I-methylene blue nokulala: okwabhalwa ezivivinyweni, nalokho okungazange kukalwe muntu

Umugqa owodwa etafuleni lezehlakalo ezingathandeki uwubufakazi obukhulu kunabo bonke obukhona ngokuphathelene nokulala kulo mndeni wemithi. Esivivinyweni samasonto angu-52 esabiwa ngokungahleliwe sokwehla komqondo kwe-frontotemporal okubonakala ngezinguquko zokuziphatha, ukuqwasha kwabikwa yiziguli ezingu-3 kwezingu-110 ezazithatha u-8 mg ngosuku, nezingu-7 kwezingu-108 ezazithatha u-200 mg ngosuku. Ababhali babala ukuqwasha phakathi kwezehlakalo ezingathandeki ezanda ngokukhuphuka komthamo, kanye nokuntuleka kwegazi, isifo sohudo, isicanucanu, ubuhlungu lapho uchama, ukuchama kaningi nokuhlanza.

Umthamo ophindwe amashumi amabili nanhlanu wabonisa ukuqwasha okucishe kuphindwe kabili nengxenye. Lokho kuwuphawu oluncane etafuleni elincane, futhi kuya ohlangothini oluphambene nesizathu esenza abantu abaningi bafune lesi sihloko.

Asikho isivivinyo esabiwa ngokungahleliwe se-methylene blue, noma sesimo sayo esincishisiwe i-hydromethylthionine mesylate, esikale ukulala njengomphumela. Ukusesha okwenziwe ukuze kubhalwe lesi sihloko akutholanga ucwaningo olusebenzisa uhlu lwemibuzo yokulala, ukulandelela ukunyakaza nge-actigraphy, noma ubusuku elabhorethri yokulala. Okukhona yilokho isiguli esakubika nalokho udokotela akufaka ngaphansi kwekhodi ethile, okuyindlela yokuhlola ebuthakathaka kunalokho engase izwakale iyikho.

Okwabhalwa izinhlelo ezabiwa ngokungahleliwe

Amaqoqo amathathu edatha aqukethe yonke imibiko ephathelene nokulala etholakele. Amabili ayizivivinyo ezabiwa ngokungahleliwe ze-hydromethylthionine, isimo esincishisiwe sesakhiwo esiyisisekelo esifanayo se-phenothiazine esenziwe sazinza njengosawoti. Elesithathu ulwazi lwase-US lokunquma umuthi womkhiqizo ofakwa emthanjeni.

Imininingwane emibili emgqeni wesibili ibaluleke ngaphezu kwezinombolo. Okokuqala, iqembu lokuqhathanisa lalithola i-methylthioninium chloride, okuyinhlanganisela efanayo ethengiswa njenge-methylene blue, ngo-4 mg kabili ngesonto, inikezwa njengesishintshi sombala womchamo esingasebenzi ekwelapheni ukuze abahlanganyeli bangakwazi ukuhlukanisa la maqembu amabili ngokubheka indishi yendlu yangasese. Okwesibili, akukho nesisodwa sezigameko eziyisishiyagalombili zokuqwasha emaqenjini athola umuthi osebenzayo esahlulelwa umcwaningi njengokuhlobene nomuthi. Izigameko ezintathu zokozela kwabangu-332 zahlulelwa kanjalo.

Isehlakalo esingathandeki asisona isilinganiso. Yilokho umuntu akukhulumile, okubhalwe ngolimi lwamatemu oluhlukile kulolo olusetshenziswa umfundi, eqenjini labantu abanesifo esiwohlokisa isimiso sezinzwa, abaningi babo abathatha nemithi yokuthulisa nemithi yokudambisa ukucindezeleka. Ukufunda ukuthi “akubaliwe” emgqeni wesithathu njengokuthi “akwenzeki” kungaba iphutha ngesizathu esiphambene: iziguli ezingu-31 ziyisampula elincane ngokwanele ukuba lingabonisi cishe noma yini, kanti ulwazi lokunquma umuthi lusho ngokusobala ukuthi ubudlelwano phakathi kokuchayeka emuthini nempendulo yawo, kanye naphakathi kokuchayeka nokuphepha kwawo, abaziwa.

