Chinyorwa
Methylene blue pazvirwere zveCandida mumuromo: zvinoratidzwa nezvidzidzo zvekiriniki zvephotodynamic
Murwere anotarisa mugirazi, oona makwapa machena apera, obva afunga kuti fungus yapera. Kufunga ikoko kunonzwisisika. Muzviedzo zvemethylene blue inomutswa nechiedza pakurapa chirwere cheCandida mumuromo, kufunga ikoko ndiko zvakare kunonyanya kukonzera kuvhiringidzika.
Kurapa uku kune zvikamu zvitatu, uye chimwe nechimwe chine basa rakasiyana. Methylene blue inofukidza ronda, chiedza chitsvuku chinomutsa dhayi, uye dhayi yamutswa inoendesa simba kuokisijeni kuti igadzire zvimedu zvinoshanda mumakemikari zvinorarama kwenguva pfupi, zvichikuvadza masero eutachiona ari pedyo. Mashandiro anoita methylene blue sechinhu chinonzwa chiedza akakosha, nokuti pasina chiedza dhayi imwe chete iyi ine simba rakaderera zvikuru rekurwisa utachiona. Mubvunzo wekiriniki wakanyanya kunangana nechinhu chimwe: kana matanho aya akashandiswa pachirwere cheCandida mumuromo, chii chinovandudzika, kutaridzika kwemuromo kana mhedzisiro yekurima fungus murabhoritari, uye kuvandudzika kwacho kunogara kwenguva yakareba sei.
Musiyano iwoyo ndiwo unoronga zvose zviri pasi apa. Kupindura pakurapwa kunoonekwa kunoreva kuderera kwemaronda anooneka, kutsvuka kana rukoko rwakaita seganda, uye marwadzo kana kunzwa kupisa. Kupindura kwefungus kunoreva kuderera kwezvikamu zvinokwanisa kuumba mapoka pakurimwa murabhoritari kana kubviswa kwayo zvachose. Muromo unogona kuzadzisa tsananguro yokutanga usingazadzisi yechipiri.
Zvakaedzwa nezviedzo zviviri zvikuru
Chiedzo chinonyanya kuenderana nemubvunzo uyu, chakaitwa kuvanhu vakuru vane chirwere cheCandida mumuromo chinoratidzwa nekutsvuka, chakagovera vatori vechikamu 41 zvisina kurongwa kuboka rekurapwa kwephotodynamic nemethylene blue kana kuboka remusanganiswa wemvura wenystatin. Muboka rechiedza, kurapwa kwaiitwa vhiki nevhiki kwemavhiki anosvika mana. Dhayi yaive nechikamu che0.1 muzana uye yaisiyiwa iripo kwemaminitsi 15, yozoteverwa nechiedza chelaser che660 nm chine simba re4 joules papoinzi kwemasekonzi 40 papoinzi; huwandu hwemapoinzi hwaitemwa nekukura kwenzvimbo ine maronda. Mushonga wekuenzanisa nawo waive musanganiswa wemvura wenystatin wemumuromo we100,000 IU, waishandiswa kugezesa muromo zuva nezuva kwemazuva anenge 21. Kuteverwa kwaiitwa vhiki nevhiki panguva yekurapwa, pasina chikamu chakareba chekutarisa kudzoka kwechirwere chakashumwa. Pfupiso yakabudiswa inoshuma kupera zvachose kwemaronda mu16 pavanhu 17 vakaongororwa muboka renystatin uye mu16 pavanhu 19 vakaongororwa muboka rephotodynamic. Huwandu uhu hwevanhu vakaongororwa hunofanira kucherechedzwa nokuti hwakasiyana ne18 ne23 vakagoverwa zvisina kurongwa kumapoka, uye chiedzo hachina kuwana kuti boka rechiedza raive nani. Maronda akanyanya kuipa aive nemukana mudiki wekupera mumapoka ose ari maviri. Huwandu hwefungus hwakaderera mushure mechikamu chokutanga chechiedza, asi mushumo unotsigira kuderera pakarepo pane kubviswa zvachose kwakaratidzwa neuchapupu. Mashoko akazara anowanikwa muchiedzo chakagovera vanhu zvisina kurongwa pakurapwa kwephotodynamic kweCandida inoratidzwa nekutsvuka.
