Zvitsva biologic zvinodhaka zvinopa tariro kune vanorwara vanorwara
Kunyange zvazvo pasina mushonga wekusingaperi epakori psoriasis, pane marapirwo akasiyana-siyana anokwanisa kubatsira kubvisa zviyero uye kudzivirira masero echepere kukura nokukurumidza. Zvisarudzo zvinosanganisira mafuta anonhuwira, chirwere chechiedza, uye mishonga yemishonga inotorwa kana mumuromo kana muchijoka. Kuchengetwa kweganda kwakanaka uye kusarudza mararamiro kunogonawo kukubatsira kuti uve nekutarisa pane chirwere chinoramba chichikanganisa vakawanda semamiriyoni manomwe eMelika, maererano neAmerican Academy of Dermatology.
Zvinyorwa
Topical corticosteroids, inonziwo steroids, inonzi inonyanya kushandisa nzira dzokurapa zvinyoronyoro zvinonzi psoriasis. Zvisinei, sechirwere chisingagumi chinonzi autoimmune disorder , plaque psoriasis inogona kuwedzera zvimwe. Mune zvimwe zviitiko, mhinduro ye autoimmune inoda kuve yakanyanyisa kudzivirira muviri kuti urege kukuvadza zvakare. Nokuda kweizvi, vanachiremba vanowanzotendeukira kuzvinodhaka izvo zvinotarisa maitiro ekuzvidzivirira kwezvirwere zvezvirwere zvezvirwere, zvichienderana nehurongwa (sekuzara) kana muchikamu.
Topical Corticosteroids
Nyaya dzepamusoro dze corticosteroids dzinowanzoshandiswa sekutarisa solo kuvanhu vane runyoro rwepaloriasis, uye inogona kushandiswa pamwe chete nedzimwe mishonga kune vanhu vane muongorori kusvika kumatambudziko akaoma.
Kana ukaronga steroid yepicalical, dermatologist yako ichatarisa nzvimbo uye zvakasimba zvepaki dzako. Kune avo vari pachiso kana mazamu, masimba-masimba, 1.0% mazvigadziro anogona kunyoreswa, asi steroid yepakati-kusvika-potency inogona kushandiswa pane dzimwe nhengo dzomuviri.
Nyaya dzinodavirwa steroid dzinowanikwa nemishonga pamwe chete nepamusoro pemiti yakasiyana-siyana, zvinonhuwira, mafuta, shampoos, mapenzi, uye sprays. Kunyange zvazvo ichishanda, kushandiswa kwenguva refu kana kushandiswa kwepamusoro kunogona kutungamirira paganda atrophy (kuponda kweganda), iyo inowanzosakanganiswa.
Non-Biologic Zvinodhaka
Zvisiri-biologic zvinodhaka ndizvo izvo zvakagadzirirwa mubazi.
Ikoko kune zvitatu zvisati zviri biologics zvinowanzoshandiswa kurapa plaque psoriasis:
- Methotrexate iine immune-suppressive drug inenge yakapoteredza kwemakore anopfuura makumi mashanu uye inoshanda kuburikidza nekuderedza mafungiro ezvirwere zvemuviri. Iko inowanzoshandiswa mumutambo wokutanga mushonga wekuenzanisa kusvika kune zvakanyanya plaque psoriasis. Nokudzivisa simba rekudzivirirwa kwezvirwere zvezvirwere zvezvirwere zvese mumuviri waro, methotrexate inogona kukonzera migumisiro yechipfuva ichibva pane chiropa chekutyisa kusvika kumapfupa ekuderedza marora. Periodic kuongororwa ropa kunodiwa kuti urege kudzivirira maitiro.
- Cyclosporine ine mishonga inodzivirira-immressive yakafanana ne methotrexate. Iyo inoshandiswa apo psoriasis inenge yakakura kana isina kupindura kune imwe imwe yemishonga yemishonga. Kunyange zvazvo cyclosporine inoshanda nokukurumidza pamusununguko wemuviri, inodawo kugara ichiongorora migumisiro yechirwere, kusanganisira kukwirira kweropa, chiropa chekutyisa, uye kupererwa kwepfungwa.
