Isihloko
I-methylene blue ne-migraine: izimangalo zokwelapha uma ziqhathaniswa nobuhlungu bekhanda ngemva kokuyisebenzisa
I-methylene blue ayiyona indlela yokwelapha i-migraine eqinisekisiwe. Imibhalo yezocwaningo lwezokwelapha etholwe kulokhu kubuyekeza ayinikezi ucwaningo olulawulwayo olubonisa ukuthi iyamisa ukuhlasela kwe-migraine, iyakuvimbela, noma yelapha i-aura. Imibiko yokudamba kobuhlungu bekhanda nemibiko yobuhlungu bekhanda ngemva kokuyisebenzisa ingaba khona yomibili ngaphandle kokuqinisekisa ukuthi i-methylene blue iyithinta kanjani i-migraine exilongiwe.
Esinye isizathu salokhu kudideka ukuthi ubuhlungu bekhanda bungadamba lapho kwelashwa imbangela yabo. I-methylene blue yelapha i-methemoglobinemia etholakale kamuva ekwelashweni kwasesibhedlela. Leso simo ngokwaso singabangela ubuhlungu bekhanda obukhulu obufana ne-migraine. Ukwelashwa okuphumelelayo kuleso simo kuphendula umbuzo ohlukile kowokuthi umuntu one-migraine kufanele yini athathe i-methylene blue.
Thola usizo oluphuthumayo uma kuba nobuhlungu bekhanda obuvela kungazelelwe nobukhulu ngokwedlulele, ubuthakathaka obusha noma ubunzima bokukhuluma, ukuquleka, noma ubuhlungu bekhanda obuhambisana nobunzima bokuphefumula nezindebe eziluhlaza okwesibhakabhaka noma ezimpunga. Ungacabangi ukuthi lezi zimpawu ziyindlela elindelekile yokujwayela i-methylene blue. Umhlahlandlela we-NHS wobuhlungu bekhanda uchaza ubuhlungu obukhulu obuvela kungazelelwe nezimpawu zesimiso sezinzwa njengezimpawu zesimo esiphuthumayo.
Lokho izimangalo nge-migraine ezikubonisa ngempela
Izingxoxo ezinikeziwe ziveza okwenzeka okuphambene: enye ingxoxo esithangamini ibika ubuhlungu bekhanda ngemva kwe-methylene blue, kanti enye iqukethe izimangalo zokudamba kobuhlungu ekuqaleni kokuhlasela. Lokhu kungokubonwe abafundi, hhayi idatha yezokwelapha yokusebenza komuthi. Ingxoxo yesibili ize ichaze ukuthi ubuningi bento eketshezini bebungaqinisekile, okwenza kube nzima ukuchaza lokho kuchayeka.
Ucwaningo oluwusizo lokwelapha lungaqinisekisa ukuxilongwa kwe-migraine, luchaze umkhiqizo nendlela yokuwusebenzisa, luqhathanise neqembu lokulawula, bese lukala umphumela njengokuphela kobuhlungu ngesikhathi esinqunyiwe noma ushintsho enanini lezinsuku ze-migraine ngenyanga. Ukudamba kobuhlungu bekhanda bomuntu oyedwa akunakukunikeza lokho kuqhathanisa okungekho. I-migraine iyaguquguquka, abantu bavame ukuthatha eminye imithi, futhi okusetshenziselwa ukungenelela kungathathwa lapho ukuhlasela sekuvele kushintsha.
Ucwaningo nge-nitric oxide lunikeza isizathu esiphathelene nokusebenza komzimba sokuphenya izindlela ezibangela ubuhlungu bekhanda, kodwa aluqinisekisi ukuthi i-methylene blue iyindlela yokwelapha. Ocwaningweni lwe-migraine lukaLassen nozakwabo lwango-1998, isivimbeli se-nitric oxide synthase esifakwa emthanjeni, i-L-NMMA, sadambisa ubuhlungu bekhanda emahoreni amabili kubahlanganyeli abangu-10 kwabangu-15 abelashwayo uma kuqhathaniswa nabangu-2 kwabangu-14 eqenjini lokulawula. Nokho, kulolo cwaningo kwakungabahlanganyeli abathathu kuphela ababelwe ngokungahleliwe ukuthola i-placebo; abanye abayishumi nanye eqenjini lokulawula babevela ezifundweni zangaphambilini. Okubaluleke nakakhulu, i-L-NMMA ingumuthi ohlukile. Umphumela wayo awunakudluliselwa ku-methylene blue noma emikhiqizweni ethengiswa ezitolo ethathwa ngomlomo.
Umehluko ofanayo uyasebenza ocwaningweni nge-methylene blue kwezinye izimo zobuhlungu. Inqubo yobuhlungu obusendaweni ethile noma ucwaningo ngokulimala kwezinzwa akuqinisekisi ukuthi kufanele isetshenziselwe i-migraine.
