Isihloko
Kungani kunzima ukufihla ukwabiwa kokwelashwa ezivivinyweni ze-methylene blue
Amavolontiya ayishumi nantathu agwinya, ngamunye, ikhepsuli engabonisi okungaphakathi, alale emshinini wokuskena, enze nemisebenzi yenkumbulo. Akekho ekamelweni owaziyo ukuthi ubani othole umuthi. Umbiko wesivivinyo ubiza indlela yokucwaninga ngokuthi ifihlela izinhlangothi zombili ukwabiwa kokwelashwa, futhi ngaleso sikhathi leyo ncazelo inembile. Bese bonke beya emakhaya, futhi wonke umhlanganyeli othole i-methylene blue ukhipha umchamo oluhlaza okwesibhakabhaka. Ingabe ukwabiwa kokwelashwa bekufihliwe esivivinyweni? Impendulo ethembekile inomkhawulo omncane kunalelo gama: bekufihliwe lapho kuthathwa ezinye izilinganiso, kodwa bekungafihliwe lapho kuthathwa ezinye. Lowo mehluko uyiyona ndaba yonke yokufihla ukwabiwa kokwelashwa ezivivinyweni zomtholampilo ze-methylene blue.
Ukufihla lapho kunikezwa umthamo akusho ukufihla kuze kuphele ukulandelela
Ukufihla ukwabiwa kokwelashwa kusho ukuthi abantu abangachemisa umphumela abazi ukuthi ubani wabelwe luphi uhlobo lokwelashwa. Amaqembu amathathu abalulekile: abahlanganyeli, abasebenzi abaxhumana nabo, nabantu abahlola imiphumela. Ukwabiwa okungahleliwe kanye nekhepsuli engabonisi okungaphakathi kufihla ukwabiwa ngesikhathi kunikezwa umthamo. Kulapho abafundi abaningi beyeka khona ukucabanga ngale ndaba, futhi yilelo phutha.
Udayi oluhlaza okwesibhakabhaka udalula ulwazi ngokuhamba kwesikhathi, futhi ulwazi ngalunye oludalulekayo lufinyelela eqenjini elihlukile ngesikhathi esihlukile. Ikhepsuli ifihla umbala lapho igwinywa. Ngemva kwamahora, umchamo uwuveza kumhlanganyeli. Imishini yokuqapha ingawuveza kubasebenzi ngaphambi kwalokho. Ngakho umbuzo ofanele nganoma yikuphi ukuqhathaniswa kwe-methylene blue ne-placebo awukona ukuthi ukwabiwa kokwelashwa bekufihliwe yini esivivinyweni sonke. Uwukuthi ubani wayazi ini, futhi nini, maqondana nesilinganiso ngasinye.
Yini edalula ukwabiwa kokwelashwa
Izimpawu ezidalulayo ziyabonakala emzimbeni, zincike emthamo, futhi zibhalwe kahle:
Umchamo oluhlaza okwesibhakabhaka noma oluhlaza okwesibhakabhaka oxubene noluhlaza okotshani. Lesi yisona sibonakaliso esiyinhloko emithamweni emincane ephuzwa ngomlomo. Sivela emahoreni ambalwa ngemva kokugwinya futhi ngokuvamile sihlala cishe usuku. Esivivinyweni saseSan Antonio sokuthwebula izithombe zokusebenza kobuchopho, wonke umhlanganyeli othole i-methylene blue wabika ukuthi ukhiphe umchamo oluhlaza okwesibhakabhaka ngemva kokushiya isikhungo sokuthwebula izithombe, kuyilapho kungekho mhlanganyeli othole i-placebo owabika ukushintsha kombala. Ukutholakala kombala emchameni kwenzeka ngemva kokuskena, okuyinto ebalulekile, njengoba kuzocaca ngezansi.
Indle nolimi okuluhlaza okwesibhakabhaka. Lokhu kuvela isikhashana ngemva kokuthatha umthamo ngomlomo futhi kubonakala kubahlanganyeli nakunoma ubani obahlolayo.
Ukushintsha kombala wesikhumba nengxenye emhlophe yamehlo. Emithamweni ephakeme efakwa emthanjeni, udayi ushintsha ngokusobala umbala wesikhumba nowezingxenye ezimhlophe zamehlo. Lesi sibonakaliso sifinyelela kubasebenzi ngesikhathi sokuvakasha, hhayi kumhlanganyeli kuphela ngemva kwalokho.