Lapho izimangalo zokulala zivela khona

Cishe zonke izihloko, amavidiyo namakhasi emikhiqizo axhumanisa le nhlanganisela nokulala agcina ekhomba umphumela owodwa. Ngo-2007, u-Oxenkrug nozakwabo bakala ukusebenza kwe-monoamine oxidase nama-indole endlaleni ye-pineal yamagundane ngemva komthamo owodwa ofakwe ngaphansi kwesikhumba.

I-methylene blue yayiyisivimbi esincintisanayo nesibuyiseleka emuva se-monoamine oxidase yohlobo A ku-Ki ecishe ibe ama-nanomole angu-180, futhi ivimba uhlobo B cishe kuma-nanomole angu-1,400, okubonisa ukukhetha uhlobo A cishe ngokuphindwe kasishiyagalombili. Amagundane amahlanu eqenjini ngalinye, u-10 mg/kg ngaphansi kwesikhumba, nezindlala ze-pineal zasuswa ngemva kwemizuzu engu-90. I-melatonin yakhuphuka isuka ku-0.17 yaya ku-0.71 nanograms ngendlala ngayinye. I-N-acetylserotonin, eyandulela i-melatonin ngokuqondile ekwakhekeni kwayo, yasuka ngaphansi komkhawulo wokutholwa yaya ku-0.86. I-serotonin yendlala ye-pineal yakhuphuka isuka ku-79 yaya ku-118, kanti i-5-HIAA, umkhiqizo wokuhlakazeka kwayo, yehla isuka ku-10.9 yaya ku-4.1.

Ukucabanga okulandelayo kuhambisana nekhemistri. I-serotonin iyisisetshenziswa sokuqala sokwakha i-melatonin, kanti i-noradrenaline iqhuba isinyathelo sokufakwa kweqembu le-acetyl esiguqula i-serotonin ibe yi-N-acetylserotonin. Uma kuvinjwa i-enzyme ehlakaza kokubili, indlala ye-pineal iba nesisetshenziswa sokuqala esiningi ngesikhathi sokukhanya kanye nenhlanganisela eyandulelayo eyengeziwe lapho kufika isikhathi sobumnyama.

Lokhu kusekude nokubonisa ukuthi umuntu ulala kangcono. Isilinganiso singesiqukethwe yindlala esilwaneni esifakwe umuthi wokubulala izinzwa ngomzuzu owodwa, futhi akukho kulolo hlelo lokuhlola okubhala ukuthi igundane lalala isikhathi esingakanani, lazumeka ngokushesha kangakanani, noma lazizwa kanjani ngakusasa ekuseni. Iphepha labhalwa ngokuphathelene nezindlela zokusebenza ezidambisa ukucindezeleka, kanti ingxenye yalo yengxoxo iphakamisa ukuthi ukukhuphula i-melatonin yasemini kungase kulungise isigqi samahora angu-24 esisukile esikhathini saso ezigulini ezicindezelekile. Lokho kuwumbono ongakahlolwa engxenyeni yengxoxo, futhi yiwona mthombo wesimangalo sokulala.

Isimangalo samaphupho acacile asinawo umthombo oshicilelwe

Ukusesha okwenziwe ukuze kubhalwe lesi sihloko akutholanga mbiko wesiguli esisodwa, uchungechunge lwemibiko yeziguli, okufakiwe esivivinyweni, noma ucwaningo lapho i-methylene blue yayihlotshaniswa namaphupho acacile, amaphupho amabi, noma ushintsho ekukhumbuleni amaphupho. Lesi simangalo sikhona ezingxoxweni zezinkundla, hhayi emibhalweni yocwaningo.

Ubufakazi besigaba salo muthi bukhomba okuphambene ngesikhathi sokwelashwa. Lapho i-clorgyline ne-pargyline, izivimbi ezikhetha i-monoamine oxidase yohlobo A no-B, zinikezwa amasonto amane ezigulini ezinokuphazamiseka kwemizwa, ukulala kwe-REM kwacindezelwa cishe ngokuphelele, nesikhathi esiphelele sokulala sehla. Ukubuyekezwa okuhlelekile kwemithi yokudambisa ukucindezeleka nokuphupha, okuhlanganisa izifundo zomtholampilo ezingu-21 nemibiko yeziguli ezingu-25, kwathola ukuthi ukuvama kokukhumbula amaphupho kuyehla lapho kuthathwa i-phenelzine, isivimbi se-monoamine oxidase esivamile. Amaphupho amabi kuleyo mibhalo avela ngesikhathi sokuyeka umuthi, lapho ukulala kwe-REM kubuya ngokwanda, hhayi ngesikhathi umuthi uthathwa.