- Otezla (apremilast) yakagamuchirwa muna 2014 kuzobata psoriasis uye psoriatic arthritis , chimiro cherheumatoid arthritis yakabatana zvikuru ne psoriasis. Otezla inoshanda nekuvhara enzyme, inozivikanwa se phosphodiesterase 4, iyo inodzora kuvhiringidza kwesero. Kunyange zvazvo Otezla yakanyatsorambidzwa, inogona kukonzera chirwere, chirwere chinoputika, kana kuti musoro kana kutanga. Zvishoma nezvishoma, vanhu vanogona kuora kurasikirwa kana zviratidzo zvekuora mwoyo.
Biologic Zvinodhaka
Biologic zvinodhaka zviya zvakagadzirwa nemapuroteni evanhu kana emhuka. Nhamba inowedzera ye biologics yakagamuchirwa kuitira kurapwa kwekuenzanisa kusvika kune zvakanyanya mapikori psoriasis. Kusiyana ne methotrexate, biologics inotsvaga chimwe chikamu chemuviri wechirwere chemumviri panzvimbo yehutachiona hwemuviri.
Biologics inonunurwa kana kuiswa mujeri kana mukati-kati (kuburikidza nemuviri). Inowanzotarisirwa kune vanhu vane muongorori kusvika kune vane psoriasis vasina kupindura kune dzimwe mishonga.
Ikozvino inogamuchirwa mahofisi anotarisa chimwe chezvikamu zvitatu zvemuviri wezvirwere zvemuviri:
- Cimzia (certolizumab), Humira (adalimumab) , Enbrel (etanercept) , Remicade (infliximab) , uye Simponi (golimumab) block tumor necrosis factor (TNF) .
- Stelara (ustekinumab) , Cosentyx (secukinumab) , Siliq (brodalumab), Taltz (ixekizumab), uye Tremfya (guselkumab) vanovhara maitiro akasiyana-siyana einterleukin, puroteni inoberekwa nemasero machena anokonzera maitiro ekudzivirira zvirwere.
- Orencia (abatacept) inodzivirira chimiro chechichena chechiropa chinonzi T-cell , icho chitunha chemuviri chemasimba chinoshandisa kuti chikurudzire kupindura kwekuvhiringidza.
Sezvo biologic zvinodhaka zvinogona kuwedzera mungozi yehutachiona, chero kutemwa, kuora, kana chiratidzo chepachirwere kunofanirwa kurapwa nachiremba. Matambudziko anowanzowanzobatanidza chirwere chinonzi injection site, zvirwere zvokuputika, uye zvirwere zvakadai semvura. Muzviitiko zvisingawanzoitiki, mamwe mararamiro uye zviratidzo zveeurologic (zvakadai sekugumburwa uye multiple sclerosis) zvinogona kukura.
Mishonga Inotsigira
Iko kunewo mishonga yemishonga inowanzoshandiswa kutsigira kutanga kurapwa kwe psoriasis:
- Calcipotriol (calcipotriene) inogadzirwa nemavitamini D3 analogog akatanga kuzivikanwa mumakore ekuma1990 kubata chirwere chisingaperi chine playo psoriasis. Inotendwa kunatsiridza zviratidzo kuburikidza nekudzikisa kuwandisa kwekeratinocytes muganda. Zvimwe mavitamini D3 zvakafanana zvinosanganisira calcitriol uye tacalcitol.
- Tazorac (tazarotene) inonzi repino retinoid inobva ku vitamine A inogona kunonoka kushandiswa kwemasero eganda uye kuderedza kupisa. Inotengeswawo pasi pemazita ezita Avage naFabior. Zvimwe zvinokonzera zvinosanganisira kushungurudzwa kweganda uye kushuva kwezuva.