Ukuphazamiseka kwezinzwa zokulinganisa. I-methylene blue imunca ukukhanya okusetshenziswa yimishini yokulinganisa ukugcwala komoya-mpilo egazini ngokushaya kwenhliziyo, ngakho ukufundwa kokugcwala komoya-mpilo kuba okungathembekile ngesikhathi sokufakwa komuthi emthanjeni. Ocwaningweni lwaseKing's College lokugeleza kwegazi ebuchosheni, ithimba alikwazanga ukuqapha ukugcwala komoya-mpilo ngenxa yalesi sizathu ngqo, okusho ukuthi abasebenzi ababeseduze nombhede babethola uphawu ngomshini lokuthi kukhona okwehlukile.
Qaphela ukuthi lokhu akulingani ezinhlangothini zombili: konke okuvezwa udayi kukhomba ohlangothini olulodwa. Umhlanganyeli onomchamo oluhlaza okwesibhakabhaka ufunda ukuthi uthole umuthi. Umhlanganyeli onomchamo ojwayelekile ufunda kuphela ukuthi cishe uthole i-placebo ye-methylene blue, ngaphandle uma i-placebo uqobo yayiklanyelwe ukushintsha umbala womchamo, okuyinto ama-placebo azanyiwe kuze kube manje angayenzi.
Lokho izivivinyo ezikuzamile ngempela
Izigaba zezindlela ezisetshenzisiwe ezivivinyweni zokuthwebula izithombe zinikeza isibonelo esingcono kakhulu sokufunda le ndaba, ngoba zichaza izinyathelo zazo zokubhekana nale nkinga ngemininingwane engavamile. Abafundi abalandela ubufakazi bemithamo emincane bazolwazi lolu cwaningo ezincwadini zesayensi eziphathelene nenkumbulo.
Izivivinyo ezimbili zaseSan Antonio zabela ngokungahleliwe abantu abadala abaphilile ukuthi bathole i-methylene blue yezinga le-USP engu-280 mg ngomlomo (cishe 4 mg/kg) noma i-placebo yodayi wokudla i-FD&C Blue No. 2, kupakishwe kumakhepsuli angabonisi okungaphakathi futhi akhulula okukuyo ngokushesha. I-placebo enombala yayifana nokuqukethwe yikhepsuli ngesikhathi sokunikezwa komthamo kodwa yayingawushintshi umbala womchamo, ngakho ukulingisa kwayo kwehluleka khona kanye lapho kwakubaluleke khona. Likwazi lokhu, ithimba lesivivinyo se-Radiology lanezela inqubo yokuziphatha: abahlanganyeli bacelwa ukuba bachame ngaphambi kokuthatha ikhepsuli futhi bangaphinde bachame kuze kube ngemva kweseshini yokuthwebula izithombe, ngenhloso ethile yokugwema ukuthi umbala womchamo udalule ukwabiwa kokwelashwa. Umhlengikazi wocwaningo ohlukile wayegcina ulwazi lokwabiwa okungahleliwe ezitsheni ezinamalebula alandelanayo futhi akazange abe nenye indima ocwaningweni. Ngokombiko, ukwabiwa kokwelashwa kwahlala kufihliwe kubahlanganyeli, kubahlengikazi, nakubahloli bemiphumela kwaze kwaphela ukuhlaziywa, njengoba kuchazwe embikweni wokuthwebula izithombe ngezindlela eziningi. Ucwaningo oluhambisanayo lokuxhumana kobuchopho lwasebenzisa indlela efanayo futhi lwabika okwenzeka ngemva kwalokho okufanayo: yiqembu le-methylene blue kuphela elaqaphela ukushintsha kombala womchamo kwesikhashana ngemva kokushiya isikhungo.
Ucwaningo lwaseKing's College lwalandela indlela ehlukile nevuleke kakhudlwana. Amavolontiya ayisishiyagalombili aphilile athola, ngamunye, i-placebo ye-glucose efakwa emthanjeni kanye nemithamo emibili ye-methylene blue efakwa emthanjeni (0.5 no-1 mg/kg) ngezinsuku ezihlukene ngokulandelana okwabiwe ngokungahleliwe. Indlela yokucwaninga ichazwa ngokuthi ifihlela uhlangothi olulodwa futhi iqhathanisa izikhathi ezahlukene kumhlanganyeli oyedwa: abacwaningi babazi ukuthi yini efakwa emthanjeni, futhi umhlanganyeli ngamunye wayeba yisisekelo sakhe sokuqhathanisa phakathi kwamaseshini, njengoba kuchazwe ephepheni lokugeleza kwegazi nemetabolism. Ngokusebenzisa udayi oluhlaza okwesibhakabhaka ofakwa emthanjeni, kwakungekho ukuzenzisa ngokuthi abahlanganyeli babezohlala bengazi ukwabiwa kokwelashwa phakathi kokuvakasha okuhlukene.