Ngakho indlela yokusebenza evame ukucashunwa njengesizathu samaphupho acacile ibikezela ukulala kwe-REM okuncane nokukhumbula amaphupho okuncane esimweni esivamile, kube nokubuya okungemnandi lapho umuthi uyekwa. Ukuthi i-methylene blue iyakwenza yini noma yikuphi kwalokhu kumuntu akukahlolwa. Ukuvimba kwayo kuyabuyiseleka emuva, iyisivimbi esibuthakathaka kakhulu kune-phenelzine, futhi izifundo zabantu ebezingaphendula lo mbuzo azizange zenziwe.

Isimangalo se-jet lag sinomthombo wangempela

Kukhona iphepha elilodwa elingumsuka waso. U-Oxenkrug no-Requintina bakha imodeli ye-jet lag emagundaneni ngokushintsha umjikelezo wokukhanya, base bekala i-serotonin, i-N-acetylserotonin ne-melatonin yendlala ye-pineal nge-chromatography yoketshezi yokusebenza okuphezulu esebenzisa ukutholwa kwe-fluorescence.

Kwabikwa imiphumela emibili. Imijovo ye-melatonin ekuqaleni kwesikhathi esisha sobumnyama yasheshisa ukubuyela kwesigqi se-N-acetylserotonin ne-melatonin. Futhi i-N-acetylserotonin ne-methylene blue, echazwe ephepheni njengesivimbi se-monoamine oxidase A, zanciphisa ukuphazamiseka kwe-N-acetylserotonin okwakubangelwa ukukhanya, kodwa hhayi okwe-melatonin.

Funda lokho ngokucophelela. Kumodeli yezilwane yesimo esiqondile lesi simangalo esiphathelene naso, i-methylene blue yashintsha inkomba eyodwa yenhlanganisela eyandulelayo kodwa ayizange ishintshe isigqi se-melatonin. Iziphetho zephepha uqobo ziphathelene nesikhathi esingcono sokufika lapho kundizwa kubhekwe empumalanga nokuthi i-melatonin kufanele inikezwe nini. Aliphakamisi i-methylene blue njengokwelashwa kwe-jet lag, futhi alukho ucwaningo lwabantu oluyihlolile ngaleyo njongo.

Ukuncishwa ukulala kwamagundane amancane akusona isilinganiso sokulala

Ukuhlolwa okuvame ukucashunwa njengobufakazi bokuthi i-methylene blue isiza ngokuncishwa ukulala akuzange kukale ukulala. U-Marzabadi nozakwabo bafaka amagundane amancane angamaduna angu-60 ohlobo lwe-BALB/c ohlelweni olushintshiwe lwezinkundla eziningi, lapho isilwane esibekwe enkundleni encane siphoqeleka ukuba sihlale siphapheme, baqhathanisa iqembu lokuqhathanisa elalisenkundleni ebanzi nezilwane ezincishwe ukulala, i-methylene blue yodwa, i-laser eshaya ngezikhawu engu-810-nanometre yodwa, kanye nokuhlanganiswa kwalokhu kokubili.

I-methylene blue yajovwa ngo-0.5 mg/kg ezinsukwini eziyishumi ezilandelanayo ngaphambi kokuqala kokuncishwa ukulala, kanti i-laser yasetshenziswa njalo emva kosuku olulodwa. Ukufunda nokukhumbula kwahlolwa ngomzila odidayo omise okuka-T, ukuhlolwa kokuxhumana kwezenhlalo kanye nebhokisi le-shuttle, kwase kukalwa amazinga e-PSD-95, GAP-43 ne-synaptophysin engxenyeni yobuchopho i-hippocampus ngemva kwalokho.

