Isihloko
I-methylene blue yokutheleleka nge-Candida emlonyeni: lokho okuboniswa izivivinyo ze-photodynamic ezigulini
Isiguli sibuka esibukweni, sibone ukuthi amabala amhlophe asephelile, bese siphetha ngokuthi nesikhunta sesiphelile. Leso siphetho sibonakala sinengqondo. Ezivivinyweni ze-methylene blue eyenziwa isebenze ukukhanya ekuthelelekeni ngesikhunta emlonyeni, yiso futhi isiphetho esidala ukudideka okukhulu kakhulu.
Ukwelashwa kunezingxenye ezintathu, futhi ingxenye ngayinye yenza umsebenzi ohlukile. I-methylene blue imboza isilonda, ukukhanya okubomvu kuvusa udayi, bese udayi ovusiwe udlulisela amandla kumoya-mpilo ukuze kwakheke izinhlobo zamakhemikhali ezisebenzayo eziphila isikhathi esifushane ezilimaza amangqamuzana amagciwane aseduze. Imininingwane yokuthi i-methylene blue isebenza kanjani njengento ezwela ukukhanya ibalulekile, ngoba ngaphandle kokukhanya lowo dayi ofanayo unamandla amancane kakhulu okulwa namagciwane. Umbuzo wezokwelapha ugxile kakhudlwana: lapho lolu chungechunge lusetshenziswa ku-candidiasis yomlomo, yini ethuthukayo, ukubukeka komlomo noma umphumela wokukhuliswa kwesampula yesikhunta, futhi lokho kuhlala isikhathi esingakanani.
Lo mehluko uyisisekelo sakho konke okulandelayo. Ukusabela kwezimpawu kusho izilonda ezibonakalayo ezimbalwa, ububomvu noma ulwelwesi-mbumbulu oluncane, nobuhlungu noma ukushisa okuncane. Ukusabela okuphathelene nesikhunta kusho amayunithi ambalwa akha amakoloni esampuleni ekhulisiwe noma ukususwa okuphelele kwesikhunta. Umlomo ungahlangabezana nencazelo yokuqala kodwa ungahlangabezani neyesibili.
Lokho okwahlolwa izivivinyo ezimbili eziyisisekelo
Isivivinyo esihlobene ngokuqondile kakhulu nabantu abadala abane-candidiasis yomlomo ebangela ububomvu sabela ababambiqhaza abangu-41 ngokungahleliwe ekwelashweni nge-methylene blue ne-photodynamic noma ekwelashweni ngomuthi owuketshezi lwe-nystatin, iqembu elisebenzisa ukukhanya lithola izikhathi zokwelashwa masonto onke kuze kube amasonto amane. Ukujiya kukadayi kwakungamaphesenti angu-0.1, ushiywe imizuzu engu-15 ngaphambi kokukhanyiswa, bese kusetshenziswa ukukhanya kwe-laser okungu-660 nm ngamandla angu-4 joules ephuzwini ngalinye imizuzwana engu-40 ephuzwini ngalinye, inani lamaphuzu linqunywa ukusabalala kwesilonda. Umuthi wokuqhathanisa wawuwuketshezi lwe-nystatin lomlomo olungu-100,000 IU olwalusetshenziswa ukugeza umlomo nsuku zonke cishe izinsuku ezingu-21. Ukulandelela kwakwenziwa masonto onke ngesikhathi sokwelashwa, kungabikwanga isigaba esinwetshiwe sokuhlola ukubuya kwesifo. Isifinyezo esishicilelwe sibika ukunyamalala okuphelele kwezilonda ezimweni ezingu-16 kwezingu-17 ezahlolwa eqenjini le-nystatin nasezimweni ezingu-16 kwezingu-19 ezahlolwa eqenjini le-photodynamic. Kuyafaneleka ukuqaphela le mininingwane yamanani asetshenziswe ukubala imiphumela, ngoba ihlukile kubantu abangu-18 nabangu-23 ababelwa ngokungahleliwe, futhi isivivinyo asitholanga ukuthi iqembu elisebenzisa ukukhanya lenza kangcono. Izilonda ezinzima zazinamathuba amancane okuphela kuwo womabili amaqembu. Amanani esikhunta ehla ngemva kwesikhathi sokuqala sokwelashwa ngokukhanya, kodwa umbiko usekela ukuncipha okusheshayo kunokuba ufakazele ukuqedwa ngokuphelele. Umbiko ogcwele uyatholakala esivivinyweni esisebenzisa ukwabiwa ngokungahleliwe sokwelashwa nge-photodynamic kwe-candidiasis ebangela ububomvu.
