Chinyorwa
Methylene blue nemigraine: zvinotaurwa nezvekurapa zvichienzaniswa nekutemwa nemusoro mushure mekushandiswa
Methylene blue haisi mushonga wakasimbiswa wekurapa migraine. Zvinyorwa zvekurapa zvakawanikwa pakuongorora uku hazvina kupa muyedzo une boka rekuenzanisa unoratidza kuti inomisa migraine painotanga, inoidzivirira, kana kurapa aura. Mishumo yekudzikira kwekutemwa nemusoro nemishumo yekutemwa nemusoro mushure mekushandiswa zvinogona kuvapo zvese pasina kusimbisa kuti methylene blue inokanganisa sei migraine yakaonekwa nenyanzvi.
Chimwe chinokonzera kuvhiringidzika ndechekuti kutemwa nemusoro kunogona kudzikira kana chikonzero chako charapwa. Methylene blue inoshandiswa muzvipatara kurapa methemoglobinemia inowanikwa mushure mekuberekwa. Chirwere ichocho chinogona pachacho kukonzera kutemwa nemusoro kwakanyanya kunofanana nemigraine. Kubudirira kwekurapa mumamiriro iwayo kunopindura mubvunzo wakasiyana newokuti munhu ane migraine anofanira kutora methylene blue here.
Tsvaga rubatsiro rwechimbichimbi kana ukangoerekana watemwa nemusoro zvakanyanya, ukava neutera hutsva kana kuomerwa nekutaura, ukarasikirwa nekuziva, kana kutemwa nemusoro kuchiperekedzwa nekuomerwa nekufema uye miromo yebhuruu kana yegrey. Usafunga kuti zviratidzo izvi zvinongova kuchinja kunotarisirwa apo muviri unojaira methylene blue. Nhungamiro yeNHS yekutemwa nemusoro inoti kurwadziwa kwakanyanya kunongoerekana kwatanga nezviratidzo zvetsinga zvinoda rubatsiro rwechimbichimbi.
Zvinonyatsoratidzwa nezvinotaurwa nezvemigraine
Hurukuro dzakapihwa dzinoratidza zvakaitika zvinopesana: imwe hurukuro paforamu inotaura nezvekutemwa nemusoro mushure memethylene blue, asi imwe ine zvinotaurwa nezvekudzikira kwekurwadziwa pedyo nekutanga kwemigraine. Izvi zvinhu zvakaonekwa nevaverengi, kwete data rekiriniki rinoratidza kushanda kwemushonga. Hurukuro yechipiri inototaura kuti kusimba kwemushonga uri mumvura kwakanga kusinganyatsozivikanwi, zvichiita kuti zviome kunzwisisa huwandu hwakashandiswa.
Ongororo yekurapa inobatsira yaizosimbisa kuti munhu ane migraine, yotsanangura magadzirirwo emushonga nenzira yaunopiwa nayo, yoenzanisa neboka rekuenzanisa, uye yoyera mhedzisiro yakadai sekusava nekurwadziwa panguva yakatarwa kana kuchinja kwehuwandu hwemazuva ane migraine pamwedzi. Kudzikira kwekutemwa nemusoro kwemunhu mumwe chete hakugoni kutsiva kuenzanisa ikoko kusipo. Migraine inochinja-chinja, vanhu vanowanzotora mimwe mishonga, uye mushonga unogona kutorwa apo migraine yacho iri kutotanga kuchinja.
Tsvakurudzo yenitric oxide inopa chikonzero chinobva pamashandiro emuviri chekuongorora zvinokonzera kutemwa nemusoro, asi haisimbisi methylene blue semushonga. Muongororo yemigraine yaLassen nevamwe ya1998, L-NMMA, mushonga unodzivisa nitric oxide synthase wakapihwa mutsinga, wakaderedza kutemwa nemusoro pamaawa maviri mu10 ve15 vakarapwa, zvichienzaniswa ne2 ve14 muboka rekuenzanisa. Zvisinei, muchiyedzo ichocho vanhu vatatu chete vakapihwa placebo nenzira yekusarudzwa pasina hurongwa; vanhu gumi nemumwe veboka rekuenzanisa vakabva muongororo dzakamboitwa. Chinotonyanya kukosha ndechekuti L-NMMA mushonga wakasiyana. Mhedzisiro yawo haigoni kushandiswa kumethylene blue kana kuzvigadzirwa zvinotengeswa kuti zvinwiwe.
Musiyano iwoyo unoshandawo kutsvakurudzo yemethylene blue mune mamwe mamiriro ekurwadziwa. Maitiro ekurapa kurwadziwa kuri panzvimbo imwe chete kana ongororo yekukuvadzwa kwetsinga hazvisimbisi kuti methylene blue inoshandiswa kurapa migraine.