Ukuncishwa ukulala kwehlisa amazinga okushintshana, ukuthambekela ekuhlanganyeleni nezinye izilwane, ukusabela ezilwaneni ezingajwayelekile kanye nenkomba yokukhumbula. Akukho kokwelashwa ngakunye okwaguqula iningi lalezo zilinganiso libuyele esimweni sangaphambili. Ukuhlanganiswa kwakho kwenza lokho, futhi kwakhuphula zonke izinkomba ezintathu zama-synapse. Okutholakele ukuthi inhlanganisela yokwelashwa okunikezwe kusengaphambili yavikela inkumbulo ezilwaneni ezaziphazanyiselwe ukulala. Kulolu hlelo lokuhlola, ukuncishwa ukulala yikona okulimazayo, hhayi umphumela okalwayo. Asizange sibhalwe isikhathi sokuzumeka, ubude besikhathi sokulala noma ukwakheka kwezigaba zokulala, futhi ukufunda leli phepha njengobufakazi bokuthi umuntu ulala kahle kangakanani kuphendulela lokho elakukala.

Ekuseni noma ebusuku: izinombolo aziwuxazululi umbuzo

Iseluleko sesikhathi sokuthatha umuthi siphindaphindwa ngokuzethemba kodwa asikaze sihlolwe. Asikho isivivinyo esiqhathanise ukuthathwa ekuseni nokuthathwa kusihlwa, kunoma yiliphi iqembu labantu, nganoma yimuphi umphumela wokulala.

Okukaliwe ukuthi le nhlanganisela ihamba kancane kangakanani emzimbeni. Ocwaningweni lomthamo owodwa kumavolontiya aphilile, u-200 mg othathwe ngomlomo ngemva kokulungiselelwa kwamathumbu wabonisa amazinga egazini ayekhuphuka amahora ayishumi nambili futhi afika esicongweni ngesikhathi esimaphakathi samahora angu-16. Isikhathi sokwehla komuthi ube uhhafu sasisukela emahoreni angu-14 kuya kwangu-27 kulowo mthamo, futhi sisukela kwangu-6 kuya kwangu-26 ku-400 mg. Umkhiqizo ofakwa emthanjeni ochazwe olwazini lokunquma umuthi unesikhathi sokwehla ube uhhafu esicishe sibe amahora angu-24, kanti cishe u-40% ukhishwa emchameni ungashintshile, nokuchayeka emuthini kukhuphuka kakhulu lapho ukusebenza kwezinso kuphazamisekile.

Ngakho umthamo womlomo othathwe ngesikhathi sokudla kwasekuseni ufika esicongweni esikaliwe cishe phakathi kwamabili. Kufanele ukucabangisise lokho, ngoba izingcezu ezimbili zeseluleko ezivame ukusabalala zincike ekutheni lokhu akulona iqiniso. “Yithathe ekuseni ukuze ingaphazamisi ukulala” kucabanga ukuthi umphumela uyobe usudlulile ngesikhathi sokulala. “Yithathe ebusuku ngoba iphela ngokushesha” kucabanga okuphambene. Ucwaningo olulodwa olutholakalayo lokuhamba komuthi emzimbeni womuntu alusekeli umphumela omfushane wakusihlwa, kanti ukuhlolwa kwamagundane okuyisisekelo sendaba ye-melatonin kuphakamisa ukunikezwa komthamo ekuqaleni kwesikhathi sokukhanya ngesizathu esihluke ngokuphelele, sokwandisa inhlanganisela eyandulela i-melatonin yasemini. Kukhona umhlahlandlela ohlukile wokuthi le nhlanganisela ihlala isikhathi esingakanani emzimbeni uma izinombolo zokukhishwa kwayo kuyilokho obukufuna.

Impendulo eqotho yombuzo wesikhathi sokuyithatha ukuthi akekho owaziyo, futhi amazinga akaliwe awasekeli ukwenza sengathi kukhona owaziyo.

Umbiko owodwa womuntu onenkinga yokulala eyashintsha

Kutholakale umbhalo owodwa kuphela oshicilelwe ophathelene nomuntu onenkinga yokulala owanikezwa i-methylene blue, futhi umbiko wesiguli esisodwa.

