Kutheni kunzima ukufihla ulwabiwo lonyango kulingo lwemethylene blue

Amavolontiya alishumi elinesithathu aginya, ngalinye, ikhapsuli engabonisi okungaphakathi, alale kwisixhobo sokuskena, aze enze imisebenzi yenkumbulo. Akukho mntu kwelo gumbi waziyo ukuba ngubani ofumene ichiza. Ingxelo yolingo ichaza uyilo njengolufihlela abathathi-nxaxheba nabaphandi ulwabiwo lonyango, yaye ngelo xesha loo nkcazelo ichanekile. Emva koko wonke umntu uyagoduka, aze wonke umthathi-nxaxheba ofumene imethylene blue achame umchamo oluhlaza okwesibhakabhaka. Ngaba ulwabiwo belufihliwe kolu lingo? Impendulo enyanisekileyo inemida engqongqo kunelo gama: ulwabiwo belufihliwe xa kuthathwa eminye imilinganiselo, kodwa lungafihlwanga xa kuthathwa eminye. Loo mahluko ngowona mxholo upheleleyo wokufihla ulwabiwo lonyango kulingo lwezonyango lwemethylene blue.

Ukufihla ngexesha lokunikwa kwedosi akufani nokufihla kulo lonke ixesha lokulandelela

Ukufihla ulwabiwo lonyango, abaziingcali kwiindlela zophando abaya belubiza ngokuba kukugquma ulwazi, kuthetha ukuba abantu abanokwenza iziphumo zithambekele kwicala elithile abalwazi unyango olwabelweyo. Amaqela amathathu abalulekile: abathathi-nxaxheba, abasebenzi abanxibelelana nabo, nabantu abavavanya iziphumo. Ulwabiwo olwenziwa ngokungakhethiyo kunye nekhapsuli engabonisi okungaphakathi lufihla ulwabiwo ngexesha lokunikwa kwedosi. Kulapho abafundi abaninzi bayeka khona ukucinga, yaye yimpazamo leyo.

Idayi eluhlaza okwesibhakabhaka ityhila ulwazi ngokuhamba kwexesha, yaye ukutyhileka ngakunye kufikelela kwiqela elahlukileyo ngexesha elahlukileyo. Ikhapsuli ifihla umbala xa iginywa. Kwiiyure kamva umchamo uwutyhilela umthathi-nxaxheba. Izixhobo zokubeka esweni zinokuwutyhilela abasebenzi kwangaphambi koko. Ngoko umbuzo ochanekileyo ngalo naluphi na uthelekiso lwemethylene blue neplacebo awungowokuba ulwabiwo belufihliwe ngokubanzi kusini na. Ngowokuba ngubani owayesazi ntoni, yaye nini, ngokunxulumene nomlinganiselo ngamnye.

Yintoni etyhila ulwabiwo

Iimpawu ezityhilayo zezomzimba, zixhomekeke kwidosi, yaye zibhalwe kakuhle:

Umchamo oluhlaza okwesibhakabhaka okanye oxube oluhlaza okwesibhakabhaka noluhlaza okwengca. Olu lolona phawu luphambili kwiidosi ezisezantsi ezithathwa ngomlomo. Luvela kwiiyure ezimbalwa emva kokuginya yaye ludla ngokuhlala malunga nosuku. Kulingo lwaseSan Antonio lokuthatha imifanekiso yomsebenzi womzimba, wonke umthathi-nxaxheba ofumene imethylene blue waxela ukuba uchame umchamo oluhlaza okwesibhakabhaka emva kokushiya iziko lokuthatha imifanekiso, ngoxa kungekho namnye kwiqela leplacebo owaxela naluphi na utshintsho lombala. Olu phawu lomchamo lwafika emva kokuskena, nto leyo ibalulekileyo, njengoko kuza kucaca ngezantsi.

Ilindle eliluhlaza okwesibhakabhaka nolwimi oluluhlaza okwesibhakabhaka. Ezi mpawu zivela okwexeshana emva kokuthatha idosi ngomlomo yaye ziyabonakala kubathathi-nxaxheba nakubani na obaxilongayo.

Ukufakwa kombala kulusu nakumhlophe wamehlo. Kwiidosi eziphezulu ezifakwa emthanjeni, idayi itshintsha umbala wolusu nowendawo emhlophe yamehlo ngendlela ebonakalayo. Olu phawu lufikelela kubasebenzi ngexesha lotyelelo, hayi kumthathi-nxaxheba kuphela emva koko.