Izincwadi ezindala zesayensi yezengqondo zibonisa isu lesithathu: ukusebenzisa umthamo omncane njengokuqhathanisa okusebenza emzimbeni. Isivivinyo seminyaka emibili esasishintshanisa ukwelashwa, se-methylene blue sokuphazamiseka kwengqondo okuhambisana nezikhathi zokujabula ngokweqile nezokudangala, sasebenzisa 15 mg ngosuku njengomthamo wokuqhathanisa no-300 mg ngosuku cishe. Lo mniningwane ulandiswa engxoxweni yephepha lokugeleza kwegazi nemetabolism. Umsebenzi wakamuva ngento esuselwe ku-methylene blue yesifo i-Alzheimer wasebenzisa umthamo omncane owawuhloswe ekuqaleni njengowokuqhathanisa, wathola ukuthi wawusebenza njengokwelashwa. Umthamo omncane wokuqhathanisa ulingisa imiphumela engemihle nezimpawu ezibonakalayo kangcono kakhulu kunekhepsuli engenawo umuthi osebenzayo, kodwa uvuma okuthile okubalulekile: isivivinyo singalinganisela kuphela umehluko phakathi kwemithamo, hhayi umphumela womuthi uma uqhathaniswa nokungawutholi nhlobo.
Ukuhlolwa okuqine kakhulu komqondo we-placebo enombala kuvela esivivinyweni se-PTSD esaqhathanisa i-methylene blue engu-260 mg ephuzwa ngomlomo ne-placebo ye-indigo carmine kumakhepsuli ayefana ngokubukeka. Abahlanganyeli baze bakhuthazwa ukuba baphuze amanzi ukuze banciphise ukugqama komphumela. Ukushintsha kombala womchamo kwabikwa namanje ngamaphesenti angu-95.6 eqenjini le-methylene blue, uma kuqhathaniswa namaphesenti angu-21.1 eqenjini le-placebo, esivivinyweni sikaTelch nozakwabo sokunciphisa impendulo yokwesaba efundiwe. Udayi osekhepsulini ulingisa indlela umthamo obukeka ngayo. Awulingisi lokho umhlanganyeli akuzwayo nakubonayo.
Ukuqhathaniswa kwezindlela zezivivinyo: lokho uhlangothi ngalunye olwalungakubona
Leli thebula liyilesi sihloko sifingqiwe. Funda umugqa ngamunye njengokulandelana kwesikhathi, hhayi njengokunikezwa kwamamaki.
| Isivivinyo | Umthamo nendlela yokuwunikeza | Indlela yokucwaninga eshiwo | I-placebo | Lokho abahlanganyeli ababengakubona | Lokho abahloli ababengakubona | Ingabe impumelelo yokufihla yahlolwa? |
|---|---|---|---|---|---|---|
| Rodriguez nabanye, Radiology 2016 (n=26) | I-methylene blue ye-USP engu-280 mg ngomlomo, umthamo owodwa | Ukwabiwa okungahleliwe, ukufihlela izinhlangothi zombili, ukuqhathaniswa ne-placebo | I-FD&C Blue No. 2 kumakhepsuli angabonisi okungaphakathi | Umchamo oluhlaza okwesibhakabhaka ngemva kokushiya isikhungo (bonke abathole umuthi); akukho ngesikhathi sokuskena, kusizwa yinqubo yokungachami | Akukho ngesikhathi sokuskena; ukuhlaziywa kwemiphumela kwenziwa ukwabiwa kusafihliwe kwaze kwaphela | Akukho ukuhlolwa kokuqagela; imibiko yomchamo yaqoqwa njengophawu olubonakala kamuva lokuthola umuthi |
| Rodriguez nabanye, Brain Imaging Behav 2017 (n=28) | I-methylene blue ye-USP engu-280 mg ngomlomo, umthamo owodwa | Ukwabiwa okungahleliwe, ukufihlela izinhlangothi zombili, ukuqhathaniswa ne-placebo | I-FD&C Blue No. 2 kumakhepsuli angabonisi okungaphakathi | Ukushintsha kombala womchamo kwesikhashana ngemva kokushiya isikhungo, eqenjini lomuthi kuphela | Akukho ngesikhathi sokuskena; abahlanganyeli nabacwaningi babengazi ukwabiwa kwaze kwaphela ukuhlaziywa | Akukho ukuhlolwa kokuqagela okubikiwe |
