Isihloko
Ingabe i-methylene blue yelapha i-UTI? Izimpawu, ukutheleleka, nemithi ehlanganisiwe
I-methylene blue iyodwa ayiyona indlela yokwelapha efakazelwe yokutheleleka emgudwini womchamo okubangelwa amagciwane. Ukuba khona kwayo emuthini ohlanganisiwe wezinkinga zomchamo akubonisi ukuthi ibhodlela le-methylene blue eyodwa lizokuqeda ukuvuvukala kwesinye, livimbele ukuphinda kwako, noma lel aphe ukutheleleka kwendlala yesinye. Ucwaningo lwezokwelapha okuxoxwa ngalo ngezansi lwahlola imithi ehlanganisiwe, lwase lwengeza ama-antibiotic kamuva.
Umehluko wokuqala owusizo uphakathi kokuzizwa ungcono kanye nokwelapha imbangela. Kokubili kubalulekile. Umuthi unganciphisa ukufinyela okubuhlungu kwesinye kuyilapho amagciwane esekhona; izimpawu zingaqhubeka futhi lapho ukutheleleka ngamagciwane kungaseyona imbangela. Iziqondiso ze-NIDDK zokwelapha ukutheleleka kwesinye zihlukanisa ama-antibiotic asetshenziselwa ukutheleleka ngamagciwane emithini yobuhlungu nasekuhlolweni okwengeziwe lapho ukutheleleka kungenakuqinisekiswa.
Lokho izimpawu zomchamo ezingakufakazela
Ukushisa lapho uchama, isidingo esiphuthumayo sokuchama, ukuchama njalo, nokungakhululeki engxenyeni engezansi yesisu kungavela uma une-UTI. Nokho, kuchaza lokho umuntu akuzwayo, hhayi imbangela yako. I-cystitis isho ukuvuvukala kwesinye; ukuvuvukala kwesinye okubangelwa amagciwane kungenye imbangela, kanti i-interstitial cystitis/isimo sobuhlungu besinye kuyinkinga ehlukile yokuxilongwa.
Ukuhlolwa kokutheleleka kwesinye kuhlanganisa umlando wezempilo, ukuhlolwa komzimba, nokuhlolwa okufanele. Ukuhlaziywa komchamo kungathola izinto ezifana namangqamuzana amhlophe egazi negazi. Ukuhlolwa kokukhuliswa kwamagciwane emchameni kubheka ukukhula kwamagciwane futhi kungasiza ekukhetheni i-antibiotic. Lezi zivivinyo ziphendula imibuzo ehlukene, ngakho amazwi athi “ukuhlolwa komchamo wami akutholanga lutho” adinga ukucaciswa: yisiphi isivivinyo, senziwa nini, futhi sasihlobene kanjani nokwelashwa okwakusetshenziswa?
Izimpawu eziqhubekayo lapho izivivinyo zingatholanga lutho zidinga ukunakwa. Ukungatholakali kwamagciwane ekuhlolweni kokukhuliswa kwawo akusona isizathu sokunganaki ubuhlungu, kodwa nobuhlungu abufakazeli ukutheleleka okufihlekile. Isitatimende sesimo se-Urological Society of Australia and New Zealand siyayivuma imikhawulo yokuxilonga futhi sincoma ukuhlolwa okuhambisana nezidingo zomuntu ngamunye. Umphumela kufanele uhunyushwe ngokuhambisana nezimpawu nokunye okutholakele, kunokuba ube yisizathu sokuqala imijikelezo ephindaphindwayo yemithi elwa namagciwane ngaphandle kokuqashwa.