Ukuphazamiseka kwezixhobo zokulinganisa. Imethylene blue ifunxa ukukhanya okusetyenziswa zizixhobo ezilinganisa ioksijini egazini ngokubetha kwentliziyo, ngoko imilinganiselo yokugcwala kweoksijini ayithembeki ngexesha lokufakwa kwechiza emthanjeni. Kuphononongo lweKing's College lokuhamba kwegazi ebuchotsheni, iqela alikwazanga ukubeka esweni ukugcwala kweoksijini ngenxa yesi sizathu kanye, nto leyo ethetha ukuba abasebenzi ababekufutshane nomthathi-nxaxheba babenophawu oluvela kwisixhobo olubonisa ukuba kukho into eyahlukileyo.

Qaphela ukungalingani: yonke into etyhilwa yidayi yalatha kwicala elinye. Umthathi-nxaxheba onomchamo oluhlaza okwesibhakabhaka uyazi ukuba ufumene ichiza. Umthathi-nxaxheba onomchamo oqhelekileyo wazi kuphela ukuba mhlawumbi ufumene iplacebo yemethylene blue, ngaphandle kokuba iplacebo ngokwayo yenzelwe ukufaka umbala kumchamo, nto leyo ezingayenziyo ezo sele zizanyiwe ukuza kuthi ga ngoku.

Yintoni eye yazanywa ngokwenene kulingo

Amacandelo eendlela ezisetyenzisiweyo kulingo lokuthatha imifanekiso anika owona mzekelo ufanelekileyo wokuhlalutya, kuba achaza amanyathelo awo okuthintela ukutyhileka ngokweenkcukacha ezingaqhelekanga. Abafundi abalandela ubungqina beedosi ezisezantsi baya kuwaqonda la maphononongo kwiincwadi zophando ngenkumbulo.

Amalingo amabini aseSan Antonio abela abantu abadala abasempilweni ngokungakhethiyo ukuba bafumane 280 mg yemethylene blue yodidi lwe-USP ethathwa ngomlomo (malunga ne-4 mg/kg) okanye iplacebo yombala wokutya we-FD&C Blue No. 2, ezifakwe kwiikhapsuli ezingabonisi okungaphakathi nezikhupha okungaphakathi ngoko nangoko. Iplacebo enombala yayifana noko kwakungaphakathi kwikhapsuli ngexesha lokunikwa kwedosi kodwa yayingafaki umbala kumchamo, ngoko ukulinganisa kwayo kwasilela kanye apho kwakubaluleke khona. Lisazi oku, iqela lolingo lweRadiology longeza inkqubo yokuziphatha: abathathi-nxaxheba bacelwa ukuba bachame ngaphambi kokuthatha ikhapsuli baze bangaphindi bachame de kuphele iseshoni yokuthatha imifanekiso, ngenjongo ethile yokuthintela umbala womchamo ekutyhileni ulwabiwo. Umongikazi wophando owahlukileyo wayegcina isitshixo solwabiwo olungakhethiyo kwizikhongozeli eziphawulwe ngokulandelelana yaye engathathi nxaxheba kwenye into kuphononongo. Ulwabiwo lwahlala lufihliwe kubathathi-nxaxheba, kubongikazi, nakubavavanyi beziphumo de kwagqitywa uhlalutyo, ngokutsho kwengxelo yokuthatha imifanekiso ngeendlela ezininzi. Uphononongo olunxulumeneyo lonxibelelwano lwasebenzisa uyilo olufanayo lwaza lwaxela into efanayo eyenzeka emva koko: liqela lemethylene blue kuphela elaqaphela utshintsho lwethutyana kumbala womchamo emva kokushiya iziko.

Uphononongo lweKing's College lwathatha indlela eyahlukileyo nethetha phandle ngakumbi. Amavolontiya asibhozo asempilweni afumana, ngalinye, iplacebo yeglucose efakwa emthanjeni kunye needosi ezimbini zemethylene blue ezifakwa emthanjeni (0.5 ne-1 mg/kg) ngeentsuku ezahlukeneyo, ngokulandelelana okumiselwe ngokungakhethiyo. Uyilo luchazwa njengolufihla ulwabiwo kwiqela elinye noluthelekisa umthathi-nxaxheba nesiqu sakhe: abaphandi babesazi ukuba kufakwe ntoni emthanjeni, yaye umthathi-nxaxheba ngamnye wayesisiseko sakhe sokuthelekisa phakathi kweeseshoni, njengoko kuchaziwe kwiphepha lokuhamba kwegazi nemetabolism. Xa kusetyenziswa idayi eluhlaza okwesibhakabhaka efakwa emthanjeni, kwakungekho kuzenzisa ukuba abathathi-nxaxheba babengayi kulwazi ulwabiwo kutyelelo olulandelelanayo.

