Inqaku
Ingaba i-methylene blue inyanga i-UTI? Iimpawu, usulelo, namayeza adityanisiweyo
I-methylene blue yodwa ayilonyango olusekiweyo losulelo lwebhaktiriya kumjelo womchamo. Ukubakho kwayo kwiyeza elidityanisiweyo leengxaki zomchamo akubonisi ukuba ibhotile ye-methylene blue yodwa iya kunyanga ukudumba kwesinyi, ithintele ukuphinda kwalo, okanye inyange usulelo lwedlala lobudoda. Uphononongo lwezonyango oluxoxwa ngezantsi lwavavanya amayeza adityanisiweyo lwaza kamva longeza amayeza okubulala iibhaktiriya.
Umahluko wokuqala oluncedo uphakathi kokuziva ngcono kunye nokunyanga unobangela. Zombini zibalulekile. Iyeza linganciphisa ukuqaqamba kwesinyi okubangelwa kukuxhuzula kwezihlunu ngoxa iibhaktiriya zisekhona; iimpawu nazo zinokuqhubeka naxa usulelo lwebhaktiriya lungasenguye unobangela. Isikhokelo se-NIDDK sokunyanga usulelo lwesinyi sahlula amayeza okubulala iibhaktiriya asetyenziselwa usulelo lwebhaktiriya kumayeza eentlungu nakuvavanyo olongezelelweyo xa usulelo lungenakuqinisekiswa.
Oko kunokuqinisekiswa ziimpawu zomchamo
Ukutshisa, imfuneko engxamisekileyo yokuchama, ukuchama rhoqo, nokungakhululeki kumazantsi esisu kunokwenzeka xa kukho i-UTI. Noko ke, ezi mpawu zichaza oko umntu akuvayo, kunokuba zichonge unobangela. I-cystitis ithetha ukudumba kwesinyi; ukudumba kwesinyi okubangelwa ziibhaktiriya ngomnye unobangela, ngoxa i-interstitial cystitis/isifo seentlungu zesinyi iyingxaki eyahlukileyo ekufuneka ifunyaniswe.
Uvavanyo losulelo lwesinyi ludibanisa imbali yezempilo, ukuhlolwa, neemvavanyo ezifanelekileyo. Uhlalutyo lomchamo lunokufumanisa izinto ezifana neeseli ezimhlophe zegazi negazi. Uvavanyo lokukhulisa iibhaktiriya kwisampuli yomchamo lujonga ukukhula kweebhaktiriya kwaye lunokunceda ekukhetheni iyeza lokuzibulala. Ezi mvavanyo ziphendula imibuzo eyahlukileyo, ngoko amazwi athi “uvavanyo lwam lomchamo alufumananga nto” afuna ukucaciswa: loluphi uvavanyo, lwenziwa nini, kwaye lwenziwa nini xa kuthelekiswa nonyango?
Iimpawu eziqhubekayo ngoxa iimvavanyo zingafumani nto zifuna ukuqwalaselwa. Ukungafumaneki kweebhaktiriya kuvavanyo lokuzikhulisa akusosizathu sokungahoyi iintlungu, kodwa iintlungu nazo aziqinisekisi usulelo olufihlakeleyo. Ingxelo yesikhundla yoMbutho we-Urology wase-Australia naseNew Zealand iyavuma ukuba kukho imida ekufumaniseni isifo kwaye icebisa uvavanyo olulungiselelwe umntu ngamnye. Isiphumo kufuneka sitolikwe kunye neempawu nezinye izinto ezifunyenweyo, endaweni yokuba sibe sisizathu sokuqalisa ngokuphindaphindiweyo unyango lokubulala iintsholongwane olungabekwanga esweni.