Tafura yehumbowo: siyanisa mamiriro ekutemwa nemusoro
| Mamiriro | Zvinonyatsotaurwa nehumbowo | Zvahusingagoni kusimbisa |
|---|---|---|
| Migraine yakaonekwa nenyanzvi, ine aura kana isina | Zvakaitika zvinotaurwa paindaneti netsananguro dzemashandiro emuviri; hapana muyedzo wekurapa migraine nemethylene blue une boka rekuenzanisa wakawanikwa pakuongorora uku | Chirongwa chinoshanda chekurapa migraine, kubatsira pakuidzivirira, kana mhedzisiro yakavimbika paaura |
| Kuongororwa kwemashandiro emishonga yemigraine mumiedzo | Ongororo diki yeL-NMMA yakapihwa mutsinga kune vane migraine isina aura, iine vamwe vanhu vakapihwa placebo muongororo dzekare vakashandiswa pakuenzanisa | Kushanda kwemethylene blue, inova kemikari yakasiyana |
| Kutemwa nemusoro kunonzi kunokonzerwa nemethemoglobinemia | Ongororo yakabudiswa ine nyaya yekutemwa nemusoro kwakanyanya, kushanduka kweganda kuva rebhuruu, nezvimwe zviratidzo zvakapera mushure mekurapwa | Kubatsira pakurapa migraine isingakonzerwi nechimwe chirwere mumunhu asina methemoglobinemia |
| Kutemwa nemusoro mushure mejekiseni remethylene blue rakanyorerwa nachiremba | Kutemwa nemusoro kunowanikwa pakati pemhedzisiro isingadiwi yakanyorwa pagwaro rejekiseni rinonyorerwa nachiremba | Kuwanda kwekutemwa nemusoro kana pachishandiswa chigadzirwa chinonwiwa, kana kuti kutemwa nemusoro kwese mushure mekushandiswa kunokonzerwa nedhayi |
| Kutemwa nemusoro kutsva mushure mekushandisa zvisina kunyorerwa nachiremba | Nhoroondo yekurapa inoda kuongororwa nguva yezvakaitika, chigadzirwa, mishonga, uye zviratidzo zvakaperekedza | Kuyera serotonin, kuona chirwere kubva panguva yezvakaitika chete, kana chikonzero chekushandisa zvakare |
Tafura iyi inosiyanisa mapoka akaongororwa nematambudziko ekurapa. Hairatidzi mukana wekuti munhu mumwe chete angava nechimwe nechimwe chazvo.
Nei chinyorwa chemethemoglobinemia chisiri muyedzo wemigraine
Chinyorwa chetsvakurudzo chakapihwa kuti chiongororwe, Kutemwa Nemusoro uye Methemoglobinemia chaKhan nevamwe, chakabuda paindaneti muna 2019 uye mumagazini yaJanuary 2020. Chinoongorora kutemwa nemusoro kunokonzerwa nechimwe chirwere uye chinosanganisira murwere aiva nekurwadziwa kwakanyanya mumusoro wese, kunzwa kubayiwa-bayiwa kutenderedza muromo, miromo nemaoko zvebhuruu, kusvotwa, uye kupererwa nemweya paaiita basa rinoda simba. Zviratidzo zvakapera mushure mekurapwa nemethylene blue.
Methemoglobinemia inochinja hemoglobin zvekuti ropa harigoni kuendesa okisijeni sezvarinofanira kuita. Kurapa dambudziko iroro reropa kunogona kuderedza zviratidzo zvaro. Mushumo uyu unoyambira kuti zviratidzo zvaro zvinogona kufungidzirwa zvisizvo semigraine inoperekedzwa nekushushikana kana kufema zvakanyanyisa. Hauna kugovera vanhu vane migraine isingakonzerwi nechimwe chirwere mumapoka emethylene blue kana placebo nenzira yekusarudzwa pasina hurongwa, uye kupindura kwacho pakurapwa hakuratidzi kudzivirirwa kana kudzikira kwemigraine yakajairika. Tsananguro yakazara yekurapwa kwemethemoglobinemia muchipatara inotaura nezvekushandiswa uku.
Kuvaverengi vari kutsvaga chaizvo nezve“methylene blue neaura yemigraine,” tsamba yakazobudiswa inotsanangura methemoglobinemia inofanana nemigraine ine aura yekuona. Izvi zvinoratidza kufanana kwezviratidzo pakuona chirwere, kwete humbowo hwekurapa aura nemethylene blue. Chinyorwa chinowanikwa paPubMed hachina pfupiso, saka ruzivo rwekurapwa kwemurwere iyeye harugoni kufungidzirwa kubva pamusoro wacho.
Kutemwa nemusoro mushure mekushandisa hakusi muyedzo weserotonin
Gwaro rekunyorera PROVAYBLUE rinonyora kutemwa nemusoro pakati pemhedzisiro isingadiwi yakashumwa. Data iroro rinotaura nezvechigadzirwa chinonyorerwa nachiremba chinopihwa mutsinga kuvarwere vane methemoglobinemia. Haripi chiyero chengozi yemushonga unonwiwa une zvinhu zvakasiyana uye unoshandiswa nenzira yakasiyana.
