Iko marara emakemikari ekurapa anobata zvakavanzika zvakavanzika
Pasinei nezvingaitwa nevamwe, FDA haina kumbobvumirwa "kubvumirwa" maitiro sekurapa. Pane kudaro, muna 2004, mitsara yakaudza firm French kuti haifaniri FDA kuvigirwa kutengesa mishonga yemishonga semushonga wezvokurapa muUnited States. Maererano neDFA , zvikwereti zvakafanana nemichina (zvinenge zvichida mahedheni) anotengeswa pamberi paMay 28, 1976 - musi wawakagadziridzwa neMedhiyo Dhidhiro .
Nokudaro, hapana kugamuchirwa kwemashoko emakwenzi kunoda.
Iwe unogona kutaura kuti pfungwa yandinoita ndeyekuti "kubvumirwa" kana kuti "kwete kubvumirwa" mahedheni ari kutengeswa uye anoshandiswa kurapwa muUnited States. Zvechokwadi, FDA haisi kuzoita chero chinhu chipi zvacho chichimisa makambani kubva kutengesa mahara; zvisinei, FDA haisi kutonga sekuchengetedza kwavo kana kubudirira - zvakasiyana zvikuru. Uyezve, mitsara haifaniri kusungirwa kuti iongorore zvakashata sechiremba semishonga uye kunyatsonzwisisa sayenzi yeraech therapy.
Kunyange zvazvo maronda akashandiswa seropa-kurega chirwere kubvira kare, isu tichiri kuziva zvishoma pamusoro pezvipembenene, zvisikwa zviduku. Kune chikamu chikuru, kutsvakurudza kunongopedzisira kune nhamba shomanana yezvidzidzo zviitiko uye nyaya dzenyaya dzisina kunyanya zvishoma-randomedzeswa-kuedza miedzo. Kunyange zvakadaro, izvo zvatinoziva pamusoro pezvikwereti zvehutano hukuru hwehutano: Mucheka wemagetsi ndeye pfuma yevasodilatory uye anticoagulant (blood-thinning) molecules.
Mishonga yeMakemikari uye Yakakura Kwazvo
Mapundu anokonzerwa neropa (sanguivorous) minye. Sezvakaita pasiworms, miviri yavo yakasarudzwa, uye varume ava vaduku vanogona kuwedzera, chibvumirano uye kukanganisa munzira dzakawanda. Hiruda medicinalis ndeyemhando dzecheki dzinowanzoshandiswa sechiremba. Zvisinei, mamwe mhando yemakete anoshandiswa, zvakare, kusanganisira Hirudinaria granulosa muIndia uye American medinal leech, Macrobdella decora .
Hembe ndeyezvipembenene zvekunze zvinokwanisa kuyamwa huwandu hweropa kazhinji kamuviri hwemuviri wake kubva kumubati waro. Mushure mokunge yakasanganiswa nekuvhara kwechivande izvo zvinoita kuti ropa rirege kubatana, maronda anochengeta ropa iri mu lateral diverticula. Nokudaro, ropa kubva kune imwe yekudya rinogona kushanda sezvokudya zvinovaka muviri kwemwedzi inoverengeka.
Ropa-kurega kana Hirudo therapy rakatanga kunyorwa muEgypt yekare uye rakaramba richienda kumavirazuva kusvikira kuma1800s apo tsika yacho yainge isingafadzi. Zvinonzwisisika, pasinei nekuwirwa zvisingafariri muWest, tsika yekucheka phlebotomy yakaramba isingawanikwi muAmount kana mishonga yechiIslam.
Kwemakumi emakore, leech yakashandiswa sechishandiso chekubatsira ne microsurgery uye mapurasitiki nekuvhiya kwekuvandudza. Uyezve, masayendisiti achangotanga kunzwisisa ma molecule ayo maitiro eLeech saliva uye zvavanogona kuita. Pano pane mamwe emamwe akawanda anoshamisa ma molecular maieties akawanikwa mu leech spit:
- Hirudin . Muna 1950, musayendisiti weGermany ainzi Fritz Marquardt akatsaura molecule iyo yaakatumidza hirudin kubva pane zvakavanzika zveHiruda medicinalis . Icho chinoitika kuti hirudin ine dzakawanda zveanticoagulant zvakadai seropa rakapisa heparin pasina mamiriro akaipa akaipa. Kunyanya, hirudin inosunga kukonzera kubatana kwepamusoro uye haifaniri kutarisana nemasikirwo mumurwere neheparin-induced thrombocytopenia. Uyezve, hirudin inogona kushandiswa kune vanhu vanosimudzirwa heparin kana kune avo vanoratidzira antithrombin III kukwana. Kusvika iye zvino, vatsvakurudzi vakagadzira hurongwa hwakasiyana-siyana hunoshandisa mabhakitiriya, mbiriso, uye eukaryotes vane tariro yekukohwa hirudin yakakwana yekurapa. Izvo zvinogona kushandiswa ku hirudin zvakakura uye zvinosanganisira chero chirwere chinokonzerwa nehutachiona (kuvhara mazamu) pasi pemakumbo akaita sitiroko , kurwisa kwemwoyo , uye kushungurudzika kwepfungwa .
- Hyaluronidase . Iyo enzyme hyaluronidase inorudzi rwetenderizer iyo inosunungura (inogadzirisa zvinogadziriswa) yevanhu inogadzirisa mishonga kuitira kuti leech inywe ropa. Iyo inobatsirawo kuita shanduko yekurapa uye kurwadziwa kunorwadza. Iyi enzyme ichiri kuongororwa kuti ishandiswe mumakemikrasi uye kukura kwemishonga inoputika kuburikidza neganda.