Ukuthomalalisa iimpawu xa kuthelekiswa nokunyanga usulelo
Sebenzisa olu thelekiso xa uvavanya ibango ngemveliso okanye uxoxa ngempendulo kunyango. Lwahlula oko kubonwayo kwisigqibo esinokuxhaswa kuko.
| Oko kubonwayo okanye into ekujoliswe kuyo ngonyango | Oko kunokukuxelela kona | Oko kungenakukuqinisekisa kukodwa |
|---|---|---|
| Ukuncipha kokutshisa, kwemfuneko engxamisekileyo yokuchama, okanye kokuxhuzula kwezihlunu zesinyi | Iimpawu ziphucukile, nto leyo esisiphumo esibalulekileyo | Ukuba iibhaktiriya zazikho ekuqaleni okanye ziphelisiwe |
| Ukusebenza ngokuchasene neebhaktiriya phantsi kweemeko zaselebhu | Into ethile ichaphazela iibhaktiriya phantsi kweemeko ezivavanyiweyo | Ukuba imveliso ethathwa ngomlomo ifikelela ngokukhuselekileyo kumlinganiselo osebenzayo kumjelo womchamo wesigulana |
| Ukungafumaneki kweebhaktiriya kuvavanyo lokukhulisa iibhaktiriya kumchamo | Akukho kukhula kweebhaktiriya okufanele kuxelwe okufunyenweyo phantsi kweemeko zolo vavanyo | Isizathu sokuqhubeka kweempawu, okanye ukuba imveliso ethile ibangele eso siphumo |
| Unyango lwe-UTI yebhaktiriya olukhokelwa yingcali yezonyango | Unyango lujongene nosulelo oluvavanyiweyo, kunye nokulandelwa okusekelwe kwimeko yezonyango | Ukuba isiganeko ngasinye sexesha elizayo sinobangela omnye okanye sifuna iyeza elifanayo |
| Umchamo oluhlaza okwesibhakabhaka okanye oluhlaza emva kokusebenzisa i-methylene blue | Idayi inokutshintsha umbala womchamo | Ukubulawa kweebhaktiriya, impumelelo yonyango, okanye umlinganiselo wobuzaza bosulelo |
Umzekelo, umntu uqala ukusebenzisa ipilisi enamayeza adityanisiweyo aze axele ukuba ukuqaqamba ngenxa yokuxhuzula kwezihlunu kunciphile ngaloo ngokuhlwa. Olu lulwazi oluluncedo ngeempawu. Ukuze kuthiwe i-methylene blue inyange usulelo, kusekho eminye imibuzo: ngaba lwalukho usulelo, yintoni enye eyayikwipilisi, ngaba amayeza okubulala iibhaktiriya nawo asetyenziswa, kwaye kwenzeka ntoni kuvavanyo lokulandelela?
Kutheni amayeza adityanisiweyo ahlukile
Ileyibhile yeekhapsuli ze-Uribel ekwi-DailyMed ichaza ukuthomalaliswa kweempawu zomchamo ezibangelwa kukucaphuka. Izithako zayo zinendima ezahlukeneyo ezichaziweyo:
| Isithako | Indima echazwe kule leyibhile yeekhapsuli |
|---|---|
| Hyoscyamine | Ikhulula izihlunu ezigudileyo ukuze inciphise ukuxhuzula kwazo |
| Phenyl salicylate | Ikhupha i-salicylate ukuze ithomalalise iintlungu |
| Methenamine | Ikhupha i-formaldehyde kumchamo oneasidi, nto leyo eyenza isebenze ngokuchasene neebhaktiriya |
| Sodium phosphate monobasic | Inceda ukugcina umchamo uneasidi efunekayo ukuze i-methenamine isebenze |
| Methylene blue | Ineempawu ezibuthathaka zokuthintela iintsholongwane; inokutshintsha umbala womchamo |
Le leyibhile ichaza ngokucacileyo ukuba i-FDA ayikuvumanga okubhalwe kwileyibhile okanye ayifumanisanga ukuba le mveliso ikhuselekile kwaye iyasebenza. Ukudweliswa kwi-DailyMed akusiso isiqinisekiso sokuvunywa. Imixube iyahluka, ngoko jonga ipakethe yokwenene endaweni yokusebenzisa le theyibhile kuyo yonke imveliso enegama elifanayo. Isikhokelo sethu samayeza adityanisiweyo eengxaki zomchamo ane-methylene blue sichaza umahluko phakathi kweemveliso.