Chiedzo chechipiri chikuru chaive chiedzo chidiki chokutanga chekuongorora, chinoratidza pachena musiyano pakati pekuvandudzika kunoonekwa nemhedzisiro pafungus. Vanhu vakuru gumi nevasere vane chirwere cheCandida mumuromo chakasimbiswa nekuongororwa kwekiriniki uye kwefungus vakagoverwa zvisina kurongwa vachishandisa mapoka madiki, 9 muboka rimwe nerimwe, uye 16 vakapedza. Vanhu vane chirwere cheshuga, vanopfeka mazino ekugadzira, vakamboshandisa mishonga inorwisa mabhakitiriya, kana vane hutsanana husina kunaka vaigona kunyoresa, asi vane utachiona hweHIV hwakasimbiswa vaisabvumidzwa. Boka rechiedza rakashandisa dhayi ine chikamu chakaderera zvikuru, 0.1 mg pa mL, yakasiyiwa iripo kweminiti 1, nechiedza chediode che660 nm chine simba re1.2 kusvika ku3.3 joules pa cm2 kwemasekonzi anenge 60 panzvimbo imwe neimwe, zvikamu zvitanhatu mumavhiki maviri. Mushonga wekuenzanisa nawo waive mapiritsi enystatin anonyungudutswa mumuromo e500,000 IU katatu pazuva kwemazuva 14. Kuteverwa kwakapera pazuva 14, pasina kuongororwazve gare gare kuti chirwere chainge chadzoka here. Kuvandudzika kunoonekwa kwakawanikwa mu6 pavanhu 9 pakurapwa kwephotodynamic, zvichienzaniswa ne8 pavanhu 9 panystatin. Kupindura kwefungus kwaive 5 pavanhu 9 zvichienzaniswa ne8 pavanhu 9, uye kubviswa kwefungus zvachose kwaive 4 pavanhu 9 zvichienzaniswa ne8 pavanhu 9. Hapana musiyano wakasvika pachiyero chekukosha kwehuwandu, zvinotarisirwa pachiedzo chidiki chakadai. Chinhu chinobatsira chakawanikwa musiyano uri mukati meboka rechiedza pacharo: 66.7 muzana vakaratidza kuvandudzika kunoonekwa, asi 44.4 muzana vakaratidza kubviswa kwefungus zvachose. Maronda aivandudzika kakawanda kupfuura kupera kwefungus pakurimwa murabhoritari. Hapana zviitiko zvakakomba zvinokuvadza zvakaitika. Maitirwo echiedzo nehuwandu hwacho zvinotsanangurwa muchiedzo chidiki chokutanga chekuona kana kurapa Candida mumuromo kuchigoneka pachigaro chekurapirwa mazino.
Vaverengi vari kutsvaga methylene blue pachirwere cheCandida mumuromo vanofanira kuyeuka musiyano iwoyo vasati vaverenga mwero upi zvawo wekupora uri mumusoro wenhau. Chiyero chekupora chinosanganisa zviratidzo nemhedzisiro yekurimwa murabhoritari chinovanza mashoko chaiwo anodiwa nemurwere ane zviratidzo zvinodzoka.
Mhedzisiro inoonekwa kana ichienzaniswa nemhedzisiro pafungus
| Chiedzo neboka revanhu | Maitirwo, mushonga wekuenzanisa nawo, kuteverwa | Mhedzisiro inoonekwa pamaronda | Mhedzisiro pafungus | Miganhu mikuru |
|---|---|---|---|---|
| Medeiros 2023, vanhu vakuru vane Candida mumuromo inoratidzwa nekutsvuka, 41 vakaongororwa | Kugoverwa zvisina kurongwa, musanganiswa wemvura wenystatin 100,000 IU wekugezesa muromo zuva nezuva kwemazuva anenge 21, kuteverwa vhiki nevhiki kusvika kumavhiki 4 | Kupera zvachose kwemaronda munenge 84 muzana nekurapwa nechiedza zvichienzaniswa nevanenge 94 muzana nenystatin, hapana kurapwa kwakaratidzwa kuva nani | Huwandu hweCandida hwakaderera mushure mechikamu chokutanga, kubviswa zvachose hakuna kusimbiswa | Vanhu vashoma, kuteverwa kwenguva pfupi, huwandu hwakashandiswa pakuverenga kupera kwemaronda hahuwirirani nehuwandu hwevakagoverwa kumapoka, maronda akanyanya kuipa aive mashoma pakati peakapera |