Uncwadi oludala lwezonyango lwengqondo lubonisa indlela yesithathu: idosi ephantsi njengesilawuli esisebenzayo. Ulingo lweminyaka emibini, apho abathathi-nxaxheba batshintshiselana ngonyango, lwemethylene blue kwi-manic depressive psychosis lwasebenzisa 15 mg ngosuku njengemeko yokuthelekisa malunga ne-300 mg ngosuku, inkcukacha ebaliswa kwicandelo lengxoxo lephepha lokuhamba kwegazi nemetabolism. Umsebenzi owenziwa kamva ngesiphumo semethylene blue esenzelwe isifo se-Alzheimer wasebenzisa idosi ephantsi eyayilungiselelwe ekuqaleni ukuba ibe sisilawuli, waza wafumanisa ukuba iziphatha njengonyango. Idosi ephantsi esetyenziswa njengesilawuli ilinganisa iziphumo ebezingalindelekanga neempawu ezibonakalayo ngcono kakhulu kunekhapsuli engenasithako sisebenzayo, kodwa incama into ebalulekileyo: ulingo lunokuqikelela kuphela umahluko phakathi kweedosi, lungaze luqikelele isiphumo sechiza xa lithelekiswa nokungafumani nto.

Olona vavanyo lungqongqo lwengcinga yeplacebo enombala luvela kulingo lwe-PTSD olwathelekisa 260 mg yemethylene blue ethathwa ngomlomo neplacebo ye-indigo carmine kwiikhapsuli ezazibonakala zifana. Abathathi-nxaxheba bade bakhuthazwa ukuba basele amanzi ukuze banciphise ukubonakala kwesiphumo. Utshintsho kumbala womchamo lwasaxelwa ngama-95.6 ekhulwini eqela lemethylene blue xa kuthelekiswa nama-21.1 ekhulwini eqela leplacebo, kulingo lukaTelch noogxa bakhe lokuphelisa impendulo efundiweyo. Idayi ekwikhapsuli ilinganisa indlela idosi elungiselelwe ngayo. Ayilinganisi amava omthathi-nxaxheba.

Ukuthelekisa iindlela zolingo: into iqela ngalinye elalinokuyibona

Le theyibhile linqaku ngendlela eshwankathelweyo. Funda umqolo ngamnye njengolandelelwano lwamaxesha, hayi njengamanqaku omgangatho.

Ulingo	Idosi nendlela yokuyinika	Uyilo oluchaziweyo	Iplacebo	Into abathathi-nxaxheba ababenokuyibona	Into abavavanyi ababenokuyibona	Ngaba impumelelo yokufihla yavavanywa?
Rodriguez et al., Radiology 2016 (n=26)	280 mg yemethylene blue ye-USP ethathwa ngomlomo, idosi enye	Ulwabiwo olungakhethiyo, olufihliweyo kubathathi-nxaxheba nakubaphandi, olulawulwa ngeplacebo	FD&C Blue No. 2 kwiikhapsuli ezingabonisi okungaphakathi	Umchamo oluhlaza okwesibhakabhaka emva kokushiya iziko (kubo bonke abafumene ichiza); akukho nto ngexesha lokuskena, kuncediswa yinkqubo yokungachami	Akukho nto ngexesha lokuskena; ulwabiwo lwahlala lufihliwe ngexesha lohlalutyo lweziphumo de lwagqitywa	Akukho vavanyo lokuqikelela; iingxelo zomchamo zaqokelelwa njengophawu lwechiza oluvela emva kwexesha
Rodriguez et al., Brain Imaging Behav 2017 (n=28)	280 mg yemethylene blue ye-USP ethathwa ngomlomo, idosi enye	Ulwabiwo olungakhethiyo, olufihliweyo kubathathi-nxaxheba nakubaphandi, olulawulwa ngeplacebo	FD&C Blue No. 2 kwiikhapsuli ezingabonisi okungaphakathi	Utshintsho lwethutyana kumbala womchamo emva kokushiya iziko, kwiqela lechiza kuphela	Akukho nto ngexesha lokuskena; ulwabiwo lwalufihliwe kubathathi-nxaxheba nakubaphandi de kwagqitywa uhlalutyo	Akukho vavanyo lokuqikelela luxeliweyo
Singh et al., J Cereb Blood Flow Metab 2023 (n=8)	0.5 ne-1 mg/kg ezifakwa emthanjeni, kunye neplacebo yeglucose, ukutshintshiselana ngonyango	Ulwabiwo olufihliweyo kwiqela elinye, ukuthelekisa umthathi-nxaxheba nesiqu sakhe, ulandelelwano olungakhethiyo	50 mL yesisombululo seglucose	Umchamo oluhlaza okwesibhakabhaka neemvakalelo ezinxulumene nokufakwa emthanjeni phakathi kweeseshoni; ukufihla kutyelelo olulandelelanayo akunakwenzeka ngokuthembekileyo	Abaphandi babengafihlelwanga ulwabiwo ngokoyilo; iziphumo ezilinganiswayo zokuthatha imifanekiso zabalwa ngekhompyutha	Akukho vavanyo lokuqikelela; amanqaku obuqu amandla, imeko yeemvakalelo, neentlungu axelwa ngeseshoni nganye