Ukudambisa izimpawu uma kuqhathaniswa nokwelapha ukutheleleka
Sebenzisa lokhu kuqhathanisa lapho uhlola isimangalo ngomkhiqizo noma uxoxa ngokusabela ekwelashweni. Kuhlukanisa okubonakele nesiphetho okungasisekela.
| Okubonakele noma inhloso yokwelashwa | Lokho okungakutshela kona | Lokho okungenakukufakazela kukodwa |
|---|---|---|
| Ukuncipha kokushisa, kwesidingo esiphuthumayo sokuchama, noma kokufinyela okubuhlungu kwesinye | Izimpawu sezithuthukile, okuwumphumela obalulekile | Ukuthi amagciwane ayekhona ekuqaleni noma aseqediwe |
| Umsebenzi wokulwa namagciwane ngaphansi kwezimo zaselabhorethri | Into ithinta amagciwane ngaphansi kwezimo ezihloliwe | Ukuthi umkhiqizo ophuzwa ngomlomo ufinyelela ngokuphepha ezingeni elisebenzayo emgudwini womchamo wesiguli |
| Ukuhlolwa kokukhuliswa kwamagciwane emchameni okungatholanga amagciwane | Akukho ukukhula kwamagciwane obekungabikwa okutholakele ngaphansi kwezimo zaleso sivivinyo | Ukuthi kungani izimpawu ziqhubeka, noma ukuthi umkhiqizo othile ubangele lowo mphumela yini |
| Ukwelashwa kwe-UTI ebangelwa amagciwane okuqondiswa uchwepheshe wezokwelapha | Ukwelashwa kubhekana nokutheleleka okuhloliwe, nokulandelelwa kuncike esimweni sezokwelapha | Ukuthi zonke izigameko ezizayo zinembangela efanayo noma zidinga umuthi ofanayo |
| Umchamo oluhlaza okwesibhakabhaka noma oluhlaza okotshani ngemva kwe-methylene blue | Udayi ungashintsha umbala womchamo | Ukubulawa kwamagciwane, ukuphumelela kokwelashwa, noma isilinganiso sobukhulu bokutheleleka |
Ngokwesibonelo, umuntu uqala iphilisi elihlanganisa imithi abese ebika ukuncipha kwamajaqamba ngalobo busuku. Lokho kuwulwazi oluwusizo ngezimpawu. Ukuze kuthiwe i-methylene blue iqede ukutheleleka, kusenemibuzo eyengeziwe: ingabe kwakukhona ukutheleleka, yini enye eyayisephilisini, ingabe nama-antibiotic asetshenziswa, futhi kwenzekani ekuhlolweni okulandelayo?
Kungani imithi ehlanganisiwe ihlukile
Ilebula yekhepsuli ye-Uribel ku-DailyMed ichaza ukudambisa izimpawu zokucasuka emgudwini womchamo. Izithako zayo zinemisebenzi ehlukene echaziwe:
| Isithako | Umsebenzi ochazwe kule lebula yekhepsuli |
|---|---|
| I-Hyoscyamine | Ixegisa imisipha ebushelelezi ukuze inciphise ukufinyela okubuhlungu |
| I-Phenyl salicylate | Ikhipha i-salicylate ukuze kudambe ubuhlungu |
| I-Methenamine | Ikhipha i-formaldehyde emchameni one-asidi, okwenza umsebenzi wokulwa namagciwane |
| I-Sodium phosphate monobasic | Isiza ukugcina umchamo une-asidi edingekayo ukuze i-methenamine isebenze |
| I-Methylene blue | Inezici ezibuthakathaka zokulwa namagciwane; ingashintsha umbala womchamo |
Le lebula isho ngokucacile ukuthi i-FDA ayigunyazanga imininingwane ekulebula futhi ayinqumanga ukuthi lo mkhiqizo uphephile futhi uyasebenza. Ukufakwa ku-DailyMed akusona isitifiketi sokugunyazwa. Ukwakheka kwemikhiqizo kuyehluka, ngakho hlola iphakethe langempela kunokuba usebenzise leli thebula kuyo yonke imikhiqizo enamagama afanayo. Umhlahlandlela wethu wemithi ehlanganisiwe yezinkinga zomchamo equkethe i-methylene blue uchaza umehluko phakathi kwemikhiqizo.