Mukuita kwekurapa, kutemwa nemusoro kutsva kunogona kuva mhedzisiro isingadiwi, migraine yawakajaira, rimwe dambudziko rekutemwa nemusoro, kana chikamu chechimwe chirwere. Nguva yezvakaitika inokosha, asi kuti chinhu chakaitika “mushure” hachikwani kuratidza kuti chakaitika “nekuda kwechimwe.” Nyora zvakaitika uye tsvaga zano usati washandisazve chigadzirwa chisina kunyorerwa nachiremba. Usashandisa zvakare kuti uedze hukama hwacho kana kuwedzera mumwe mushonga kuti upikisane nemhedzisiro yacho.
Kunetseka pamusoro pekudyidzana kwemishonga kune hwaro: miedzo yakashandisa maenzyme evanhu akacheneswa inoratidza kuti methylene blue inodzivisa monoamine oxidase A. Asi kutemwa nemusoro hakuratidzi huwandu hweserotonin hwemunhu. Kudzikira kwezviratidzo mushure mekushandisa chimwe chinhu kana kusatemwa nemusoro hazvigoni kusimbisa kana kuramba kuvapo kwekukuvadzwa nemuviri kunokonzerwa neserotonin yakawandisa.
Tarisa mazita chaiwo emishonga yemigraine
Kurapa migraine kunogona kusanganisira mishonga yemapoka akasiyana. Gwaro resumatriptan rinorambidza kuishandisa pamwe chete nemushonga unodzivisa MAO-A. Mimwe mishonga inoshandiswa kudzivirira migraine, kusanganisira mishonga yekurapa kuora mwoyo, inodawo kucherechedzwa. Gwaro rejekiseni remethylene blue rinoyambira nezveserotonin syndrome kana rikashandiswa nemishonga inokanganisa serotonin kana maopioid. Nyanzvi yemishonga inoda mazita chaiwo emishonga, kwete kungoti “mushonga wemigraine.”
Tsvaga rubatsiro rwekurapa rwechimbichimbi mushure mekushandisa kana kusagadzikana kana kuvhiringidzika zvikaitika pamwe chete nefivha, kudikitira kwakanyanya, kudedera, kuomarara kwemhasuru, kana kupfura-pfura kwemhasuru. Kusangana kwezviratidzo izvi kunonyanya kunetsa kupfuura kutemwa nemusoro kwega. Usarega mushonga wekudzivirira migraine wawakanyorerwa kuti uwane mukana wekushandisa methylene blue, kana kuzvigadzirira nguva yekumirira kuti mushonga wapera mumuviri. Nhungamiro yekudyidzana kwemishonga inotsanangura mapoka akakodzera kutariswa; kusavapo pamazita mashoma hakurevi kuti kushandisa kwakachengeteka.
Nyora zvakaitika usinganonoki kutsvaga kurapwa
Dhawunirodha pepa rekunyora nhoroondo yezviratidzo kuti uende naro paunoona nyanzvi. Rinonyora zvakaitika pane kuona chirwere kana kupa zano rekurapa.
Tsanangura kana kurwadziwa uku kuchifanana nemaitiro ako awakajaira, kuti kwakatanga riini zvichienzaniswa nenguva yawakashandisa chigadzirwa, zvawakatora, uye zvimwe zviratidzo zvakaitika. Nyora kuchinja kwemishonga yaunogara uchishandisa yekutemwa nemusoro uye kuti unoshandisa kangani mishonga yekurapa kutemwa nemusoro pakunotanga. Kushandisa kakawanda kunogona pachako kuomesa kuongororwa kwekutemwa nemusoro.
Nhungamiro yeNICE yekuongorora kutemwa nemusoro inotsigira kunyora kuti kutemwa nemusoro kunoitika kangani, kunotora nguva yakareba sei, kwakanyanya zvakadini, zviratidzo zvinoperekedza, mishonga, uye zvingangokumutsa. Inosiyanisawo aura yakajairika inotanga zvishoma nezvishoma yopazopera nezviratidzo zvinoda kuongororwazve. Chiitiko chekutanga kana chakasiyana zvikuru chine chekuita nekuona kana tsinga hachifaniri kungonzi “iaura chete” zvichibva pane zvakataurwa paindaneti.
Kana ukava nekutemwa nemusoro kutsva kana kunoramba kuripo mushure mekushandisa, enda nemudziyo wacho kana mufananidzo wakajeka wegwaro rechigadzirwa pamwe chete nepepa rawazadza kuna chiremba kana nyanzvi yemishonga. Nhungamiro yakazara yekuchengeteka uye mibvunzo yekukurukura nenyanzvi yezvekurapa zvinobatsira kuronga hurukuro iyoyo ichitarisa chigadzirwa chaicho uye mashandisirwo aunoda kuita.