Isivivinyo sesibili esiyisisekelo siwucwaningo oluncane lokuqala lokuhlola, oluwubeka ngokucacile umehluko phakathi kokusabela kwezimpawu nokusabela okuphathelene nesikhunta. Abantu abadala abayishumi nesishiyagalombili abane-candidiasis yomlomo eqinisekiswe ngokuhlolwa kwezimpawu nangokuhlolwa kwesikhunta babelwa ngokungahleliwe ngamaqoqo, abangu-9 eqenjini ngalinye, kwathi abangu-16 baqeda isivivinyo. Abantu abanesifo sikashukela, abasebenzisa amazinyo okufakelwa, abake bathola ama-antibiotic, noma abanenhlanzeko engeyinhle babengabhalisa, kuyilapho ababene-HIV eqinisekisiwe babengafakwa. Iqembu elisebenzisa ukukhanya lasebenzisa ukujiya kukadayi okuphansi kakhulu, okungu-0.1 mg nge-mL ngayinye, udayi ushiywe umzuzu ongu-1 ngaphambi kokukhanyiswa, nokukhanya kwe-diode okungu-660 nm ngamandla angu-1.2 kuya ku-3.3 joules nge-cm2 ngayinye cishe imizuzwana engu-60 endaweni ngayinye, izikhathi eziyisithupha zokwelashwa emasontweni amabili. Umuthi wokuqhathanisa wawungamaphilisi e-nystatin ancibilika emlonyeni angu-500,000 IU kathathu ngosuku izinsuku ezingu-14. Ukulandelela kwaphela ngosuku lwe-14, kungabikho ukuhlolwa kokubuya kwesifo kamuva. Ukusabela kwezimpawu kwafinyelela kwabangu-6 kwabangu-9 ngokwelashwa nge-photodynamic uma kuqhathaniswa nabangu-8 kwabangu-9 nge-nystatin. Ukusabela okuphathelene nesikhunta kwakungu-5 kwabangu-9 uma kuqhathaniswa nabangu-8 kwabangu-9, futhi ukususwa okuphelele kwesikhunta kwakungu-4 kwabangu-9 uma kuqhathaniswa nabangu-8 kwabangu-9. Awukho umehluko owafinyelela ekubalulekeni ngokwezibalo, okuyinto elindelekile esivivinyweni esincane kangaka. Okutholakele okuwusizo yigebe elikhona ngaphakathi kweqembu elisebenzisa ukukhanya uqobo: ukusabela kwezimpawu ngamaphesenti angu-66.7 uma kuqhathaniswa nokususwa okuphelele kwesikhunta ngamaphesenti angu-44.4. Izilonda zathuthuka kaningi kunokuba isikhunta siphele emasampuleni akhulisiwe. Azikho izehlakalo ezimbi ezinkulu ezenzeka. Indlela isivivinyo esasihlelwe ngayo namanani kuchazwe ocwaningweni lokuqala lokuhlola ukuthi ukwelashwa kwe-candidiasis yomlomo kungenzeka yini endaweni yokwelashwa kwamazinyo.
Abafundi abafuna ulwazi nge-methylene blue yokutheleleka ngesikhunta noma nge-methylene blue yokutheleleka ngesikhunta emlonyeni kufanele bakhumbule lelo gebe ngaphambi kokufunda noma yiliphi izinga lokwelapheka elibekwe esihlokweni. Isilinganiso sokwelapheka esihlanganisa izimpawu nemiphumela yamasampula akhulisiwe sifihla lona kanye ulwazi oludingwa isiguli esinezimpawu ezibuya njalo.