I-methenamine ne-methylene blue yizinto ezihlukene. Izincomo ze-NICE nge-UTI ephindayo zihlanganisa i-methenamine hippurate njengenketho yokuvimbela ezigulini ezikhethiwe ngemva kokuba noma iyiphi i-UTI ekhona isilashwe ngokwanele. Leso sincomo asifakazeli ukuthi i-methylene blue iyindlela yokuvimbela, futhi asenzi umuthi ohlanganisiwe wokudambisa izimpawu ube ongashintshaniswa ne-methenamine hippurate.
Lokho isivivinyo semithi ehlanganisiwe esakulinganisa ngempela
Isivivinyo sango-2020 sikaGama nozakwabo esahlukanisa ababambiqhaza ngamaqembu ngokungahleliwe, lapho ababambiqhaza nabacwaningi babengazi ukuthi ubani uthola muphi umuthi sabandakanya abantu abadala abangu-288 abanokuvuvukala kwesinye okuphindayo, cishe bonke bengabesifazane. Saqhathanisa i-methenamine ne-methylene blue okuphuzwa ngomlomo nenhlanganisela equkethe lezo zithako kanye ne-acriflavine ne-belladonna. Kwakungekho qembu elalithola i-methylene blue kuphela futhi kwakungekho qembu elalithola umuthi ongenasithako esisebenzayo.
Umphumela oyinhloko owalinganiswa kwakuwukuthuthuka engxenyeni yohlu lwemibuzo ephathelene nokuchama ngendlela ejwayelekile ngemva kwezinsuku ezintathu. Ukuthuthuka kwenzeka ku-69.4% naku-72.2% wamaqembu, ngokulandelana, ngaphandle komehluko obalulekile ngokwezibalo phakathi kwamaqembu. Kwabe sekwengezwa ama-antibiotic akhethwe ngokwemiphumela yokuhlolwa kokukhuliswa kwamagciwane ezinsukwini ezintathu zokugcina zocwaningo lwezinsuku eziyisithupha.
Ngakho ucwaningo lunikeza ulwazi ngezimpawu zesikhathi esifushane ngesikhathi sendlela yokwelapha ngemithi ehlanganisiwe eqashwe ochwepheshe. Alukwazi ukuhlukanisa igalelo le-methylene blue, ukubonisa ukuqedwa kwamagciwane ngokuyisebenzisa iyodwa, noma ukufakazela ukuvimbela kwesikhathi eside. Inqubo yalo ayilona uhlelo lokuzelapha ekhaya, futhi okutholakele akufakazeli ukusebenza kwayo ekwelapheni ukuvuvukala kwendlala yesinye okungapheli okubangelwa amagciwane.
Ubuhlungu besinye obuqhubekayo, ukuvuvukala kwendlala yesinye, namatshe
Lapho izimpawu ziphinda, ukuhlolwa kudinga ukuhlukanisa ukutheleleka okuphindaphindwayo nesimo sezimpawu esiqhubekayo. I-interstitial cystitis ixilongwa ngokuhlola izimpawu nokukhipha ezinye izimbangela ezingase zibe khona, kusetshenziswa umlando wezempilo, ukuhlolwa komzimba, nezivivinyo njengoba kufanele. Ayixilongwa ngenxa nje yokuthi ukuhlolwa okukodwa kokukhuliswa kwamagciwane akuwatholanga.
Lo mehluko ubalulekile futhi emadodeni anobuhlungu esinqeni, ukuchama okubuhlungu, noma “ukuvuvukala kwendlala yesinye” okubonakala kungapheli. I-NIDDK ihlukanisa ukuvuvukala kwendlala yesinye okubangelwa amagciwane nokuvuvukala kwendlala yesinye okungapheli, lapho ngokuvamile ukutheleleka kungatholakali. Isimo sobuhlungu besinqe obungapheli singadinga indlela ehlukile kunokwelapha ukutheleleka kwendlala yesinye okufakazelwe. Izimpawu zomchamo noma ukusabela kwesikhashana emuthini akukhombi igciwane eliyimbangela.