Umbiko wesiguli wango-2021 ku-Cureus uchaza umfana oneminyaka engu-15 one-Kleine-Levin syndrome, isimo esingavamile seziqephu eziphindaphindayo zokulala ngokweqile ezithatha izinsuku kuya emasontweni, ezihambisana nokudideka, umuzwa wokuthi indawo ezungezile ayiyona eyangempela, nokushintsha kokuziphatha. Wayeselashwe nge-lithium iminyaka emithathu, kanti i-modafinil, i-methylprednisolone, imithi engavamile yokwelapha ukuphazamiseka okukhulu kwengqondo kanye ne-amantadine kwakungazange kulethe ukuthuthuka. Lapho eneminyaka engu-18 waqala isiqephu esathatha cishe izinyanga eziyisithupha. Ngemvume yabazali, wanikezwa u-10 mg we-methylene blue ngomlomo ihora elilodwa ngaphambi kokukhanya okubomvu okwakufakwa emakhaleni njalo ebusuku imizuzu engu-25, ngo-633 nanometres, u-11.4 joules ngesentimitha-skwele. Kungakapheli isonto, ukulala ngokweqile nezimpawu zokuziphatha kwaphela. Ngemva kweminyaka emibili kwakungakabuyi futhi wayengathathi omunye umuthi.

Ababhali bayakusho bona umkhawulo: umuntu oyedwa, hhayi ucwaningo olulandelela izinguquko ngokuhamba kwesikhathi, futhi iziqephu ze-Kleine-Levin ziyaziwa ngokuncipha ukuvama ngokuhamba kweminyaka, okwenza kungenzeki ukunquma ukuthi ukuphela kwezimpawu kwakungenxa yokwelashwa. Kukhona umkhawulo wesibili abangawugcizeleli. Kwakusetshenziswa izindlela ezimbili ngesikhathi esisodwa, enye yazo iwukukhanya okubomvu okufakwa emgodini wekhala kanye nenhlanganisela ukusetshenziswa kwayo konke nge-photodynamic okuncike ekutheni ukukhanya kuyisebenze. Umfundi akakwazi ukuhlukanisa umthelela wedayi, owokukhanya nowokuhamba kwesikhathi, futhi lo mbiko awusona isizathu sokuzama i-methylene blue ngenkinga yokulala.

Okusekelwa idatha yabantu ukuthuliswa

Lapho kukhona izilinganiso zabantu zesimiso sezinzwa esimaphakathi, ikakhulu zikhomba ukuthuliswa kunokuqapha.

Ucwaningo lwango-2008 ku-Anaesthesia lwaqhathanisa iziguli ezingu-11 ezazinikezwe i-methylene blue kusengaphambili neziguli ezingu-11 ezifaniswe nazo eqenjini lokuqhathanisa ngesikhathi sokufakwa komuthi wokubulala izinzwa nokuhlinzwa, kusetshenziswa inkomba ye-Bispectral kanye nokufakwa kwe-propofol okulawulwa ngezinga elihlosiwe. Ezingeni le-propofol elibikezelwe endaweni yokusebenza lama-microgram angu-2 ngemililitha ngayinye, amaphuzu okuthuliswa namanani enkomba ayephansi kakhulu eqenjini elalithole umuthi. Ngesikhathi sokuhlinzwa, iziguli ezazithole umuthi kusengaphambili zazidinga ngokwesilinganiso i-propofol encane ngo-50% ukuze zifinyelele ukujula okufanayo kokubulawa kwezinzwa. Iphepha liqala ngokuphawula ukuthi ukubambezeleka kokuphaphama ngemva kokubulawa kwezinzwa nokuphazamiseka kwezinzwa kwase kubikiwe ezigulini ezazihlinzwa indlala ye-parathyroid ezazithole i-methylene blue kusengaphambili, futhi liphetha ngokweluleka ukulungiswa komthamo ngokucophelela noma nini lapho lo muthi ufakwa ngesikhathi esizungeze ukuhlinzwa.

Ulwazi lokunquma umuthi lusho into efanayo ngamanye amazwi. Ukwelashwa kungabangela ukudideka, isiyezi nokuphazamiseka kokubona, futhi iziguli ziyelulekwa ukuba zigweme ukushayela noma imishini eyingozi kuze kuphele lokho, okuwumyalo ongenabo ubudlelwano obusobala nenhlanganisela ethengiswa njengosizo lokulala.

Bese kuba nokusetshenziswa okwelapha ngempela isimo esifana nokulala. I-ifosfamide, umuthi wokwelapha umdlavuza ngamakhemikhali, ingabangela ukuphazamiseka kokusebenza kobuchopho okunezimpawu eziyinhloko zokozela kakhulu, ukuyaluza nokudideka, okungadlulela ekubeni yikhoma. I-methylene blue ingenye yezindlela zokwelapha ezinikezwayo kulokhu. Ekubuyekezweni kwezigameko ezingu-24 e-MD Anderson Cancer Center, iziguli ezingu-20 zathola i-methylene blue futhi izimpawu zaphela kwezingu-19, zaphinda zavela kwezintathu kweziyisihlanu ezaphinde zanikezwa i-ifosfamide kamuva zisayithola ngenjongo yokuvimbela.