Zimbini iindlela ezibonakala ngokucacileyo. Okokuqala, akukho nalinye kula mathathu elenze uvavanyo olusesikweni lwempumelelo yokufihla, olufana nokucela abathathi-nxaxheba ukuba baqikelele ulwabiwo lwabo xa behamba. Ukufihla okuchaziweyo yinkcazelo yenkqubo; uvavanyo lokuqikelela bubungqina besiphumo, yaye obo bungqina abukho. Lo msantsa uqhelekile, awuphelelanga kule dayi: uphononongo lwamalingo ali-191 alawulwa ngeplacebo lwafumanisa ukuba malunga nama-2 ekhulwini kuphela avavanya impumelelo yokufihla kubathathi-nxaxheba nakubaphandi okanye kubavavanyi, njengoko kwaxelwa nguFergusson noogxa bakhe. Okwesibini, ixesha lisindisa inxalenye yebango kumalingo edosi ethathwa ngomlomo: uphawu olutyhilayo lwafika emva kokuqokelelwa kwedatha yesixhobo sokuskena, ngoko iziphumo ezilinganiswayo zemifanekiso zalinganiswa xa kwakusengakholeleka ukuba ulwabiwo lufihliwe, kodwa oko kwakunikwa amanqaku kamva kwakungenjalo.

Ukuvavanya uqikelelo kunokwenzeka, yaye olunye ulingo lwemethylene blue lubonisa indlela. Kulingo lwesitofu esifakwa ngaphakathi kwidiski ngenxa yeentlungu ezivela kwidiski, izigulane zazithintelwa ekuboneni isisombululo esitofwayo zaza zabuzwa emva koko ukuba zicinga ukuba zifumene luphi unyango. Malunga neekota ezintathu kwiqela ngalinye zaphendula zathi azazi, kungekho mahluko ubalulekileyo phakathi kwamaqela, ngokutsho kwengxelo yolingo lukaKallewaard. Oku kwahluke ngokohlobo ekubhaleni nje ukuba ulwabiwo lufihliwe kumaqela omabini kwicandelo leendlela. Zikhona izalathisi ezisesikweni ezenzelwe le njongo kanye, ingakumbi isalathisi sokufihla sikaBang esichazwe nguBang noogxa bakhe.

Kutheni ulindelo nabavavanyi bengachaphazeli ngendlela efanayo

Akuba umthathi-nxaxheba eqondile ulwabiwo lwakhe, iziphumo zolindelo zigxila kwiziphumo ezilinganiswayo ezisekelwe kwiimvakalelo zakhe: amanqaku amandla nemeko yeemvakalelo, izikali zeempawu, nemisebenzi exhomekeke kumzamo. Amanqaku obuqu eKing's College abonisa oku kutyhileka. Abathathi-nxaxheba banika amanqaku amandla, imeko yeemvakalelo, neentlungu emva kokufakwa ngakunye emthanjeni, ngexesha apho nabani na ofumene idayi wayenesizathu esaneleyo sokuyazi. Iphepha lixela amanqaku aphezulu amandla kwidosi ephantsi namanqaku eentlungu anyukayo ngokunyuka kwedosi. Loo milinganiselo isenokuba ziziphumo zechiza, ulindelo, okanye zombini, yaye uyilo alunakuzahlula ezi zimbini.