Imiphumela yezimpawu uma iqhathaniswa nemiphumela ephathelene nesikhunta
| Isivivinyo neqembu labantu | Ukuhlelwa, okuqhathaniswa nakho, ukulandelela | Umphumela wezimpawu zezilonda | Umphumela ophathelene nesikhunta | Imikhawulo ebalulekile |
|---|---|---|---|---|
| Medeiros 2023, abantu abadala abane-candidiasis yomlomo ebangela ububomvu, kwahlaziywa abangu-41 | Ukwabiwa ngokungahleliwe, uketshezi lwe-nystatin olungu-100,000 IU lokugeza umlomo nsuku zonke cishe izinsuku ezingu-21, ukulandelela masonto onke kuze kube amasonto angu-4 | Ukunyamalala okuphelele cishe ngamaphesenti angu-84 ngokwelashwa ngokukhanya uma kuqhathaniswa cishe namaphesenti angu-94 nge-nystatin, akubonakalanga ukuthi olunye lwenza kangcono | Amanani e-Candida ehla ngemva kwesikhathi sokuqala sokwelashwa, ukuqedwa ngokuphelele akuzange kuqinisekiswe | Isampula encane, ukulandelela okufushane, amanani asetshenziswe ukubala ukunyamalala kwezilonda awahambisani nengqikithi yababelwa ngokungahleliwe, izilonda ezinzima zazimbalwa phakathi kwezaphela |
| Zhou 2026, abantu abadala abane-candidiasis yomlomo eqinisekisiwe, abangu-18 babelwa ngokungahleliwe | Isivivinyo sokuqala esisebenzisa ukwabiwa ngokungahleliwe, amaphilisi e-nystatin ancibilika emlonyeni angu-500,000 IU kathathu ngosuku izinsuku ezingu-14, ukulandelela kuze kube usuku lwe-14 | Ukusabela kwabangu-6 kwabangu-9 uma kuqhathaniswa nabangu-8 kwabangu-9, p ulingana no-0.576 | Ukususwa okuphelele kwabangu-4 kwabangu-9 uma kuqhathaniswa nabangu-8 kwabangu-9, p ulingana no-0.131 | n ulingana no-18 ngaphandle kokubalwa kwamandla esivivinyo okuthola umehluko ngokwezibalo, asikho isigaba sokuhlola ukubuya kwesifo, umthamo nohlelo lokwelashwa akuzange kuthuthukiswe ukuze kube okufanele kakhulu |
| Isivivinyo se-candidiasis ehlobene ne-HIV, iziguli ezingu-21 cishe ezingu-7 eqenjini ngalinye | Ukwabiwa ngokungahleliwe emaqenjini amathathu, i-fluconazole engu-100 mg nsuku zonke izinsuku ezingu-14 kanye neqembu elisebenzisa ukukhanya kuphela, ukulandelela kuze kube usuku lwe-30 | Ababhali babika ukuthi isifo asibuyanga eqenjini elisebenzisa ukukhanya kuze kube usuku lwe-30 uma kuqhathaniswa nokubuya ngesikhathi esifushane nge-fluconazole | Ababhali babika ukuqedwa kwamakoloni ngemva kokwelashwa ngokukhanya okwahlala kuze kube usuku lwe-30 | Amanani amancane kakhulu eqenjini ngalinye, ukubikwa kwezehlakalo ezimbi kusezingeni lesifinyezo, uhlelo lwesikhathi esisodwa sokwelashwa lukhawulela ukusetshenziswa kwemiphumela kwamanye amaqembu |
| Ukuvuvukala komlomo okuhlobene namazinyo okufakelwa kohlobo lwe-II, ababambiqhaza abangu-40 | Ukwabiwa ngokungahleliwe, ijeli ye-miconazole kane ngosuku izinsuku ezingu-15, ukuhlolwa kokubuya kwesifo cishe ngosuku lwe-30 | Ukuphela kwezimpawu nokuphela kwamagciwane okuhlanganisiwe ngamaphesenti angu-40 ngokukhanya kanye ne-laser enamandla aphansi uma kuqhathaniswa namaphesenti angu-80 nge-miconazole | Kubikwe njengomphumela ohlanganisiwe, akuhlukaniswanga ngokucacile | Isikhathi esisodwa sokwelashwa nge-photodynamic kanye nezikhathi zokwelashwa nge-laser, umphumela ohlanganisiwe uvimbela ukuhlukaniswa kwemiphumela ezilondeni nemiphumela emasampuleni akhulisiwe |
Ithebula libonisa iphethini. Lapho izivivinyo zehlukanisa lezi zilinganiso ezimbili zemiphumela, ukusabela kwezilonda kwenzeka kaningi kunokususwa kwesikhunta emasampuleni akhulisiwe. Lapho zizihlanganisa, umfundi akakwazi ukubona ukuthi yimuphi umphumela oholele kulokho okutholakele. Lokho okulawulwa umthamo wokukhanya okubomvu kuchaza ingxenye yalo mehluko, ngoba ukujiya kukadayi, isikhathi sokuwushiya ngaphambi kokukhanyiswa, ubude begagasi, amandla endaweni ngayinye, nenani lezikhathi zokwelashwa kuyahluka kuyo yonke imigqa.