| Singh nabanye, J Cereb Blood Flow Metab 2023 (n=8) | 0.5 no-1 mg/kg emthanjeni, kanye ne-placebo ye-glucose, ukushintshanisa ukwelashwa | Ukufihlela uhlangothi olulodwa, ukuqhathanisa kumhlanganyeli oyedwa, ukulandelana okungahleliwe | Isixazululo se-glucose esingu-50 mL | Umchamo oluhlaza okwesibhakabhaka nemizwa ehlobene nokufakwa emthanjeni phakathi kwamaseshini; ukufihla phakathi kokuvakasha akukholakali | Abacwaningi babazi ukwabiwa ngokwendlela yokucwaninga; izilinganiso zemiphumela yezithombe zabalwa ngekhompyutha | Akukho ukuhlolwa kokuqagela; ukubikwa komuntu ngamunye kwamandla, kwesimo sengqondo, nobuhlungu kwabikwa ngeseshini ngayinye |
Kugqama izinto ezimbili. Okokuqala, akukho nesisodwa kulezi ezintathu esahlola ngokusemthethweni impumelelo yokufihla, njengokucela abahlanganyeli ukuba baqagele ukwabiwa kwabo lapho bephuma. Ukufihla okushiwo kuyincazelo yenqubo; ukuhlolwa kokuqagela kuwubufakazi bomphumela, futhi lobo bufakazi abukho. Leli gebe livamile, alikhethekile kulo dayi: ukubuyekezwa kwezivivinyo ezingu-191 eziqhathaniswa ne-placebo kwathola ukuthi cishe amaphesenti angu-2 kuphela ahlola impumelelo yokufihla kokubili kubahlanganyeli nakubacwaningi noma kubahloli, njengoba kubikwe nguFergusson nozakwabo. Okwesibili, isikhathi sisindisa ingxenye yesimangalo ezivivinyweni zomuthi ophuzwa ngomlomo: isibonakaliso safika ngemva kokuqoqwa kwedatha yomshini wokuskena, ngakho izilinganiso zemiphumela yezithombe zathathwa ngesikhathi lapho kusakholakala khona ukuthi ukwabiwa kwakufihliwe, kuyilapho noma yini eyalinganiswa kamuva yayingasenjalo.
Ukuhlola ukuqagela kungenzeka, futhi esinye isivivinyo se-methylene blue sibonisa ukuthi kwenziwa kanjani. Esivivinyweni sokujova ngaphakathi kwediski lomgogodla ngenxa yobuhlungu obuvela kudiski, iziguli zavinjelwa ukuba zibone isixazululo esijovwayo futhi zabuzwa kamuva ukuthi zazicabanga ukuthi zithole luphi ukwelashwa. Cishe izingxenye ezintathu kwezine eqenjini ngalinye zaphendula ngokuthi azazi, kungekho mehluko obalulekile ngokwezibalo phakathi kwamaqembu, embikweni wesivivinyo sikaKallewaard. Lokho kwehluke ngokuphelele ekubhaleni ukuthi izinhlangothi zombili bezingazi ukwabiwa esigabeni sezindlela ezisetshenzisiwe. Kunezinkomba ezisemthethweni ezihloselwe lokhu ngqo, ikakhulukazi inkomba ye-Bang yokufihla ukwabiwa echazwe nguBang nozakwabo.
Kungani okulindelwe nabahloli kubalulekile ngezindlela ezingalingani
Lapho umhlanganyeli eseqondile ukuthi wabelwe luphi ukwelashwa, imiphumela yokulindela igxila ezilinganisweni ezincike emizweni nasekuboneni komuntu: izilinganiso zamandla nesimo sengqondo, izikali zezimpawu, nemisebenzi encike emzamweni. Izilinganiso zemizwa yabahlanganyeli zaseKing's College zibonisa lokhu kubeka engcupheni. Abahlanganyeli balinganisa amandla, isimo sengqondo, nobuhlungu ngemva kokufakwa ngakunye emthanjeni, ngesikhathi lapho noma ubani othole udayi ayenezizathu ezanele zokwazi lokho. Iphepha libika izilinganiso zamandla eziphakeme emthamo omncane kanye nezilinganiso zobuhlungu ezikhuphuka njengoba umthamo ukhuphuka. Lezo zilinganiso zingase ziveze ukusebenza komuthi, okulindelwe, noma kokubili, futhi indlela yokucwaninga ayikwazi ukuhlukanisa lokhu kokubili.