I-methenamine ne-methylene blue zizinto ezahlukeneyo. Iingcebiso ze-NICE nge-UTI ephindayo ziquka i-methenamine hippurate njengokhetho lokuthintela kwizigulana ezikhethiweyo emva kokuba nayiphi na i-UTI ekhoyo inyangiwe ngokwaneleyo. Loo ngcebiso ayiqinisekisi ukuba i-methylene blue iyaluthintela usulelo, okanye ukuba umxube wamayeza wokuthomalalisa iimpawu unokusetyenziswa endaweni ye-methenamine hippurate.
Oko kwalinganiswa ngokwenene luvavanyo lwamayeza adityanisiweyo
Uvavanyo luka-2020 lukaGama noogxa bakhe, olwabela amaqela ngokungakhethiyo nolwalufihla ulwabiwo kubathathi-nxaxheba nakubaphandi lwabhalisa abantu abadala abangama-288 ababenokudumba kwesinyi okuphindayo, phantse bonke bengabasetyhini. Lwathelekisa i-methenamine kunye ne-methylene blue ezithathwa ngomlomo nomxube onezo zithako kunye ne-acriflavine ne-belladonna. Kwakungekho qela lisebenzisa i-methylene blue kuphela kwaye kwakungekho qela lifumana i-placebo.
Isiphumo esiphambili yayikukuphucuka kwicandelo lephepha lemibuzo elijongene nokuchama rhoqo ngendlela eqhelekileyo emva kweentsuku ezintathu. Ukuphucuka kwenzeka kwi-69.4% nakwi-72.2% yamaqela, ngokulandelelana, kungekho mahluko ubalulekileyo phakathi kwamaqela. Emva koko kongezwa amayeza okubulala iibhaktiriya akhethwe ngokweziphumo zovavanyo lokukhulisa iibhaktiriya kwiintsuku ezintathu zokugqibela zophononongo lweentsuku ezintandathu.
Ngoko ke olu phononongo lunika ulwazi ngeempawu zexesha elifutshane ngexesha lokusebenzisa indlela yonyango ngamayeza adityanisiweyo phantsi kweliso lengcali. Alukwazi ukwahlula igalelo le-methylene blue, ukubonisa ukuba iyodwa iphelisa iibhaktiriya, okanye ukuqinisekisa ukuthintela ixesha elide. Inkqubo yalo ayiloluhlu lonyango lwasekhaya, kwaye iziphumo zalo aziqinisekisi ukusebenza kwayo ekunyangeni ukudumba kwedlala lobudoda okungapheliyo okubangelwa ziibhaktiriya.
Iintlungu zesinyi eziqhubekayo, ukudumba kwedlala lobudoda, namatye
Xa iimpawu ziphinda, uvavanyo kufuneka lwahlule usulelo oluphindayo kwimeko eqhubekayo ebangela iimpawu. I-interstitial cystitis ifunyaniswa ngokuvavanya iimpawu nangokukhupha ezinye iingcaciso ezinokwenzeka, kusetyenziswa imbali yezempilo, ukuhlolwa, neemvavanyo njengoko kufanelekile. Ayifunyaniswa nje kuba uvavanyo olunye lokukhulisa iibhaktiriya lungazifumananga.
Lo mahluko ubalulekile nakumadoda aneentlungu kummandla wesinqe, iintlungu xa echama, okanye “ukudumba kwedlala lobudoda” okubonakala kungaze kuphele. I-NIDDK yahlula ukudumba kwedlala lobudoda okubangelwa ziibhaktiriya ekudumbeni kwedlala lobudoda okungapheliyo, apho usulelo ludla ngokungafumaneki. Isifo seentlungu ezingapheliyo kummandla wesinqe sinokufuna indlela eyahlukileyo kuleyo yokunyanga usulelo lwedlala lobudoda oluqinisekisiweyo. Iimpawu zomchamo okanye ukuphucuka okwethutyana emva kokusebenzisa into yonyango azichongi intsholongwane ebangela ingxaki.