Kungani izinhlelo zokwelashwa zihluka kangaka
Ukujiya kukadayi kusukela kumaphesenti angu-0.01 kuya ku-0.1 ezivivinyweni eziyinhloko zomlomo. Isikhathi sokuwushiya ngaphambi kokukhanyiswa sisukela kumzuzu ongu-1 kuya emizuzwini engu-15. Ezinye izinhlelo zelapha kanye, ezinye zelapha izikhathi eziyisithupha emasontweni amabili. Umthamo wokukhanya, inani lamaphuzu akhanyiswayo, nokuthi amazinyo okufakelwa ngokwawo ayakhanyiswa yini konke kushintsha amandla alethwayo. Lokhu kuhlukahluka kusho ukuthi awukho umthamo owodwa we-methylene blue we-Candida ongafingqwa. Noma yiliphi inani elihlanganisiwe lingaxuba izindlela zokwelashwa ezihlukene ngaphansi kwegama elilodwa.
Umehluko emaqenjini abantu wengeza olunye ungqimba. I-candidiasis ebangela ububomvu, isifo esinolwelwesi-mbumbulu, ukuvuvukala komlomo okuhlobene namazinyo okufakelwa, ne-candidiasis ehlobene ne-HIV kuziphatha ngezindlela ezihlukile futhi kubuya ngenxa yezizathu ezihlukile. Abasebenzisa amazinyo okufakelwa babhekana nokuphinde kwakheke amakoloni esikhunta avela ebusweni balawo mazinyo. Abantu abanomlomo owomile, isifo sikashukela, abasebenzisa ama-steroid ahogelwayo, noma abasanda kuthola ama-antibiotic babhekana nezimo ezihlukene ezenza isifo sibuye. Umphumela eqenjini elilodwa awusebenzi ngokuzenzakalela kwelinye, futhi asikho kulezi zivivinyo zomlomo esihlola izimangalo nge-Candida esabalele emzimbeni noma esemathunjini.
Indlela yokufunda isivivinyo sokutheleleka ngesikhunta emlonyeni ngemizuzu emibili
Okokuqala, hlola umusho ochaza iqembu labantu. Abantu abadala abasebenzisa amazinyo okufakelwa, abantu abane-HIV, namaqembu avamile ane-candidiasis yomlomo baphendula imibuzo ehlukile. Okwesibili, bhala phansi ukuthi kuqhathaniswa nani kanye nosayizi wesampula. Uketshezi lwe-nystatin, amaphilisi e-nystatin ancibilika emlonyeni, ijeli ye-miconazole, ne-fluconazole akuzona izindlela zokuqhathanisa ezingashintshaniswa, futhi izivivinyo ezinababambiqhaza abangu-7 kuya kwabangu-23 eqenjini ngalinye zingasekela kuphela iziphetho zokuthi indlela ingasebenziseka yini. Okwesithathu, thola usuku lokulandelela. Umphumela olinganiswa ngosuku lwe-14 noma ngosuku lwe-30 ulinganisa ukusabela kwesikhathi esifushane, hhayi ukuvimbela ukubuya kwesifo. Okwesine, funa amanani ahlukene ezilonda nawamasampula akhulisiwe. Uma umbiko uveza kuphela ukwelapheka okuhlanganisiwe, kuthathe njengobufakazi obungaphelele embuzweni ophathelene nesikhunta.