Izilinganiso ezingancikile emizweni yomuntu zimelana nokulindela ngendlela ehlukile. Umhlanganyeli akakwazi ukwenza iphethini yomoya-mpilo egazini ivele emshinini wokuskena ngokuyifisa nje, okungesinye sezizathu ezenza imiphumela yezithombe igcine ingxenye enkulu yokubaluleka kwayo ngisho noma ukufihla kungaphelele. Kodwa ukunganciki emizweni yomuntu akusho ukungathinteki nhlobo. Izinqubo zokuhlaziya zihlanganisa ukukhetha izifunda, imingcele yokuhlukanisa idatha, nokukhetha amamodeli, futhi umhlaziyi owazi ukwabiwa angaholela lezo zinqumo emphumeleni awuthandayo. Amathimba aseSan Antonio avala lelo gebe ngokugcina ukwabiwa kufihliwe kuso sonke isigaba sokuhlaziya. Lowo musho owodwa ezindleleni zawo unesisindo esikhulu kunamagama athi kufihlelwe izinhlangothi zombili ezifinyezweni zawo.
Izindlela ezijwayelekile zokubhekana nezinto zokungenelela ezinjengodayi zilandela ngqo kulokhu: hlukanisa abantu abahlola imiphumela nabantu abanikeza umuthi, sebenzisa imibhalo efanayo yokuxhumana nabahlanganyeli, khetha izilinganiso eziyinhloko ezithathwa ngaphambi kokubonakala kwesibonakaliso lapho kungenzeka, futhi usebenzise uhlu lwemibuzo yokuphuma olucela ukuqagela, olunenkomba efanele, kunokumane uthi ukwabiwa kwahlala kufihliwe. Imiphumela yesivivinyo senkumbulo idinga lona kanye lolu hlobo lokufunda isilinganiso ngasinye ngokwehlukana.
Indlela yokufunda isimangalo sokufihla ukwabiwa ngemizuzu emihlanu
Sebenzisa lolu hlu lokuhlola kunoma yisiphi isivivinyo se-methylene blue, futhi ubheke izimpendulo njengezishintsha indlela yokuhumusha isilinganiso ngasinye ngokwehlukana, kunokuba zenze iphepha lonke liphase noma lifeyile:
- Yini ngempela eyasetshenziswa ukuqhathanisa: ikhepsuli engenawo umuthi osebenzayo, i-placebo enombala, noma umthamo omncane? Ikhepsuli enombala engawushintshi umbala womchamo ifanisa ukubukeka kuphela ngesikhathi sokunikezwa komthamo.
- Ingabe ukwabiwa kwakufihliwe ngesikhathi sokunikezwa komthamo: amakhepsuli angabonisi okungaphakathi, ukufakwa emthanjeni okufihliwe, ukwabiwa okungahleliwe okwenziwa ngokuzimela?
- Ingabe ababhali bavuma ukuthi udayi unezimpawu ezidalulayo, futhi banezela inqubo yokuzinqanda, njengokuchama ngesikhathi esihleliwe noma ukuhlukanisa izindima zabasebenzi?
- Ubani okwathiwa ubengazi ukwabiwa, futhi kuze kube nini: ukunikezwa komthamo, ukuhlolwa, ukuhlaziywa? Ukufihla okuphela ngaphambi kokuhlaziywa kubuthakathaka kunokufihla okuqhubeka kuze kuphele ukuhlaziywa.
- Ingabe isilinganiso esiyinhloko sasincike emizweni yomuntu noma sasingancikile kuyo, futhi sathathwa ngaphambi noma ngemva kwesibonakaliso? Idatha ethathwa emshinini wokuskena nezilinganiso zangemva kokuvakasha zisezinhlangothini eziphikisanayo zalowo mugqa.
- Ingabe kukhona owahlola ukuthi ukufihla kuphumelele yini: amazinga okuqagela, inkomba yokufihla, noma yini engaphezu kwegama lendlela yokucwaninga?
Udayi awenzi izivivinyo ezinobulungiswa zingenzeki. Wenza igama elilodwa elithi kufihliwe linganeli njengesifinyezo. Indlela udayi osebenza ngayo emzimbeni iqinisekisa ukuthi ulwazi luyadaluleka, futhi izincwadi zesayensi eziphathelene nokuphepha ziqinisekisa ukuthi lezi zimpawu ziyingxenye evamile yokusebenza komuthi kunokuba zibe yizehlakalo ezingalindelekile. Ngakho funda isigaba sezindlela ezisetshenzisiwe njengokulandelana kwesikhathi sokuthi ubani wayengabona ini futhi nini. Lapho isilinganiso sathathwa ngaphambi komchamo oluhlaza okwesibhakabhaka, sithembe kakhudlwana. Lapho sathathwa ngemva kwawo, nciphisa isisindo osinika sona ngokufanele, futhi ufune ukuphindwa kocwaningo ngezilinganiso udayi ongeke uzithinte.