998 kuri migrene, L-NMMA, umuti uhagarika imikorere ya nitric oxide synthase watanzwe mu mutsi, wagabanyije umutwe nyuma y'amasaha abiri kuri 10 muri 15 bawuhawe, ugereranyije na 2 muri 14 bo mu itsinda ryo kugereranya. Ariko muri iryo gerageza, abahawe placebo batatu gusa ni bo bashyizwe muri iryo tsinda hakoreshejwe uburyo bw'amahirwe; abantu cumi n'umwe bo mu itsinda ryo kugereranya bari bavuye mu bushakashatsi bwabanje. Ikirushijeho kuba ingenzi ni uko L-NMMA ari umuti utandukanye. Ibyavuye muri ubwo bushakashatsi ntibishobora kwitirirwa ubururu bwa metilene cyangwa ibicuruzwa byo kunywa bigurishwa mu maduka.

Iryo tandukaniro rireba kandi ubushakashatsi ku bururu bwa metilene mu zindi ndwara zitera ububabare. Uburyo bwo kuvura ububabare bwo mu gice runaka cy'umubiri cyangwa ubushakashatsi ku ndwara z'imyakura ntibyemeza ko ubwo buvuzi bugenewe migrene.

Imbonerahamwe y'ibimenyetso: tandukanya imimerere yo kuribwa umutwe

Iyi mbonerahamwe itandukanya amatsinda yakoreweho ubushakashatsi n'ibibazo byo kwa muganga. Ntiyerekana urutonde rw'uko umuntu runaka ashobora kuba afite kimwe muri ibyo bibazo.

Impamvu inyandiko kuri methemoglobinemia atari igerageza kuri migrene

Inyandiko y'ubushakashatsi yatanzwe, Kuribwa umutwe na methemoglobinemia ya Khan na bagenzi be, yasohotse kuri interineti mu 2019 no mu nomero y'ikinyamakuru yo muri Mutarama 2020. Isuzuma kuribwa umutwe guterwa n'ikindi kibazo kandi ivuga umurwayi wari ufite ububabare bukabije mu mutwe wose, kumva uburyaryate hafi y'umunwa, iminwa n'amaboko by'ubururu, isesemi, no guhumeka nabi igihe akoresha imbaraga. Ibimenyetso byashize nyuma yo kuvurwa n'ubururu bwa metilene.

Methemoglobinemia ihindura hemoglobine ku buryo amaraso adashobora kugeza ogisijeni mu mubiri uko bisanzwe. Kuvura icyo kibazo cy'amaraso bishobora kugabanya ibimenyetso byacyo. Iyo nyandiko iburira ko uko iyo ndwara igaragara bishobora kwibeshywa kuri migrene iherekejwe no guhangayika cyangwa guhumeka vuba birenze urugero. Ntiyagabanyije abantu bafite migrene y'ibanze mu matsinda ahabwa ubururu bwa metilene cyangwa placebo hakoreshejwe uburyo bw'amahirwe, kandi uko umurwayi yakiriye ubuvuzi ntibyemeza ko bukumira cyangwa bugabanya ibitero bisanzwe bya migrene. Ibisobanuro birambuye ku kuvura methemoglobinemia mu bitaro bivuga iyo ntego y'ubuvuzi.

Ku basomyi bashakisha by'umwihariko “ubururu bwa metilene na aura ya migrene,” ibaruwa yasohotse nyuma isobanura methemoglobinemia isa na migrene ifite aura yo mu kureba. Ibyo ni ugusa kw'ibimenyetso mu isuzuma, si ibimenyetso byemeza kuvura aura hakoreshejwe ubururu bwa metilene. Inyandiko iboneka kuri PubMed nta ncamake ifite, bityo ibijyanye n'ubuvuzi uwo murwayi yahawe ntibishobora gukurwa mu mutwe w'iyo nyandiko gusa.

Kuribwa umutwe nyuma yo kubukoresha si ikizamini cya serotonine

Amakuru agenewe abandika PROVAYBLUE ashyira kuribwa umutwe mu ngaruka mbi zavuzwe. Ayo makuru yerekeye umuti wandikwa na muganga, utangwa mu mutsi ku barwayi bafite methemoglobinemia. Ntagaragaza uko ibyago bingana ku muti wo kunywa ufite ibiwugize n'uburyo ukoreshwa bitandukanye.