Izimangalo ngamatshe zidinga ubufakazi obuhlukile. Itshe elingasabonakali esithombeni sokuhlolwa sakamuva alibonisi ukuthi i-methylene blue ilincibilikisile, futhi ukushintsha kobuhlungu akulinganisi ukwakheka noma ubukhulu betshe. Ukuhlolwa nokwelashwa kwamatshe kuncike ezicini zawo. Isivivinyo semithi ehlanganisiwe esingenhla asibandakanyanga abantu ababenomlando wamatshe ezinso. Asinikezi bufakazi bokuncibilikiswa kwamatshe.
Hamba nalolu lwazi lapho uyobonana nochwepheshe wezempilo
Sebenzisa lolu hlu ukuze kube lula ukuhlola izimpawu eziphindayo. Bhala lokho okubonile ngaphandle kokunquma kusengaphambili ukuthi zonke izigameko zibangelwa amagciwane.
- Ukulandelana kwezimpawu ngokwesikhathi: usuku lokuqala, indawo yobuhlungu, ukuthi uchama kangaki, imfiva, igazi elibonakalayo, nokuthi ubuhlungu buyashintsha yini lapho isinye sigcwala noma siphuma umchamo. Qaphela izikhathi ezingenazimpawu futhi, lapho kufanele, ubuhlungu besinqe noma obuhlobene nokukhipha isidoda.
- Imibiko yangempela yezivivinyo: ukuhlaziywa komchamo, ukuhlolwa kokukhuliswa kwamagciwane, imiphumela yokuthi amagciwane azwela kumaphi ama-antibiotic, nezithombe zokuhlolwa. Faka izinsuku nokuthi amasampula athathwa ngaphambi noma ngemva kokusetshenziswa kwama-antibiotic noma imithi yezinkinga zomchamo.
- Ukulandelana kokwelashwa ngokwesikhathi: amagama ama-antibiotic nemithi yezimpawu, izinsuku eyasetshenziswa ngazo, izinguquko ezibonakele, nemiphumela engathandeki. Hamba nezithombe zamalebula emikhiqizo ehlanganisiwe kanye nanoma iyiphi ilebula ye-methylene blue engahlanganisiwe.
- Ulwazi olubalulekile ngempilo nemithi: amathuba okukhulelwa, izinkinga zezinso, amatshe owake waba nawo, ubunzima bokukhipha wonke umchamo esinyeni, ukungezwani nezinto ezithile, nayo yonke imithi kadokotela nezithasiselo. Umbiko wecala lomuthi ophuzwa ngomlomo wokudambisa ubuhlungu bomgudu womchamo wachaza ubuthi be-serotonin obuhlobene nomkhiqizo oqukethe i-methylene blue, okwenza kubaluleke ngokukhethekile ukudalula imithi yokwelapha ukucindezeleka neminye ethinta i-serotonin.
- Umbuzo wokulandelela: “Yini esekela ukuthi kukhona ukutheleleka kulesi sigameko, yini ehloselwe ukudambisa izimpawu, futhi kufanele kwenzekeni uma izimpawu ziqhubeka?” Sebenzisa umhlahlandlela obanzi wemibuzo yokubuza uchwepheshe wezokwelapha nge-methylene blue ukuze nixoxe ngemithi ethile.
Xhumana nochwepheshe wezempilo uma usola ukutheleleka kwesinye. Funa usizo oluphuthumayo uma unezimpawu ezingase zibonise ukutheleleka kwezinso, ezihlanganisa imfiva noma ukuqhaqhazela, ubuhlungu emhlane noma ohlangothini lomzimba, noma ukuhlanza. Ukungakwazi ukuchama nakho kudinga ukuhlolwa okuphuthumayo. Ungalindi ukuthi udayi noma umuthi wokudambisa izimpawu usebenze kulezi zimo.