Umuthi ojulisa ukubulawa kwezinzwa, obangela isiyezi nokudideka, futhi osetshenziselwa ukuguqula isimo sokozela ngokweqile esibangelwa ukwelashwa ngamakhemikhali awusilo ngokusobala usizo lokulala. Ungumuthi onemiphumela yangempela esimisweni sezinzwa esimaphakathi, indlela yaleyo miphumela encike kwezinye izinto ezithathiwe.

Imithi yasebusuku, nokuphefumula ebusuku

Okubili okubhalwe olwazini lokunquma umuthi kudinga ukunakwa yinoma ubani othatha i-methylene blue kusihlwa kanye nokunye.

Okokuqala uhlu lokuhlangana kwemithi. Ilebula ibala ama-SSRI, ama-SNRI, ama-MAOI, i-bupropion, i-buspirone, i-clomipramine, i-mirtazapine, i-linezolid, ama-opioid ne-dextromethorphan, futhi yeluleka ngokungathathi noma yimuphi umuthi osebenza ku-serotonin phakathi kwamahora angu-72 ngemva komthamo wokugcina. Emibili yaleyo mithi ivame ukuba sematafuleni aseduze kombhede. I-mirtazapine umuthi wokudambisa ukucindezeleka onomphumela wokuthulisa ovame ukuthathwa ebusuku. I-dextromethorphan iyisinqamuli sokukhwehlela emikhiqizweni yomkhuhlane yasebusuku, futhi ithengiswa ngaphandle kwencwadi kadokotela. Akukho kulokhu kuhlanganiswa okuyinto ecatshangwayo kuphela: ilebula ibhala izigameko ze-serotonin syndrome ezivela emikhiqizweni yesigaba se-methylene blue, kanti ezinye zazo zaholela ekufeni. Umbiko oshicilelwe wesigameko esihlobene nokuhlinzwa uchaza indoda eneminyaka engu-67 ukuyaluza kwayo, ukufinyela kwemisipha okuphindaphindayo nokushisa komzimba ngokweqile okwabonakala kuphela lapho iphapha ngemva kokubulawa kwezinzwa okuphelele, ngemva kokuba i-methylene blue inikezwe ngesikhathi sokuhlinzwa.

I-melatonin, ama-benzodiazepine, imithi engu-z njenge-zopiclone, ne-diphenhydramine akusebenzi ku-serotonin, ngakho ukukhathazeka lapha akuyona i-serotonin syndrome. Yilokho okwalinganiswa ucwaningo lokubulawa kwezinzwa, okuwukuthuliswa okwengezanayo emthameni ongakahlonzwa muntu ngokuningiliziwe.

Okwesibili kuphathelene nokuphefumula. Phakathi kwemiphumela engathandeki ebikiwe ngemikhiqizo yesigaba se-methylene blue, ulwazi lokunquma umuthi lubala ukuvaleka kwekhala, ubuhlungu endaweni yomlomo nomphimbo, ukugeleza kwamafinyila nokuthimula. Leyo yimibiko ezenzekelayo engenawo amazinga okuvama futhi engasho indlela umuthi owanikezwa ngayo, futhi iwuhlobo loshintsho olungabonakala ngokuvuka nomlomo owomile nomuzwa wokuthi uphefumule ngekhala ngendlela ehlukile ebusuku. Umbiko womfundi oyedwa ngoshintsho olungazelelwe lokuphefumula ngomlomo ngesikhathi elele ukhona engxoxweni yenkundla ngaphandle kokuhlolwa, umlando wemithi noma isilinganiso, okufakazela kuphela ukuthi kwenziwa umbiko, hhayi okunye.

Noma ubani onenkinga yokulala ewukuhona, ukuyeka ukuphefumula okubonwe omunye umuntu, noma ukozela emini okukhulu ngokwanele ukuba azumeke eshayela kufanele abheke umbuzo wokuma kokuphefumula ngesikhathi sokulala kunokuba abheke isengezo. Ukuma kokuphefumula kungaxilongwa, kungelashwa, futhi abukho ubufakazi obungenhla obubhekana nakho.