Ithebula lobufakazi: hlukanisa izimo zobuhlungu bekhanda
| Isimo | Lokho ubufakazi obuphathelene nakho ngempela | Lokho obungenakukuqinisekisa |
|---|---|---|
| I-migraine exilongiwe, ene-aura noma engenayo | Okwenzeka okubikwa ku-inthanethi nezizathu eziphathelene nendlela esebenza ngayo; alukho ucwaningo olulawulwayo lokwelapha i-migraine nge-methylene blue olutholwe kulokhu kubuyekeza | Uhlelo olusebenzayo lokwelapha i-migraine, inzuzo yokuvimbela, noma umphumela othembekile ku-aura |
| Ucwaningo lokuhlola ukusebenza kwemithi ku-migraine | Ucwaningo oluncane lwe-L-NMMA efakwa emthanjeni ku-migraine engenayo i-aura, oluneqembu elengeziwe lokulawula elathola i-placebo ezifundweni zangaphambilini | Ukusebenza kwe-methylene blue, eyinhlanganisela ehlukile |
| Ubuhlungu bekhanda obubangelwa yi-methemoglobinemia | Ukubuyekeza okushicilelwe okuqukethe isigameko sobuhlungu bekhanda obukhulu, ukuba luhlaza kwesikhumba ngenxa yokuntuleka komoya-mpilo, nezinye izimpawu ezaphela ngemva kokwelashwa | Inzuzo nge-migraine eyinhloko kumuntu ongenayo i-methemoglobinemia |
| Ubuhlungu bekhanda ngemva komjovo we-methylene blue onikezwe ngencwadi kadokotela | Ubuhlungu bekhanda buvela phakathi kwemiphumela engemihle kulwazi lomjovo onikezwa ngencwadi kadokotela | Ukuthi ubuhlungu bekhanda buvela kaningi kangakanani ngomkhiqizo othathwa ngomlomo, noma ukuthi bonke ubuhlungu bekhanda ngemva kokuchayeka bubangelwa udayi |
| Ubuhlungu bekhanda obusha ngemva kokuchayeka ngaphandle kokuyalelwa udokotela | Umlando wezokwelapha odinga ukuhlolwa kwesikhathi, umkhiqizo, imithi, nezimpawu ezihambisana nakho | Isilinganiso se-serotonin, ukuxilongwa ngokwesikhathi kuphela, noma isizathu sokuphinda uchayeke |
Leli thebula lihlukanisa amaqembu abantu afundwe ocwaningweni nezinkinga zezokwelapha. Alihleli amathuba okuthi umuntu othile abe nalezi zimo.
Kungani iphepha nge-methemoglobinemia lingelona ucwaningo lwe-migraine
Umthombo wocwaningo onikeziwe, Ubuhlungu Bekhanda ne-Methemoglobinemia kaKhan nozakwabo, wavela ku-inthanethi ngo-2019 nasohlelweni lwephephabhuku lwangoJanuwari 2020. Ubuyekeza ubuhlungu bekhanda obubangelwa esinye isimo futhi uhlanganisa isiguli esasinobuhlungu obukhulu kulo lonke ikhanda, ukushoshozela emlonyeni nxazonke, izindebe nezandla eziluhlaza okwesibhakabhaka, isicanucanu, nokuphelelwa umoya lapho sizikhandla. Izimpawu zaphela ngemva kokwelashwa nge-methylene blue.
I-methemoglobinemia ishintsha i-hemoglobin ukuze igazi lingakwazi ukuhambisa umoya-mpilo ngendlela evamile. Ukwelapha leso sifo segazi kungadambisa izimpawu zaso. Umbiko uxwayisa ngokuthi indlela esibonakala ngayo ingadidaniswa ne-migraine ehambisana nokukhathazeka noma ukuphefumula ngokweqile. Awuzange wabele abantu abane-migraine eyinhloko ngokungahleliwe ukuthi bathole i-methylene blue noma i-placebo, futhi ukusabela ekwelashweni kwawo akufakazeli ukuvimbela noma ukudambisa ukuhlasela kwe-migraine okuvamile. Incazelo ebanzi yokwelashwa kwe-methemoglobinemia esibhedlela ihlanganisa lokho kusetshenziswa.
Kubafundi abafuna ngokuqondile “i-methylene blue ne-aura ye-migraine,” incwadi eyashicilelwa kamuva ichaza i-methemoglobinemia elingisa i-migraine ene-aura ethinta ukubona. Lokho kuwukufana kwezimpawu ekuxilongweni, hhayi ubufakazi bokwelapha i-aura nge-methylene blue. Irekhodi le-PubMed elitholakalayo alinakho ukufingqwa kocwaningo, ngakho imininingwane yokwelashwa kwaleso siguli ayinakucatshangelwa ngesihloko salo.
Ubuhlungu bekhanda ngemva kokuchayeka abulona ukuhlolwa kwe-serotonin
Ulwazi lokunikeza i-PROVAYBLUE lubala ubuhlungu bekhanda phakathi kwemiphumela engemihle ebikiwe. Leyo datha iphathelene nomkhiqizo onikezwa ngencwadi kadokotela ofakwa emthanjeni futhi osetshenziswa ezigulini ezine-methemoglobinemia. Ayilinganisi ubungozi bomkhiqizo othathwa ngomlomo onezithako ezihlukile nokuchayeka okuhlukile.
