CDC Nhungamiro uye nzira dzakasiyana
Bacterial vaginosis (BV) inowanzobatwa nechirwere chepamuviri chinokonzera kusvibiswa, kubuda kwemudzimai, uye unhu hwe "fishy" hunhu. Kazhinji zviitiko hazvina kuoma uye zvinogona kurapwa nemishonga inorwisa mishonga inorwisa mabhakitiriya, inotorwa kana mumuromo kana nemasikiriti emagetsi kana gel. BV zvirwere zvinowanzozivikanwa kuti zvinowanzodzoka, kazhinji mukati memwedzi mitatu kusvika kune gumi nembiri, zvichida zvimwe kana mamwe maitiro ehutano.
Mishonga inogonawo kunyorwa panguva yekuzvitakura kuderedza njodzi yezvinetso zvakadai sechepasi kuberekwa uremu uye kupera nguva isati yasvika.
Mishonga yeMusha
Chimwe chezvinhu zvinokonzera kukanganisa bhakitiriya vaginosis ndiyo yakakwirira yekudzoka zvakare. Zvimwe zvidzidzo zvakaratidza kuti chiyero chinogona kuva chakakwirira se50 muzana; vamwe vanotenda kuti yakakura zvikuru. Uye, izvi zvinokonzera dambudziko rakapiwa kuti kushandiswa kwemishonga inorwisa mabhakitiriya kunowedzera dambudziko rekushaya zvinodhaka.
Kumugumo uyu, mishonga yakawanda yemisha yakadzidzwa kuvakadzi vane zviratidzo zveBV zvekare. Mukuru pakati pezvinhu izvi ndeye boric acid uye hydrogen peroxide, iyo yose isingadhuri uye inowanikwa nyore nyore muchitoro chemishonga pasina mushonga.
Heino zvatinoziva:
- Boric acid yakashandiswa kurarisa mbiriso yepiriso ( vaginal candidiasis ) kwemakore anopfuura zana. Chidzidzo chegore ra2015 chakaongorora kushandiswa kwaro sechine vaginal suppository kuvakadzi vane BV uye vakawana kuti, mushure memazuva gumi, chiyero chekuregererwa kwechirwere chakanga chakafanana neicho chemishonga inorwisa mabhakitiriya.
- Hydrogen peroxide, inowanikwa mune 3 muzana intravaginal solution, yakashandiswawo kumarudzi ekurapa BV. Zvisinei, kutsvakurudza muna 2011 kubva kuJohn Hopkins University kwakaratidza kuti kurapwa kwakange kusingagoni kudzvinyirira mabhakitiriya "akaipa" akabatanidzwa nehutachiona hweBV, achideredza kukosha kwahwo kuvakadzi vane zviratidzo zvakare.
Kunyange zvazvo izvi zvikanzi zvinonzi zvakachengeteka uye zvisingakwanisi, hazvifanirwe kushandiswa pasina kuongororwa zvakakwana uye kupiwa kubva kuchiremba wako. Izvi zvinonyanya kuitika kune vanotanga kurwara nguva, vakadzi vane pamuviri, kana avo vane zviratidzo zvehutachiona hwakakomba (kusanganisira fevha, muviri aches, pelvic uye / kana kurwadziwa mumimba, kana kuti kuoma kurinha).
Zvinyorwa
Mishonga inorwisa mabhakitiriya yebhakitiriya vaginosis inokurudzirwa kune vose vakadzi vane zviratidzo. Kuita izvi hakungobatsiri kupedza utachiona chete, kunoderedza mukana wemukadzi wekutora zvirwere zvepabonde zvakadai segonorrhea , chlamydia , uye trichomoniasis .
Kunyanya Kurapa
Kune zvitatu zvinoshandiswa nemishonga yemishonga inorwisa mabhakitiriya yakakurudzirwa neCenters for Disease Control and Prevention (CDC) yekurapa BV:
- Metronidazole: 500 milligrams inotorwa nemuromo (nemuromo) kaviri zuva nezuva kwemazuva manomwe
- Metronidazole: 0.75% gel rinoshandiswa kamwe chete zuva rega rega kwemazuva mashanu uchishandisa 5.0-gram inogona kuiswa mukati mekushandisa
- Clindamycin 2.0 muzana kamu: yakashandiswa kamwe panguva yekurara kwamazuva manomwe uchishandisa 5.0-gram intravaginal applicator
Alternative Treatments
Zvimwe zvirwere zvinoshandiswa kwechipiri-line therapy kana zviratidzo zvichidzoka kana kana munhu ane kuzivikanwa kunozivikanwa kune antibiotic inosarudzwa.