| Zhou 2026, vanhu vakuru vane Candida mumuromo yakasimbiswa, 18 vakagoverwa zvisina kurongwa | Chiedzo chidiki chokutanga chine kugoverwa zvisina kurongwa, mapiritsi enystatin anonyungudutswa mumuromo e500,000 IU katatu pazuva kwemazuva 14, kuteverwa kusvika pazuva 14 | Kuvandudzika mu6 pavanhu 9 zvichienzaniswa ne8 pavanhu 9, p yakaenzana ne0.576 | Kubviswa zvachose mu4 pavanhu 9 zvichienzaniswa ne8 pavanhu 9, p yakaenzana ne0.131 | n yakaenzana ne18 pasina kuverengwa kwesimba rechiedzo rekuona musiyano, hapana chikamu chekutarisa kudzoka kwechirwere, chiyero nehurongwa hazvina kugadziridzwa kuti zvinyatsokodzera |
| Chiedzo cheCandida ine chekuita neHIV, varwere 21, vanenge 7 muboka rimwe nerimwe | Kugoverwa zvisina kurongwa mumapoka matatu, fluconazole 100 mg zuva nezuva kwemazuva 14 pamwe neboka rechiedza chete, kuteverwa kusvika pazuva 30 | Vanyori vakashuma kuti chirwere hachina kudzoka muboka rechiedza kusvika pazuva 30, zvichienzaniswa nekudzoka munguva pfupi nefluconazole | Vanyori vakashuma kubviswa kwemapoka efungus mushure mekurapwa nechiedza, kwakagara kusvika pazuva 30 | Vanhu vashoma zvikuru muboka rimwe nerimwe, zviitiko zvinokuvadza zvakashumwa muchidimbu chete, hurongwa hwechikamu chimwe chete hunotadzisa kushandisa mhedzisiro kune mamwe mamiriro |
| Kuzvimba kwemuromo kune chekuita nemazino ekugadzira kweRudzi II, vatori vechikamu 40 | Kugoverwa zvisina kurongwa, jeri remiconazole kana pazuva kwemazuva 15, kuongorora kudzoka kwechirwere pazuva rinenge 30 | Kupera kwezviratidzo neutachiona zvakabatanidzwa mu40 muzana nechiedza pamwe nelaser ine simba rakaderera, zvichienzaniswa ne80 muzana nemiconazole | Yakashumwa yakabatanidzwa, isina kupatsanurwa zvakajeka | Chikamu chimwe chete chephotodynamic pamwe nezvikamu zvelaser, chiyero chemhedzisiro chakabatanidzwa chinotadzisa kupatsanura zvinoitika pamaronda nezvinoitika pakurimwa kwefungus |
Tafura inoratidza maitiro acho. Kana zviedzo zvikaparadzanisa zviyero zviviri izvi zvemhedzisiro, kuvandudzika kwemaronda kunotangira kubviswa kwefungus pakurimwa. Kana zvikazvibatanidza, muverengi haagoni kuziva kuti ndechipi chakanyanya kuunza mhedzisiro. Zvinodzorwa nechiyero chechiedza chitsvuku zvinotsanangura chimwe chikamu chekusiyana uku, nokuti chikamu chedhayi, nguva yainosiyiwa iripo, kureba kwesaisai rechiedza, simba panzvimbo yakati, uye huwandu hwezvikamu zvekurapwa zvinosiyana pamutsara mumwe nomumwe.
Nei marongero ekurapa achisiyana zvakanyanya
Chikamu chedhayi chinobva pa0.01 kusvika pa0.1 muzana muzviedzo zvikuru zvemumuromo. Nguva yainosiyiwa iripo inobva paminiti 1 kusvika pamaminitsi 15. Mamwe marongero anorapa kamwe chete, mamwe achirapa katanhatu mumavhiki maviri. Chiyero chechiedza, huwandu hwenzvimbo dzinovhenekerwa, uye kuti mazino ekugadzira pachawo anovhenekerwa here zvose zvinoshandura simba rinopiwa. Kusiyana uku kunoreva kuti hapana chiyero chimwe chete chemethylene blue paCandida chinogona kupfupikiswa. Huwandu hupi zvahwo hunobatanidzwa hwaizosanganisa marapiro akasiyana pasi pezita rimwe chete.
Kusiyana kwemapoka evanhu kunowedzera chimwe chikamu. Candida inoratidzwa nekutsvuka, chirwere chine rukoko rwakaita seganda, kuzvimba kwemuromo kune chekuita nemazino ekugadzira, uye Candida ine chekuita neHIV zvine maitiro akasiyana uye zvinodzoka nezvikonzero zvakasiyana. Vanopfeka mazino ekugadzira vanotarisana nekudzokazve kwefungus inobva pamusoro pemazino iwayo. Vanhu vane muromo wakaoma, chirwere cheshuga, vanoshandisa mishonga yesteroid inofemerwa mukati, kana vachangobva kushandisa mishonga inorwisa mabhakitiriya vanotarisana nezvikonzero zvakasiyana zvinoita kuti chirwere chidzoke. Mhedzisiro muboka rimwe haingoshande yega kune rimwe boka, uye hapana chimwe chezviedzo izvi zvemumuromo chinoedza zvinotaurwa pamusoro peCandida mumuviri wose kana mumatumbu.
