Pane imwechete iyo Standard Treatment yeRheumatoid Arthritis
Munguva yakapfuura, chirwere chegoridhe chaive chekugadzirisa kwakakwana kwekunyatsotarisa kushingaira. Mishonga yegoridhe yakashandiswa kurapa rheumatoid arthritis kubva muna 1929. Ndarama yakanyatsokurudzirwa sechirwere chechifuba. Panguva iyoyo, zvakange zvisiri izvo zvaifunga kuti tuberculosis uye rheumatoid arthritis yakanga yakabatana nemamiriro ezvinhu. Kunyange zvazvo izvi zvisiri pachena, goridhe yakaratidza kubatsira kune rheumatoid arthritis.
Iyo Inoshanda Sei
Kunyange zvazvo nzira yegoridhe inopesana nokuputika isinganzwisisi zvakakwana, uchapupu hunoratidza kuti goridhe inochengetwa mu lysosomes iyo inovharidzira kushandiswa kwean antigenic agents (chero chinhu chinokurudzira kugadzirwa kwezvirwere) uye kusunungurwa kweproinflammatory cytokines . Izvi zvinorondedzerwa sechirwere-kuchinja anti-rheumatic drug (DMARD) .
Kuwanikwa kweGoridhe
Parenteral maitiro egoridhe akajowa uye anosanganisira Myoschrysine (aurothiomalate) uye Solganol (aurothioglucose). Ridaura (auranofin) is oral gold therapy. Kwemakore, shanduro itsva dzakatanga kuvapo dzakapa hupfumi hwakanaka uye huwandu huwandu hwemungozi (semuenzaniso, mamwe DMARD uye biologic zvinodhaka ), majekiseni egoridhe aisambosarudzwa kuti ave nehumatoid arthritis. Kushandiswa kwaro kuderedzwa zvikurukuru zvichibva pamusana wemigumisiro, pamwe nekudikanwa kwekuvhara kwekliniki nekuongorora kwebhakatori, uye kusagadzikana kwejekiseni yepramuscular.
Ndarama Inotungamirirwa Sei?
Kufuridzira kwegoridhe kunoshandiswa sechijoviso chemuviri muhofisi yechiremba vhiki nevhiki kwemavhiki makumi maviri ekutanga ekurapa uye zvino inowanzoendeswa kune vhiki nhatu kana ina dzose. Kuyera ropa uye urinho kuongororwa kunorudzirwa kusati kwasvika jekisi rimwe nerimwe regoridhe, kuve nechokwadi kuti rakachengeteka kupa.
Pakutanga, chirwere chemukati chegoridhe chinowanzogadziriswa sediki kadiki 10-milligram, kamwe kamwe pavhiki. Chirwere chechipiri chema 25 milligiramu chinotevera uye mamiriyoni makumi mashanu pavhiki kusvikira mhinduro inogadziriswa, kusvika pamakiromita 750 kusvika 1000.
Migumisiro Yechikamu Ita Kuti Kurapa Kwegoridhe Kunetsa
Zvimwe zvikanganiso, chikonzero chinowanzovhiringidza chekuregererwa kwegoridhe remishonga, chinokanganisa vanenge 30 muzana yevanhu vanobatwa ne parenteral gold compounds. Zvipembenene zvakajairika zvakabatanidzwa neparrenteral gold zvinosanganisira pruritis, dermatitis, stomatitis, uye proteinuria. Negoridhe remuromo, zvigaro zvakasununguka ndezvimwe zvinokonzera kushanda, asi chirwere chemanheru chinowanzoitika kashoma (chinosvika kusvika 5 muzana yevarwere). Nephropathy uye thrombocytopenia inogonawo kukura nemishonga yegoridhe, kunyanya kune iyo yakanaka yeHLA-DR3 gene.
Kunyange zvazvo zvingava nemigumisiro yakave iri kuora mwoyo kwehutano hwegoridhe, inofanira kuonekwa kuti injini dzegoridhe dzakaisa vamwe vanhu vane rheumatoid arthritis mukuregererwa kwekusingaperi. Nyanzvi yeRheumatologist, Scott J. Zashin, MD akati, "Somugumisiro, kana murwere akawana mhinduro yakanaka kune injini dzegoridhe, ivo vanowanzoenderera mberi. Kuvhara goridhe mune varwere kunogona kukonzera kudzokorora kwechirwere chearthritis chisingagoni kupindura kudzokerazve kwerapi negoridhe. "
Zvisinei, sezvo shota yegoridhe yakashandiswa kuduku uye sekurapa kwatsva kwakagadzirwa, makambani akamira kuita mishonga. Apo pakanga pane maitiro maviri egoridhe shots panguva imwechete (Solganol neMyochrysine), Myochrysine chete ikozvino yavapo. Kakawanda, varwere vanoita kuti vateerere, zvichiita kuti kuregera kuve kwakakodzera.
Nechipfuva Chendarama Ikamiririrwa Nechirwere Chinotapira
Zvinosuruvarisa, goridhe remuromo yakabudiswa zvishoma zvisingabatsiri, saka zvakanga zvisingawanzogadziriswa. Ridaura, kugadziriswa kwegoridhe kugadzirwa, inogona kuwanikwa, asi inowanzoshandiswa muUnited States. Ndarama yegoridhe yakaratidzwa kuva yakanyatsobudirira kana ichienzaniswa ne placebo.
Yaifungidzirwa zvakaenzana naPauquenil (hydroxychloroquine) uye methotrexate , asi nehuwandu hwehutachiona.
The Bottom Line
Ndarama ndechekare DMARD (chirwere-chinogadzirisa anti-rheumatic drugs) iyo, munenge mamiriro ezvinhu ose, yakatsiviwa neDMARD itsva uye biologic zvinodhaka. Kushandiswa kwegoridhe kunowanzochengeterwa varwere vasingatendi kana vasingakwanisi kutsungirira methotrexate, mamwe maDMARD akare (akadai sePallaquenil uye sulfasalazine ), kana kuti TNF blockers .
Sources:
> Cush JJ, Weinblatt ME, Kavanaugh A. Rheumatoid arthritis: kutanga kuongororwa uye kurapwa . West Islip, NY: Professional Communications; 2010.
> Klinkhoff A. Maitiro makuru emishonga yegoridhe. Kusvika pari zvino. https://www.uptodate.com/contents/major-side-effects-of-gold-therapy.
> Klinkhoff A. Kushandiswa kweMidziyo yeGarama muRheumatic Diseases. Kusvika pari zvino. https://www.uptodate.com/contents/use-of-gold-compounds-in-rheumatic-diseases?source=see_link.