- Soriatane (acitretin) inonzi retinoid oral iyo dzimwe nguva inobatanidzwa ne UV chiedza chetachiona. Migumisiro yakaipa inosanganisira kuputika kweputi, kusuruvara kwemvere, uye kuomeswa kwemaziso, mhuno, nemuromo.
Tazorac uye Soriatane zvose zvakasarudzwa sechikamu chekudzivirira X mishonga uye haigoni kushandiswa panguva yekuzvitakura nekuda kwekuda kwekuremererwa kwekuberekwa.
Mishonga
Chiedza chezuva chinogona kubudirira mukuderedza mapegi psoriasis, asi kuwedzerwa kwenguva yakareba kunogona kuita kuti zuva riwedzere uye kuwedzera kwezviratidzo. Kusvika parizvino, UV ray therapy, inonziwo phototherapy , yava chinhu chakachengeteka kune avo vanokundikana kupindura mishonga chete.
Ultraviolet B (UVB) mihizha, kunyanya, inokwanisa kupinda mukati meganda uye inononoka huwandu hwemasero eganda pasina kukuvadza. Mishonga inogona kuitwa muhofisi yechiremba kana neimba yeimba. Chero zvazvingaitika, nzira yacho inofanira kutungamirirwa nedermatologist ine ruzivo rwephototherapy. Kunyange zvazvo ganda rako rinogona kuwedzera kutanga risati rava nani, kusagadzikana kunowanzoita kuti zvive nani.
Imwe mavara ekurapa kwechiedza, anonzi psoralen + UVA (PUVA), anobatanidza miviri yeUVA nemishonga inonzwisa chiedza inonzi psoralen, inotorwa mumuromo kana pamusoro. PUVA inonyanya kushanda kune yakagadzikana mapeji psoriasis kupfuura yemafuta anorema.
Over-the-Counter Treatments
Mukuwedzera kune zvisingabvumirwi zvinyorwa zve-topical corticosteroids, kune zvimwe zvepamusoro-the-counter (OTC) zvinowanikwa pakurapa psoriasis.
Sezvo vamwe vanogona kushanda zviri nani pane vamwe (uye vamwe vangave vakanyanya kukuvadza iwe), zvinokosha kutaura nemudhisi wako wekare asati ashandisa chero.
Pakati pezvimwe zvinowanzodiwa:
- Mari yehairi yakashandiswa kurapa psoriasis kwemakore anopfuura zana, uye kune vamwe vanopika nayo. Mari yehairi inowanikwa pasina mushonga uye inogona kuwanikwa mune zvakasiyana-siyana zvekugadzirira, kusanganisira shampoos, mafuta, mafuta, makanda, uye mapenzi. Kunyange zvazvo zvichinyaradza, zvimwe zvezvigadzirwa zvinogona kuva zvinotyisa uye kunyange zvishoma zvinonhuwira.
- Salicylic acid ndiyo inoratidzira iyo inogona kubatsira kugadzirisa uye kubvisa zviyero zvinopisa. Inowanikwa mumhando dzakasiyana-siyana dzezvinokonzera mafuta, lotions, uye mafuta anonhuwira. Dzivisa kusanganisa salicylic-ine zvigadzirwa, uye usashandise pane zvinopfuura 20 muzana yemuviri, sezvo izvi zvinogona kukonzera kuwandisa kwemashoko ekunyanya uye kuora. Usashandisa izvi pavana.
Mishonga yeMusha uye Upenyu
Nepo kune kuwedzera kwezvinyorwa zvezvinyorwa uye mazai eOTC anowanikwa pakurapa psoriasis, kune mishonga yepamusha uye maitiro ekuchengetedza ganda anogonawo kubatsira.
Mishonga yeMusha
Chinangwa chikuru chemishonga epamba ndechekudzikisa kusvibiswa, kupisa, uye kusagadzikana kweplates apo paine kubvisa zvinyoronyoro masero eganda pasina kubuda ropa.