Kuverenga chiedzo cheCandida mumuromo mumaminitsi maviri
Chokutanga, tarisa mutsara unotsanangura boka revanhu. Vanhu vakuru vanopfeka mazino ekugadzira, vanhu vane HIV, uye mapoka evanhu vane Candida mumuromo kazhinji vanopindura mibvunzo yakasiyana. Chechipiri, nyora mushonga wekuenzanisa nawo nehuwandu hwevanhu vari muchiedzo. Musanganiswa wemvura wenystatin, mapiritsi enystatin anonyungudutswa mumuromo, jeri remiconazole, uye fluconazole haisi mishonga yekuenzanisa inogona kungotsinhaniswa, uye zviedzo zvine vatori vechikamu 7 kusvika ku23 muboka rimwe nerimwe zvinongogona kutsigira mhedziso pamusoro pekuti kurapa kunogoneka here. Chechitatu, tsvaga zuva rakaguma kuteverwa. Chiyero chemhedzisiro pazuva 14 kana pazuva 30 chinoyera kupindura kwenguva pfupi, kwete kudzivirirwa kwekudzoka kwechirwere. Chechina, tsvaga huwandu hwakaparadzaniswa hwemaronda nehwemhedzisiro yekurimwa murabhoritari. Kana gwaro richingoshuma kupora kwakabatanidzwa, rione seuchapupu husina kukwana pamubvunzo wefungus.
Kushumwa kwekuchengeteka muzviedzo izvi kushoma, asi pane zvakayerwa kunopa chivimbo. Chiedzo chidiki chokutanga chakashuma munhu mumwe aive nekutsvuka kwemazino nemarwadzo enyama dzakapoteredza mazino, izvo zvakanzi zvakanga zvisina chekuita nekurapwa mushure mekuwanikwa kwechirwere chemazino. Chakashumawo munhu mumwe akarega nekuda kwekuravira nekushatirwa kwenystatin uye mumwe akarega nokuti aifunga kuti kurapwa nechiedza kwakanga kusiri kushanda. Mibvunzo yakakura pamusoro pekuti rukoko runofukidza mukati memuromo runotsungirira kurapwa zvakadii inofanira kutariswa pamwe nedata rekuchengeteka kwekushandisa parukoko irworwo, kwete mumatafura ekushanda kwekurapwa.
Zvinoreva izvi kuvarwere nevarapi
Pachirwere chine chekuita nemazino ekugadzira, mazino acho anoda kutarisirwa pamwe nerukoko rwemumuromo. Ndokusaka mashandisirwo ekutarisira Candida ine chekuita nemazino ekugadzira ari sarudzo yakaparadzana nesarudzo yemushonga unorwa nefungus kana marongero echiedza. PaCandida mumuromo inodzoka, hurongwa hunotarisa zvose zvinoonekwa mugirazi nemhedzisiro yekurimwa murabhoritari hune musoro kupfuura kungotarisa chimwe chete. Zviratidzo nechiyero chekuipa kwemaronda zvinotungamirira kutarisirwa kwekunyaradzwa uye kushanda kwemuromo. Kurimwa zvakare murabhoritari kana kuverengwa kwemapoka efungus kunotungamirira pakuona kana fungus ichiripo mushure mokunge maronda apera.
Pfupiso yakatendeseka yezviri kuzivikanwa iye zvino ndeiyi. Kurapwa kwephotodynamic nemethylene blue kunogona kuderedza maronda nekudzikisa huwandu hwefungus pachirwere cheCandida mumuromo mumazuva kusvika kumavhiki. Kubviswa kwefungus zvachose uye kunogara kwenguva refu pakurimwa murabhoritari hakuratidzwi nguva dzose zvakafanana, uye kuenzaniswa kwakananga nenystatin kana miconazole kune vanhu vashoma zvikuru uye kunoitwa kwenguva pfupi zvikuru kuti kutsigire kutaura kuti marapiro aya akaenzana. Ongororo yakakura ya2025 yezviedzo 16 zvephotodynamic zvakashandisa zvinhu zvakasiyana zvinonzwa chiedza haina kuwana musiyano wakakosha pahuwandu hwekupindura pakurapwa zvichienzaniswa nemishonga inorwisa fungus. Pakanga paine kusiyana kukuru pakati pezviedzo uye kunetseka pamusoro pekurerekera kwemhedzisiro. Izvi zvinopa mamiriro akakura ekunzwisisa nyaya iyi, kwete fungidziro yakanangana nemethylene blue chete.
Ichi chiratidzo chidiki asi chaicho. Chinotsigira kumwe kudzidza kunoshandisa zviyero zvedhayi nechiedza zvakafanana, zviyero zvemhedzisiro zvakaparadzaniswa, uye kuteverwa kwekudzoka kwechirwere. Hachitsigiri mhedziso pamusoro pekushandisa kumba, uye ongororo iyi haipfuuriri kumatumbu kana muropa. Vaverengi vanoda kuona zvakawanda pamusoro pezvidzidzo zvedhayi inomutswa nechiedza vanogona kushandisa pfupiso yezvirwere zvemumuromo zvakadzidzwa nedhayi inomutswa nechiedza pamwe nezviedzo zviviri zvikuru zvakabatanidzwa pamusoro.