Dzimwe nzira dzokurapa dzinosanganisira:
- Clindamycin: mamirigiramu 300 anotorwa nomuromo kaviri pazuva kwemazuva manomwe
- Clindamycin: 100-milligram suppositories inoshandiswa pamubhedha kwemazuva matatu
- Tinidazole: 2.0 gramu inotorwa kanaally kamwe chete kwemazuva maviri
- Tinidazole: 1.0 gramu inotorwa nemuromo kamwe chete kwemazuva mashanu
Kunyora Zvikurudzira
Chero chero mushonga unorayirwa, unoda kupedza chikoro kunyange kana zviratidzo zvako zvichiratidza. Kukundikana kuita izvi kungawedzera mungozi yekurapa mabhakitiriya.
Inorayirwa kuti urege doro munguva yekurapa uye kwemaawa makumi maviri nemasere. Kunwa kunogona kukonzera zviratidzo zvakashata zvakadai sepfungwa, kuputika, kukurumidza kwemoyo wemhepo, kuperevedza kufema, kusuruvara, kurutsa, uye kupera.
Kuti urege kudzivirirwa kune mabhakitiriya uye mamwe mishonga inokuvadza, iwe unofanirwa kurega zvepabonde kana kushandisa kondomu mukati mekurapa. Kunyange zvazvo BV isingatariswi nehutachiona hwepabonde, hutachiona hunogona kukuvadza hunogona kuve huri pamurume wepenisheni, kunyanya pasi pepamberi. Kunyange musikana wepabonde unoita dambudziko rinokonzerwa neganda-ku-genital kana kuti zvepabonde-ku-genital contact.
Pasinei nezvipingamupinyi izvi, kurapwa kwemunhu wepabonde hakuwanzodikanwa.
Nharaunda Dzakabatana
Vazhinji vanyoro. Pakati pavo:
- Mishonga yemumuromo inogona kukonzera kushushikana mumimba, kusuruvara, zvirwere zvinotonhora (kuora, runny pua, maronda), uye kunaka kwesimbi mumuromo.
- Mifananidzo inorwisa mishonga inokonzera mishonga inogona kukonzera kusvibiswa kwemudzimai, kuora musoro, kushungurudza, zviratidzo zvinotonhora, kutinhira kwemaoko nemakumbo, uye kunamatira kwesimbi mumuromo.
Pregnancy Recommendations
Chirwere chinokonzera BV panguva yekuzvitakura chinogona kuwedzera njodzi yekuberekwa kwepakutanga, kuberekwa kunorema, kupera kusati kwapera (PROM) uye, zvishoma, kazhinji, kupererwa pamuviri.
Mishonga yemishonga inorwisa mabhakitiriya inonyanya kutaurwa, kana clindamycin 300 milligrams kana metronidazole 500 milligrams inotorwa kaviri zuva nezuva kwemazuva manomwe. Nyaya dzinorwisa mishonga inorwisa mabhakitiriya, zvakasiyana, dzinoita sedzisina kubudirira pakudzivirira kubata pamuviri kunetseka.
Kunyange zvazvo nyanzvi dzakawanda dzichiratidza kuti kushandiswa kwemiromo inorwisa mabhakitiriya kunogona kuderedza ngozi ye PROM uye yakaderera kuberekwa uhu, humwe uchapupu hunoshaikwa mukukwanisa kwavo kudzivirira kutanga kwekuberekwa.
Antibiotic Resistance
Kazhinji, njodzi yemishonga inorwisa mabhakitiriya muBacterial vaginosis haisati yasvika sezvinoshamisa sezvinogona kutarisirwa nomunhu. Izvo zvinokonzerwa muchidimbu kumarudzi emaabhakitiriya anobatanidzwa muBV (ayo ari anaerobic uye haafaniri okisijeni) kana akaenzaniswa neaya anowanikwa mune mamwe maitiro e vaginitis (ayo ari aerobic uye anoda oxygen).
Mabhakitiriya anonzi Aerobic anowanikwa kunze kwemuviri uye anonyanya kuparadzirwa kubva kuvanhu nemunhu. Izvi zvinosanganisira marudzi akadaro anozivikanwa seStaphylococcus aureus, Streptococcus, uye Escherichia coli ( E. coli ). Kupararira kwemishonga inorwisa mabhakitiriya kurapa zvirwere izvi kwakaguma nekuwedzera kwemari yekuramba.