Mu bikorwa bya muganga, umutwe mushya ushobora kuba ingaruka mbi, igitero cya migrene umuntu asanzwe agira, indi ndwara itera umutwe, cyangwa igice cy'indi ndwara. Igihe byabereye ni ingenzi, ariko “nyuma ya” ntibihagije kugira ngo hemezwe “bitewe na.” Andika ibyabaye kandi ushake inama mbere yo kongera gukoresha igicuruzwa kitanditswe na muganga. Ntukongere kugikoresha kugira ngo ugerageze kumenya niba ari cyo cyabiteye, cyangwa ngo wongereho undi muti wo kubirwanya.

Impungenge ku mikoranire y'imiti zirafite ishingiro: amagerageza akoresheje anzime z'umuntu zatunganyijwe agaragaza ko ubururu bwa metilene buhagarika imikorere ya monoamine oxidase A. Ariko kuribwa umutwe ntibigaragaza igipimo cya serotonine mu mubiri w'umuntu. Kuba umuntu amererwa neza nyuma yo gukoresha ikindi kintu cyangwa kuba ataribwa umutwe ntibishobora kwemeza cyangwa guhakana uburozi bwa serotonine.

Suzuma amazina nyayo y'imiti ya migrene

Ubuvuzi bwa migrene bushobora kuba burimo imiti yo mu byiciro bitandukanye. Inyandiko ya sumatriptan ivuga ko itemewe gukoreshwa icyarimwe n'umuti uhagarika imikorere ya MAO-A. Imwe mu miti ikoreshwa mu gukumira migrene, harimo n'imiti irwanya agahinda gakabije, na yo ikeneye kwitabwaho. Inyandiko y'ubururu bwa metilene buterwa iburira ku ndwara y'ibimenyetso biterwa na serotonine nyinshi igihe bukoreshwa hamwe n'imiti igira uruhare kuri serotonine n'imiti ya opioids. Umufarumasiye akeneye amazina nyayo y'imiti, si ukuvuga gusa “umuti wa migrene.”

Shaka ubuvuzi bwihutirwa nyuma yo gukoresha ubururu bwa metilene niba ugize kudatuza cyangwa urujijo biherekejwe n'umuriro, kubira ibyuya byinshi, guhinda umushyitsi, gukomera kw'imikaya, cyangwa kwinyeganyeza kw'imikaya kutagengwa n'ubushake. Ibyo bimenyetso bihuriranye biteye impungenge kurusha kuribwa umutwe byonyine. Ntuhagarike umuti wo gukumira migrene wandikiwe kugira ngo ukoreshe ubururu bwa metilene, cyangwa ngo wishyirireho gahunda y'igihe cyo gutegereza ko umuti ubanza uva mu mubiri. Amabwiriza ku mikoranire y'imiti asobanura ibyiciro birebwa; kuba umuti utari ku rutonde rugufi ntibivuga ko wemerewe kuwukoresha.

Andika ibyabaye utadindije gushaka ubuvuzi

Kuramo urupapuro rwo kwandikaho amateka y'ibimenyetso kugira ngo urujyane igihe ugiye kubonana n'umuganga. Rwandikwaho ibyabaye, aho gutanga isuzuma cyangwa inama y'ubuvuzi.

Sobanura niba ubwo bubabare busa n'ubwo usanzwe ugira, igihe bwatangiriye ugereranyije n'igihe wakoresheje ubururu bwa metilene, ibyo wafashe, n'ibindi bimenyetso byabayeho. Shyiramo impinduka mu miti y'umutwe usanzwe ukoresha n'inshuro ukoresha imiti yo kuvura ibitero igihe bibaye. Kuyikoresha kenshi ubwabyo bishobora gutuma gusuzuma kuribwa umutwe bigorana.

Amabwiriza ya NICE ku gusuzuma kuribwa umutwe ashyigikira kwandika inshuro umutwe ubaho, igihe umara, ubukana bwawo, ibimenyetso biwuherekeza, imiti, n'ibishobora kuwutera. Atandukanya kandi aura isanzwe igenda iza buhoro kandi ishira n'ibimenyetso bisaba irindi suzuma. Ikibazo kibaye bwa mbere cyangwa gitandukanye cyane n'ibisanzwe mu kureba cyangwa mu mikorere y'urwungano rw'imyakura ntigikwiye kwitwa “aura gusa” hashingiwe ku nkuru yo kuri interineti.

Niba ugize umutwe mushya cyangwa ukomeje nyuma yo gukoresha ubururu bwa metilene, jyana agacupa cyangwa ifoto isobanutse y'ibirango byako n'urupapuro wanditseho ibyabaye ku muganga cyangwa ku mufarumasiye. Amabwiriza arambuye ku mutekano n'ibibazo byo kubaza mu kiganiro n'umuganga bifasha gutegura icyo kiganiro hashingiwe ku gicuruzwa nyacyo n'icyo ushaka kugikoresha.