- Calin . Calin imomo inoshandisa maplatelet uye von Willebrand chikonzero, zvakakosha vanyori vekuvhara, kubva pakisunga ku collagen. Collagen inosimbisa uye inosimbisa ganda redu. Nokudaro, calin inochengeta ropa richiyerera nekudzivirira kubvisa.
- Destabilase . Iyo enzyme inokanganisa inokonzera kushungurudzika kana kuvhara-uye kushandiswa kwema-antibacterial. Kutsvakurudza kunoratidza kuti inogona kukonzera zvidzidzo kune streptokinase kana mishonga inonzi plasminogen activator iyo inoshandiswa kana yakaoma mwoyo kurwisa kana kuti kurohwa.
- Eglin . Iyi puroteni duku iyi inonzi thrombin inhibitor. Rimwe zuva rinogona kuita kuti kurapwa kwekuvhiringidza kwekutyisa uye emphysema .
Mazuva Ano Mashandisiro Emishonga Emakwenzi
Kunyanya muEurope, kushandiswa kwemaeches semishonga yerapi iri kuwedzera kukurumbira. Parizvino, mahedheni uye masimba avo anticoagulant anoshandiswa nokuda kwezvinangwa zvitatu.
- Mucheka anoshandiswa kuguisa ganda rinoputika rinoshandiswa mumapurasitiki, maxillofacial uye mamwe maitiro ekuvandudza. Munhu mumwe nomumwe anorema anoshandiswa kukonzera chidimbu chakavharwa che 5 kusvika 10 mL yeropa. Kurapa kwakadaro kunopfuurira kusvikira murwere wemuviri wega wega anogona kunyatsokonzera ropa revenous.
- Mahedhe anobatsira nehutachiona hutachiona hunoenda kune imwe chikamu chemuviri wako.
- Mahedhe anobatsira kuchengetedza mitezo yemuviri kubva pakumanikidza kuburikidza nekudzivirira chirwere chemavhinga kana chemaini. Nhengo dzomuviri yakadaro dzinosanganisira minwe, chinangwa chemhino, mbiru, nzeve, miromo, uye kunyange peni (iyo pasina mubvunzo inogadzira mufananidzo unotyisa).
Sezvakanyorwa mubhuku ra2012 rakabudiswa muWiley Periodicals , vatsvakurudzi vakanyora mashoko kubva ku 277 zvidzidzo zvenyaya uye nhepfenyuro kubva muna 1966 kusvikira muna 2009 uye vakatengwa kubva kuPublicMed nedzimwe nhepfenyuro. Pakati pa 229 varwere, makumi mashanu kana makumi maviri nemakumi maviri nemashanu kubva muzana vakawana zvinetso. Inenge zvikamu zviviri kubva kune zvitatu zvezvinetso izvi zvakapararira. Vamwe vanhu vakagamuchira chirwere chechechi vaidawo kuwedzerwa ropa.
Kubva pamigumisiro yekutsvakurudza kwavo, vanyori vekudzidza kweWiley vakaratidza kuti varwere vose vanogamuchira kurapa kwechiropa vanofanirwa uye vanoongororwa kuitira kuwedzerwa ropa. Uyezve, varwere vakadaro vanofanira kutanga pa prophylactic antibiotics sequinolones. Zvimwe zvinotsigira zvinoratidza kuti chizvarwa chechitatu cephalosporin se ciprofloxacin inogona kuva yakanakisisa kugadzirisa mabhakitiriya akasiyana neaech.
Pasina mubvunzo, kuva neeches kunoshandiswa kumabhuku edziviriro ako akakwirira pane "icky" scale. Yeuka kuti ndicho chisarudzo chako kubvumira chiremba wehutano kuti aise mavhesi kunyanya sezvo dzimwe nzira dzokurapa dziripo.
Zvisinei, kunyange zvazvo kuwedzera kutsvakurudza kwakaoma - vanotarisira (kwenguva refu) uye randomized kudzora miedzo - inoda kuitwa, izvo zvatinoziva pamusoro pemakumbo zvinokurudzira zvikuru. Uyezve, molecule yakasarudzwa kubva pamakumbo echikanda inogona kuisa kiyi yekuvandudza anticoagulant, antithrombotic, anti-inflammatory, uye analgesic therapy.
Chirongwa chakakosha kuMusikana Gina Wadas, munyori wenyanzvi wechidiki wesayenzi, uye mudzidzi musayenzi uye teknolojia purogiramu yekupedza zvidzidzo kuTexas A & M University, mukuratidza nyaya iyi. Thanks, Gina!
> Vakasarudza Sources
> Divi V et al. Chitsauko 78. Muna: Lalwani AK. eds. Kurapa Kwemazuva Ano uye Kurapa muOtolaryngology - Musoro & Neck Surgery, 3e . New York, New York: McGraw-Hill; 2012. Yakasvika 12/29/2014.
> Nyaya ine musoro unoti "Kubudirira Kwemishonga Mucherechedzo muUpurojekiti Nekugadzirisa Zvokugadzirisa: Kurongeka Kwakarongeka kwe 277 Kunonzi Clinical Cases" naI IS Whitaker uye yakabudiswa muWiley Periodicals, Inc. muna 2012. Yakabva kuPublicMed on 12/28/2014.
> Nyaya yakanzi "Mushonga Wekugadzirisa Kwemishonga Kukosha kweSanguivorous Leeches" naS SM Abbas More et al rakabudiswa muUnited Medicine Review muna 2011.