Nepo izvi zvisinganyanyozivikanwi nemaabhakitiriya anobatanidzwa muBV, kupikisa kunogona kuitika dzimwe nguva. Izvo zvinowanzoenderana nerudzi rwe "bhata" bhakitiriya inogona kukonzera munguva yechirwere cheBV. Semuyenzaniso:
- Metronidazole kushorwa inofungidzirwa kuti inovaka pakupindura rudzi rwebhakitiriya rwemadzimai anonzi Atopobium vaginae. Izvo chete hazviwanzoonekwi ne clindamycin.
- Kusiyana neizvi, clindamycin kusagadzikana kwave kuri kuwedzera kunetseka pamusoro pezvipembenene zve Prevotella mabhakitiriya. Izvo hazvina kuonekwa ne metronidazole.
- Ikoko kunewo mhemberero yemetronidazole kushorwa kune imwe bhakitiriya yemudzimai inowanzonzi Gardnerella vaginalis.
Asi, mune chinangwa chakakura, dambudziko racho richiri kutaridzirwa pasi uye kubatsirwa kwehutano kunopfuura zvakanyanya migumisiro.
Kuita izvi, kurapwa kwemishonga inorwisa mabhakitiriya hakufaniri kumbodziviswa nekuda kwekana risingawanikwi risina chikonzero chekudzivisa. Pakupedzisira, kushorwa kunogona kudziviswa nokutora mishonga yako zvakakwana uye sezvinorayirwa. Uyezve, kana zviratidzo zvinodzoka zvakare, haufaniri kuzvichengetedza asi pane kuzviwana zvakarapwa munguva pfupi kupfuura mberi.
Mishonga Inobatsira Inobatsira (CAM)
Bhakitiriya vaginosis inokonzerwa ne "zvakanaka" chirwere chechikadzi, chinonzi lactobacilli, chakasara, zvichibvumira "mabhakitiriya" akaipa kuti atore uye anotadzisa utachiona. Sezvo zvakadaro, zvakave zvataurwa kuti mapurobioti , akapfuma mumabhakitiriya ane hutano akafanana neCtotobacillus acidophilus , angave anobatsira pakuzadzikisa maruva emukadzi. Uye, kune humwe humwe uchapupu hunotsigira izvi.
Kubvunzurudzwa kwekuongorora kwechipatara kwegore ra2014 kwakagumisa kuti kushandiswa kwezuva nezuva kwemishonga inonzi oral, zvichida kuburikidza nekuwedzera kana zvokudya zvakadai se yogurt, zvinogona kudzivirira utachiona hweBV kana kubatsira kutsigira maantibiotic therapy.
Izvo zvataurwa, kukwanisa kwavo kurapa chirwere cheBV pachavo hazvikwanisi. Nokuda kwazvo, CDC yakamboramba ichitsvaga kushandiswa kwemishonga inonzi probiotics mukurapa BV, kunyange sechimiro chekugadzirisa chirwere. Izvo hazvirevi kuti mapurobioti haana kukosha; zvinongova pachena kuti hapana humwe uchapupu hunoratidza kuti maitiro ebibibioti anokwanisa kutama kubva kumudumbu kusvika kumudzimai muhuwandu hunoona shanduko.
Pakave nekushaikwa kwehumwe humwe uchapupu hunotsigira kushandiswa kwemamwe mishonga yemasikirwo (zvakadai segariki kana mafuta omuti) mukurapa BV.
> Sources:
> Centres for Disease Control and Prevention. "2015 Zvirwere Zvepabonde Zvirwere Zvokurapa Mazano: Bactter Vaginosis." Atlanta, Georgia; yakarongedzwa naJune 4, 2015.
> Homayouni, A .; Bastani, P .; Ziyadi, S. et al "Migumisiro yemapurobiyasi pakudzoka kwebhakteria vaginosis: kuongorora." J Low Genit Tract Dis. 2014; 18 (1): 79-86. DOI: 10.1097 / LGT.0b013e31829156ec.
> O'Hanlon, D .; Moench, T. uye Cone, R. "Muchikadzi, mabhakitiriya anosangana neBacterial vaginosis anogona kubviswa ne lactic acid asi kwete hydrogen peroxide." BMC Infect Dis. 2011; 11: 200. DOI: 10.1186 / 1471-2334-11-200.
> Younos, N., Gobinath, R. Jegasothy, R. et al. "Kuvandudzwa kuri Gardnerella vaginalis kunobata bhakitiriya vaginosis muMalaysia." Asian Pac J Trop Bio. 2017; 7 (9): 831-35. DOI: 10.1016 / j.apjtb.2017.08.011.
> Zeron Mullins, M. uye Trouton, K. "BASIC kudzidza: is intravaginal boric acid isingasviki kune metronidazole mune zviratidzo zvechirwere chebhakitiriya vaginosis? 2015; 16: 315. DOI 10.1186 / s13063-015-0852-5.