Iziphumo ezilinganiswayo ezingasekelwanga kwiimvakalelo zobuqu zixhathisa ulindelo ngendlela eyahlukileyo. Umthathi-nxaxheba akanakwenza ipateni yeoksijini egazini ivele kwisixhobo sokuskena ngokuyinqwenela nje, nto leyo esesinye sezizathu zokuba iziphumo zemifanekiso zigcine ixabiso lazo elikhulu nangona ukufihla kungagqibelelanga. Kodwa ukungasekelwa kwiimvakalelo zobuqu akuthethi ukungachaphazeleki. Iinkqubo zohlalutyo zibandakanya ukukhethwa kweendawo, imida yokwahlula, nokukhethwa kweemodeli, yaye umhlalutyi olwazi ulwabiwo angalathisa ezo zigqibo kwisiphumo asithandayo. Amaqela aseSan Antonio avala loo msantsa ngokugcina ulwabiwo lufihliwe kulo lonke inqanaba lohlalutyo. Eso sivakalisi sinye kwiindlela zawo sinobunzima obungaphezu kwegama lokufihla kumaqela omabini kwizishwankathelo zawo.

Iindlela eziqhelekileyo zongenelelo olufana nedayi zilandela ngokuthe ngqo: gcina abantu abavavanya iziphumo bohlukile kubantu abanika ichiza, sebenzisa amazwi amiselweyo afanayo xa unxibelelana nabathathi-nxaxheba, khetha iziphumo eziphambili ezilinganiswayo ngaphambi kophawu olutyhilayo apho kunokwenzeka, uze wenze iphepha lemibuzo lokuqikelela xa behamba elinesalathisi esifanelekileyo endaweni yokubanga nje ukuba ukufihla kuqhubekile. Iziphumo zolingo lwenkumbulo zifuna kanye olu hlobo lokufunda isiphumo ngasinye ngokwahlukeneyo.

Indlela yokufunda ibango lokufihla kwimizuzu emihlanu

Sebenzisa olu luhlu kulo naluphi na ulingo lwemethylene blue, uze uzithathe iimpendulo njengezilungisa indlela osijonga ngayo isiphumo ngasinye esilinganiswayo ngokwahlukeneyo, endaweni yokwamkela okanye ukugatya lonke iphepha:

Yintoni kanye eyayisisilawuli: ikhapsuli engenasithako sisebenzayo, iplacebo enombala, okanye idosi ephantsi? Ikhapsuli enombala engafaki mbala kumchamo ifana ngokubonakala kuphela ngexesha lokunikwa kwedosi.
Ngaba ulwabiwo lwalufihliwe ngexesha lokunikwa kwedosi: iikhapsuli ezingabonisi okungaphakathi, izisombululo ezifakwa emthanjeni ezifihliweyo, ulwabiwo olungakhethiyo olwenziwa ngokuzimeleyo?
Ngaba ababhali bazivuma iimpawu ezityhilayo zedayi, yaye bongeza nayiphi na inkqubo yokuzithintela, njengokuchama ngamaxesha acwangcisiweyo okanye ukwahlula iindima zabasebenzi?
Ngubani owachazwa njengofihlelweyo ulwabiwo, yaye de kube nini: ukunikwa kwedosi, uvavanyo, uhlalutyo? Ukufihla okuphela ngaphambi kohlalutyo kubuthathaka kunokufihla okuqhubeka kulo lonke uhlalutyo.
Ngaba isiphumo esiphambili esilinganiswayo sasisekelwe kwiimvakalelo zobuqu okanye sasingasekelwanga kuzo, yaye ngaba salinganiswa ngaphambi okanye emva kophawu olutyhilayo? Idatha ethathwa ngexesha lokuskena namanqaku anikwa emva kotyelelo ami kumacala ahlukeneyo alo mda.
Ngaba ukhona owavavanya ukuba ukufihla kuphumelele: amazinga okuqikelela, isalathisi sokufihla, nayiphi na into engaphaya kwegama loyilo?

Idayi ayenzi ukuba amalingo angathathi cala angabinakwenzeka. Yenza ukuba igama elinye lokufihla linganeli njengesishwankathelo. Indlela idayi eziphatha ngayo emzimbeni iqinisekisa ukuba ulwazi luyatyhileka, yaye uncwadi lweempawu zokhuseleko luqinisekisa ukuba ezi mpawu ezityhilayo ziziphumo eziqhelekileyo zechiza kunokuba zibe ziingozi ezingalindelekanga. Ngoko funda icandelo leendlela njengolandelelwano lwamaxesha olubonisa ukuba ngubani owayenokubona ntoni, yaye nini. Apho umlinganiselo uthathwe ngaphambi komchamo oluhlaza okwesibhakabhaka, wuthembe ngakumbi. Apho uthathwe emva kwawo, bunciphise ubunzima owunika wona ngokufanelekileyo, uze ufune ukuphindwa kolingo ngeziphumo ezilinganiswayo ezingenakuchatshazelwa yidayi.