Amabango ngamatye afuna ubungqina obahlukileyo. Ilitye elingasabonakali kumfanekiso weskena owenziwe kamva alibonisi ukuba i-methylene blue ilinyibilikisile, kwaye utshintsho kwiintlungu alulinganisi ukwakheka okanye ubukhulu belitye. Uvavanyo nonyango lwamatye luxhomekeke kwiimpawu zelitye. Uvavanyo lwamayeza adityanisiweyo olungasentla aluzange lubandakanye abantu ababenembali yamatye ezintso. Aluniki bungqina bokunyibilikiswa kwamatye.
Yiza nolu lwazi kwidinga lakho
Sebenzisa olu luhlu ukuze kube lula ukuvavanya iimpawu eziphindayo. Bhala phantsi oko ukubonayo ngaphandle kokugqiba kwangaphambili ukuba isiganeko ngasinye sibangelwa ziibhaktiriya.
- Ulandelelwano lwexesha lweempawu: usuku lokuqala, indawo yeentlungu, ukuchama kangaphi, umkhuhlane, igazi elibonakalayo, nokuba iintlungu ziyatshintsha na xa isinyi sigcwala okanye sikhupha umchamo. Qaphela amaxesha angenazimpawu kwaye, xa kufanelekile, iintlungu kummandla wesinqe okanye ezinxulumene nokukhutshwa kwamadlozi.
- Iingxelo zokwenene zeemvavanyo: uhlalutyo lomchamo, uvavanyo lokukhulisa iibhaktiriya, iziphumo zokuba iibhaktiriya zichaphazeleka ngawaphi amayeza, nemifanekiso yezonyango. Quka imihla nokuba iisampuli zathathwa ngaphambi okanye emva kwamayeza okubulala iibhaktiriya okanye amayeza eengxaki zomchamo.
- Ulandelelwano lwexesha lonyango: amagama amayeza okubulala iibhaktiriya nawokuthomalalisa iimpawu, imihla yokusetyenziswa, utshintsho oluphawulweyo, neziphumo ezingathandekiyo. Yiza neefoto zeeleyibhile zeemveliso ezidityanisiweyo nayo nayiphi na ileyibhile ye-methylene blue yodwa.
- Ulwazi olufanelekileyo ngempilo namayeza: ukuba kunokwenzeka ukuba ukhulelwe, iingxaki zezintso, amatye angaphambili, ubunzima bokukhupha wonke umchamo esinyini, ukwalana nezinto, nawo onke amayeza kagqirha nezongezelelo. Ingxelo yesiganeko seyeza elithathwa ngomlomo lokuthomalalisa iintlungu zomchamo yachaza ubuthi be-serotonin obunxulumene nemveliso ene-methylene blue, nto leyo eyenza ukuba kubaluleke ngokukhethekileyo ukuchaza amayeza okudakumba namanye amayeza achaphazela i-serotonin.
- Umbuzo wokulandelela: “Yintoni exhasa ukuba kukho usulelo kwesi siganeko, yintoni ejoliswe ekuthomalaliseni iimpawu, kwaye kufuneka kwenzeke ntoni ukuba iimpawu ziyaqhubeka?” Sebenzisa isikhokelo esibanzi semibuzo nge-methylene blue onokuyibuza ingcali yezonyango kwingxoxo ejolise kumayeza athile.
Qhagamshelana nengcali yezempilo xa ukrokrela usulelo lwesinyi. Funa uncedo lonyango olungxamisekileyo xa kukho iimpawu ezinokuba zezokusuleleka kwezintso, kuquka umkhuhlane okanye ukugodola, iintlungu zomqolo okanye zecala lomzimba, okanye ukugabha. Ukungakwazi ukuchama nako kufuna uvavanyo olungxamisekileyo. Musa ukulinda ukuba idayi okanye iyeza lokuthomalalisa iimpawu lisebenze kwezi meko.