Ukubikwa kokuphepha kulezi zivivinyo kuncane kodwa kuyaduduza kulokho okukuhlanganisayo. Ucwaningo lokuqala lwabika isimo esisodwa sobubomvu nobuhlungu bezinsini okwathathwa njengokungahlobene nokwelashwa ngemva kokutholakala kwesifo samazinyo, kanye nomuntu oyedwa owahoxa ngenxa yokunambitheka nokucasuka okubangelwa i-nystatin nomuntu oyedwa owahoxa ngenxa yokubona sengathi ukwelashwa ngokukhanya akusebenzi. Imibuzo ebanzi ngokuthi ulwelwesi lomlomo lukubekezelela kanjani lokhu kufanele ibhekwe kanye nemininingwane yokuphepha yokusetshenziswa olwelwesini lomlomo, hhayi namathebula okusebenza kokwelashwa.
Lokho lokhu okukushoyo ezigulini nakubelaphi
Esifweni esihlobene namazinyo okufakelwa, amazinyo okufakelwa adinga ukunakekelwa kanye nolwelwesi lomlomo. Yingakho indlela yokuphatha i-candidiasis ehlobene namazinyo okufakelwa iyisinqumo esihlukile ekukhetheni umuthi wokulwa nesikhunta noma uhlelo lokwelashwa ngokukhanya. Uma ukutheleleka ngesikhunta emlonyeni kubuya njalo, uhlelo oluhlola kokubili okubukwa esibukweni nesampula ekhulisiwe lunengqondo kunokusebenzisa okukodwa kuphela. Izimpawu nezinga lobunzima bezilonda ziqondisa ukunethezeka nokusebenza komlomo. Ukuphinda kukhuliswe isampula noma kubalwe amakoloni kuqondisa ukuthi amakoloni esikhunta ayaqhubeka yini ngemva kokuphela kwezilonda.
Isifinyezo esithembekile sesimo samanje sithi: ukwelashwa nge-photodynamic kusetshenziswa i-methylene blue kunganciphisa izilonda futhi kwehlise amanani esikhunta ku-candidiasis yomlomo phakathi kwezinsuku namasonto. Ukususwa okuphelele nokuhlala isikhathi eside kwesikhunta emasampuleni akhulisiwe akuboniswa ngokungaguquguquki okufanayo, futhi ukuqhathaniswa okuqondile ne-nystatin noma i-miconazole kuncane kakhulu futhi kufushane kakhulu ukuba kusekele izimangalo zokulingana. Ukuhlaziywa okubanzi kwango-2025 kwezivivinyo ze-photodynamic ezingu-16 ezisebenzisa izinto ezihlukene ezizwela ukukhanya akutholanga mehluko obalulekile ngokwezibalo ekusabeleni okuphelele uma kuqhathaniswa nemithi yokulwa nesikhunta, kodwa kwakukhona ukuhlukahluka okukhulu nokukhathazeka ngokuchema. Lokho kunikeza umongo, hhayi isilinganiso esiqondene ne-methylene blue.
Lokho kuwuphawu olulinganiselwe kodwa olungokoqobo. Kusekela ucwaningo olwengeziwe olusebenzisa imingcele kadayi nokukhanya ebekwe ngendlela efanayo, izilinganiso zemiphumela ezihlukanisiwe, nokulandelela ukubuya kwesifo. Akusekeli iziphetho zokusetshenziswa ekhaya, futhi lokhu kubuyekezwa akudluleli emathunjini noma egazini. Abafundi abafuna ukubona isithombe esibanzi socwaningo ngodayi abenziwa basebenze ukukhanya bangasebenzisa ukubuka konke kwezimo zomlomo ezifundwe ngodayi abenziwa basebenze ukukhanya kanye nezivivinyo ezimbili eziyisisekelo ezixhunywe ngenhla.