Empeleni, ubuhlungu bekhanda obusha bungaba umphumela ongemuhle, ukuhlasela kwe-migraine okujwayelekile, olunye uhlobo lobuhlungu bekhanda, noma ingxenye yesinye isifo. Isikhathi sibalulekile, kodwa ukuthi kwenzeke “ngemva kwalokho” akwanele ukunquma ukuthi kwenzeke “ngenxa yalokho.” Bhala okwenzekile futhi ufune iseluleko ngaphambi kokuphinde usebenzise umkhiqizo ongawuyalelwanga udokotela. Ungaphindi uchayeke ukuze uhlole ukuhlobana kwakho noma wengeze omunye umuthi ukuze ulwe nalowo mphumela.
Ukukhathazeka ngokusebenzisana kwemithi kungokoqobo: ukuhlolwa kwama-enzyme abantu ahlanziwe kubonisa ukuvinjelwa kwe-monoamine oxidase A yi-methylene blue. Kodwa ubuhlungu bekhanda abuvezi izinga le-serotonin lomuntu. Ukudamba ngemva kokusebenzisa enye into noma ukungabi nobuhlungu bekhanda akukwazi ukuxilonga noma ukuphikisa ubuthi be-serotonin.
Hlola imithi ethile ye-migraine
Ukwelashwa kwe-migraine kungahlanganisa imithi evela ezigabeni eziningana. Ulwazi lwe-sumatriptan luyakwenqabela ukuyisebenzisa kanye nesivimbeli se-MAO-A. Eminye imithi esetshenziselwa ukuvimbela, kuhlanganise nemithi yokucindezeleka, nayo idinga ukunakwa. Ulwazi lomjovo we-methylene blue luxwayisa ngesifo se-serotonin uma isetshenziswa nemithi esebenza ku-serotonin kanye nama-opioid. Usokhemisi udinga amagama angempela emithi, hhayi ukuthi “umuthi we-migraine” kuphela.
Funa usizo lwezokwelapha oluphuthumayo ngemva kokuchayeka uma ukungahlaliseki noma ukudideka kuhambisana nomkhuhlane, ukujuluka okukhulu, ukuqhaqhazela, ukuqina kwemisipha, noma ukunyakaza komzimba okuvele kuqhamuke. Lezi zinhlanganisela zikhathaza kakhulu kunobuhlungu bekhanda bodwa. Ungayeki umuthi wokuvimbela owuyalelwe udokotela ukuze uvulele i-methylene blue indawo, noma uzihlelele isikhathi sokulinda ukuthi umuthi uphume emzimbeni. Umhlahlandlela wokusebenzisana kwemithi uchaza izigaba ezithintekayo; ukungabikho kohlu olufushane akusho ukuthi kuphephile.
Bhala isigameko ngaphandle kokulibazisa ukuthola usizo
Landa ifomu lomlando wezimpawu ozohamba nalo lapho uyobonana nochwepheshe. Libhala isigameko kunokuba linikeze ukuxilongwa noma isincomo sokwelapha.
Chaza ukuthi lobu buhlungu buyafana yini nendlela ojwayele ukubuzwa ngayo, ukuthi baqale nini uma kuqhathaniswa nesikhathi sokuchayeka, ukuthi yini oyithathile, nokuthi yiziphi ezinye izimpawu ezivelile. Faka izinguquko emithini ojwayele ukuyisebenzisa yobuhlungu bekhanda nokuthi uyisebenzisa kaningi kangakanani imithi yokwelapha ukuhlasela ngesikhathi kwenzeka. Ukuyisebenzisa njalo ngokwakho kungenza ukuhlolwa kobuhlungu bekhanda kube nzima.
Umhlahlandlela we-NICE wokuhlola ubuhlungu bekhanda usekela ukubhala ukuthi ubuhlungu bekhanda buvela kaningi kangakanani, buhlala isikhathi esingakanani, bunzima kangakanani, izimpawu ezihambisana nabo, imithi, nezinto ezingase bubuqalise. Uphinde uhlukanise i-aura evamile eqala kancane kancane futhi iphele nezimpawu ezidinga ukuhlolwa okwengeziwe. Isigameko sokuqala noma esihluke kakhulu esithinta ukubona noma isimiso sezinzwa akufanele sibizwe ngokuthi “yi-aura nje” ngokusekelwe endabeni eku-inthanethi.
Uma kuba nobuhlungu bekhanda obusha noma obungapheli ngemva kokuchayeka, hambisa isitsha noma isithombe esicacile selebula kanye nefomu kudokotela noma kusokhemisi. Umhlahlandlela obanzi wokuphepha kanye nemibuzo yengxoxo yezokwelapha kusiza ukuhlela leyo ngxoxo igxile emkhiqizweni wangempela nasekusetshenzisweni okuhlosiwe.