Ikhwalithi yento esetshenziswayo nayo iyahlukahluka lapha

Imithamo kuzo zonke izifundo ezingenhla yayiyizilinganiso zenhlanganisela echaziwe evela kumkhiqizi wemithi, enesitifiketi sokuhlaziywa esiyisekelayo. Ibhodlela elivela kumthengisi ongaqinisekisiwe alifani nalokho, futhi umehluko awuwona owokubukeka nje. Ukuchazwa njenge-USP kuyindinganiso umthengi angayihlola, kanti into engahambisani nayo cishe ingeyezinga lokusetshenziswa ezindwangwini, engase iqukathe ukungcola kwezinto eziphilayo njenge-Azure B, izincibilikisi ezisele nezinsimbi ezisindayo emazingeni abekelwa umkhawulo yisicaciso sezinga lemithi.

Abathengisi abaningi abachaza umkhiqizo njengohlolwe yinkampani ezimele bahlola izinsimbi ezisindayo kuphela bese bethula lelo qoqo elilodwa lokuhlolwa njengokuhambisana nazo zonke izimfuneko. I-Blupreme ihlola isicaciso se-USP esiphelele: ubuwena bento, ubumsulwa, ukungcola kwezinto eziphilayo, izincibilikisi ezisele, ukungcola kwezakhi, insalela ngemva kokushiswa, imikhawulo yamagciwane kanye nama-endotoxin amagciwane. Yonke inqwaba ithunyelwa nesitifiketi sokuhlaziywa, kanti ukusifunda ngendlela efanele kusho ukufanisa inombolo yenqwaba nelabhorethri nebhodlela oliphethe.

Akukho kulokho okudala inzuzo yokulala, futhi akusona isizathu sokuthatha le nhlanganisela. Uma uyithatha noma kunjalo, ukwazi ukuthi yini ekwi-capsule kuyisidingo esiyisisekelo, kanti umthombo wolwazi lokuphepha kanye nomhlahlandlela wokuhlangana kwemithi kubhekana nemibuzo okufanele ilandelwe ngaphambi kwanoma iyiphi ingxoxo yesikhathi sokuyithatha.

Okubalulekile ekugcineni

Asikho isivivinyo esabiwa ngokungahleliwe esikale ukulala ngesikhathi sokwelashwa nge-methylene blue. Okuwukuphela kwemibiko ethinta ukulala emibhalweni yezivivinyo ezabiwa ngokungahleliwe kuyimigqa yezehlakalo ezingathandeki, futhi ekuqhathanisweni kwemithamo okukhulu kunakho konke okutholakalayo izinga lokuqwasha lalingu-2.7% ku-8 mg ngosuku uma kuqhathaniswa no-6.5% ku-200 mg ngosuku.

Isimangalo samaphupho acacile asinawo umthombo oshicilelwe, futhi imibhalo ye-monoamine oxidase ibikezela okuphambene ngesikhathi sokwelashwa. Umbuzo wasekuseni uma kuqhathaniswa nobusuku awukaze uhlolwe, kanti umthamo othathwe ngomlomo ufika esicongweni egazini ngesikhathi esimaphakathi samahora angu-16, okusondele phakathi kwamabili kunasesikhathini sokudla kwasemini kumuntu othatha umthamo ngesikhathi sokudla kwasekuseni. Ukuhlolwa kokuncishwa ukulala okusatshalaliswa njengobufakazi kuwucwaningo lwenkumbulo lapho kungekho kulala okwabhalwa khona, kanti umbiko owodwa womuntu onenkinga yokulala eyaba ngcono ngowesiguli esisodwa esasingafihlelwanga ukwelashwa esikutholayo, esathola izindlela ezimbili zokwelapha ngesikhathi esisodwa.

Ukubuka konke kobufakazi babantu kuhlanganisa lokho lezi zivivinyo ezikufakazelayo ngempela, ukubuyekezwa kwenkumbulo nokugxila kuhlolisisa izilinganiso zemiphumela yokusebenza kwengqondo ezisondele kakhulu ekulaleni kulezi zifundo ezifanayo, kanti umtapo wocwaningo ukhomba amaphepha asekela zonke izimangalo ezikuleli khasi.