Pakati pezvimwe zvekusarudza zvakakosha:
- Matapirwo emvura anoshambidzwa ne Epsom munyu, mineral oil, mukaka, kana maorivhi anogona kugadzirisa ganda paanenge achisimudza zvinyoro kubva kune imwe kunze kweganda (epidermis). Shandisa mvura inodziya chete; mvura inopisa inogona kukurumidza kubvisa mafuta emuviri uye kusiya ganda rinopisa kupfuura kare.
- Mafuta anonhuwira asina mahwendefa , akadai sefreleleum jelly, aloe vera gel, kana mafuta emaminerari, anogona kubatsira mukudururira masero paanenge achivhara unyoro muganda. Izvozvi zvisizvo zvakagadzikana zvakagadziriswa zvinofanira kushandiswa mushure mekushambidza kugadzirisa kurasikirwa kwemhepo.
- Sezvakataurwa, chiedza chezuva chinogona kuderedza kuwedzera kwemasero emaganda asi kunoda kusinganzwisisiki kudarika maminitsi gumi ekudzivirirwa zvakananga pazuva. Iwe unogona kuwedzera zvishoma nezvishoma nguva yekutsvaga asi nguva dzose unozviita paunenge uchipfeka zvishoma zvishoma SPF 30 yezuva.
Imwe nzira yakakwana yekurapa inonzi psoriasis inofanira kugara ichisanganisira kurovedza muviri, kuderedza kunetseka, kudya kwakaderera-mafuta kunowanikwa mune omega-3 fatty acids, nekudzivisa doro uye fodya.
Skin Care
Kuchengetedza kwakanaka kweganda kunokosha kuti uone mavara ako epori psoriasis. Pakati peizvi ndechokudzivirirwa kwemasodha anodhaka, exfoliating scrubs, uye doro-based astringents uye vakachena. Izvi zvinogona kupisa ganda rako rakaoma uye rinogona kutotanga kupisa.
Mamwe mazano anokosha ekuchengetedza ganda anosanganisira:
- Geza uye nyuchiza ganda rako kamwe chete zuva nezuva kuti usadzima.
- Sarudza sopu yakachena kana kuchenesa yakagadzirirwa psoriasis.
- Shandisa jira rakanyorova kana kuti maoko ako kuti uwedzere. Usamboshandisa iafah kana chimwe chinhu chinogona kutsvaira kana kutsamwisa ganda rako.
- Shamba nemvura inodziya. Mvura inotonhorera inokonzera mireza yeropa inenge yave yakaputika kuti iwedzere kunyanya uye inogona kubvisa mafuta akawanda emuviri.
- Usapfu-sopu ganda rako. Kana iwe uchiwedzera, inodonha ganda rako richava. Ingo saga chete zvikamu zvemuviri wako zvinoda izvozvo.
- Mumwedzi yechando, shandura kubva pakuchenesa kwechiedza kusvika kune yakanyanya kukura kwemafuta ekugadzirisa kubhadhara kwemvura.
- Dzivisa mafuta nezvinonhuwira zvine doro.
- Nepo iwe unofanirwa kudzivisa mazamu kana iwe une maziso psoriasis, unogona kuedza kushandisa ganda-yakachengetedza concealer seDermablend kana Covermark, iyo inoshandiswa nevamwe kuvanza kupisa nemakumbo.
- Inwa mvura yakawanda-magirasi masere pazuva. Kuita kudaro zvinosvibisa ganda sezvinongoita muviri wako wose.
> Sources:
> American Academy of Dermatology (AAD) Bhuku reBasa, et al. "Nhungamiro yekuchengetedza kutungamirirwa kweporioriasis uye psoriatic arthritis: chikamu 6. Mirayiridzo yekutarisira kurapwa kwe psoriasis uye psoriatic arthritis: zviitiko zvakarongeka uye uchapupu-hunogadziriswa." J Am Acad Dermatol . 2011 Jul; 65 (1): 137-74. DOI: 10.1016 / j.jaad.2010.11.055.
> National Psoriasis Foundation. "Muchidimbu kuSevere Psoriasis uye Psoriatic Arthritis: Zvinodhaka Zvinonzi Biologic." Portland, Oregon.