Mapurogiramu ekurapa aLupus anowirirana kune zvaunoda uye unogona kuchinja munguva. Nzira uye hutano hwehutano hwe lupus hwakawedzerwa, kupa vanachiremba zvimwe zvisarudzo zvekugadzirisa chirwere ichi paanoongororwa uye pashure. Mishonga yemishonga yakadai seyamununuuppressive uye anti-inflammatory drugs, pakati pezvimwe zvingasarudzwa, inogona kushandiswa.
Zvakakosha kuti ushande pamwe chete nechiremba wako uye uite basa rinokosha pakuchengetedza chirwere chako, kuongorora zvakare chirongwa chako chekurapa nguva nenguva kuti uone kuti inoshanda sezvinobvira.
Kana imwechete lupus yakaonekwa, chiremba wako achakura chirongwa chekurapa iwe kubva pazera rako, zvepabonde, hutano, zviratidzo, uye mararamiro. Mukukudziridza hurongwa hwako hwokurapa, chiremba wako ane zvinangwa zvakawanda:
- Deredza kuputika kunokonzerwa nehosha
- Bvisa maune immune system zvisina kunaka izvo zvinokonzerwa nokuputika kwenyama
- Kudzivirira moto uye kuvabata pavanenge vachiitika
- Kudzora zviratidzo
- Deredza zvinetso
Zvinyorwa
Mishonga yemishonga inoratidzirwa inhengo inokosha yehutano hwevarwere vakawanda vane sstemic lupus erythematosus (SLE), iyo inonyanya kushandisa chirwere. Mhando yezvimwe zvinodhaka zvinodhaka zviripo zvino, izvo zvakawedzerwa mikana yekurapa kwakanaka uye zvakanakisisa zviitiko zvevarwere.
Lupus mishonga inofanira kusanganisira semishonga mishomanana sezvinobvira sekuita kwenguva pfupi sezvinobvira.
Vamwe varwere havambodi mishonga, uye vamwe vanovatora chete sezvinodiwa kana kwenguva pfupi, asi vazhinji vanoda kuramba vachirapa nemhando dzakasiyana. Pasinei nekubatsira kwavo, hapana madhiragi asina njodzi. Mishonga inowanzoshandiswa kuchengetedza lupus zviratidzo ndeiyi:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Antimalarials
- Corticosteroids
- Immunosuppressives / chirwere-chinorwisa anti-rheumatic drugs (DMARD)
Kana uine zviratidzo zveplusi , unogona kutapurirwa nehutachiona uye zvinogona kuita NSAID uye / kana chirwere chekanguva che corticosteroids.
Kana uine zvirwere zvepirus zvisinganzwisisiki , chirongwa chako chekurapa chinogona kusanganisira chirwere chechipatara pamwe chete nekanguva kfupi corticosteroid kusvikira chirwere chepachirwere chinotanga kushanda. Iwe unogonawo kubatsirwa neunununuuppressive.
Nokuda kwezvirwere zvakanyanya zvirwere zvinosanganisira nhengo dzako, iwe ungangodaro unoda chirwere chakasimba chekuzivikanwa kweumunosuppressive. Iwe unogonawo kurapwa nemazinga akakwirira e corticosteroid kwechinguva chiduku kuderedza kupisa kwako. Sezvo nepulemu ine munyoro uye ine mwero, iwe ungangodaro unobatsirwawo nehutachiona.
Zvimwe zvakasiyana-siyana zvinowanikwa uye kuoma kwezvirongwa zvehutano zvinogona kuva zvinotyisa uye zvinokanganisa. Kana kamwe chiremba wako achiuya neurongwa hwemishonga, zvakakosha kuti iwe unzwisise zvakakwana chikonzero chekutora mishonga, kuti inoshanda sei, kuti unofanirwa kutora sei, kana iwe uchida kuitora, uye izvo zvinogona kuitika zvinogona sei be. Kana usina chokwadi, iva nechokwadi chekubvunza.
Vakawanda vanorwara vanoita zvakanaka pamishonga ye lupus uye vanowanikwa mashoma emigumisiro.
Kana uchidaro, edza kuti usaora mwoyo, uchiyeuka kuti zvimwe zvinodhaka zvinowanzowanikwa. Uyewo, zivisa chiremba wako pakarepo. Zvinogona kuva nengozi kukurumidza kumira kutora mimwe mishonga, uye haufaniri kumbomira kana kuchinja kurapwa usingatauri nachiremba wako.
Antimalarials
Zvinyorwa zvekare zvinotanga kuumbwa munguva yeHondo Yenyika II nokuti quinine, chirwere chakadai chemalaria, chakanga chisina kukwana. Vatsvakurudzi vakawana kuti antimalarials inogona kushandiswawo kubata chirwere chekubatana chinowanikwa nerheumatoid arthritis . Kutevera kushandiswa kwakaratidza kuti mishonga iyi inoshanda mukugadzirisa mamiriro ezvinhu akafanana newa lupus:
- Lupus arthritis
- Ganda rinoputika
- Mouth ulcers
- Kuneta
- Fever
- Chiremera chekuremera
Antimalarials, iyo inogamuchirwa neU.S. Food and Drug Administration (FDA) kuporesa lupus, inoshandiswa kubatsira kudzivirira moto kana ichiendeswa mberi nguva dzose, asi haisi kushandiswa kugadzirisa zvakanyanya, maitiro e-lupus anokanganisa nhengo. Zvinogona kuva vhiki kana mwedzi usati waona kuti madhiragi aya ari kutarisa zviratidzo zvezvirwere.
Mhando dzeantimalarials dzinosanganisira:
- Plaquenil (hydroxychloroquine sulfate)
- Aralen (chloroquine)
Kunyange zvazvo chloroquine ichiri kushandiswa, nemhaka yehutano hwakanaka, hydroxychloroquine sulfate inowanzodiwa. Chiito chinopesana nekuputira chemishonga iyi hachina kunzwisiswa. Huru hwemafuti dzinobatawo maplatelet ako kuderedza dambudziko rekuvhara ropa uye mazinga epasi echidimbu.
Zvimwe zvinokonzerwa nehutachiona zvinogona kusanganisira:
- Dumbu rinogumbura
- Kukuvara kwe retina yeziso (zvisingawanzoitiki)
NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) inosanganisira boka guru uye rakasiyana-siyana remishonga ine zvinorwadza-kudzikinura, zvinopesana nekuputira, uye kupera kwemafivha. Urombo uye kuputika zvinetso zvakajairika kune varwere vane lupus, uye NSAID inowanzova mishonga yekusarudzwa kune varwere vane chirwere chisinganyanyi kana kuti kusangobatanidzwa kwechirongwa, kunyange vasina kubvumirwa nemaitiro neRDA kuti vararame lupus. Varwere vane chirwere chakakomba chinhengo vanogona kuwedzera zvakanyanya anti-inflammatory uye immunosuppressive drugs.
Kunyange zvazvo dzimwe NSAIDs, dzakadai sai buprofen uye naproxen, dziripo pane-the-counter, chiremba chiremba chinodiwa kune vamwe. NSAID dzinogona kushandiswa dzoga kana pamwe chete nemamwe marudzi emishonga yekudzivirira marwadzo, kuzvimba, uye fivhiri. Zvakakosha kuti utore mishonga iyi pasi pekutungamirirwa kwachiremba wako. NSAID inogona kunge iine mishonga chete inodiwa kuti irape unyoro, asi chirwere chinoshanda chinogona kuwedzera mimwe mishonga.
Nharaunda dzinowanzoitika dzeNSAID dzinogona kusanganisira:
- Dumbu rinogumbura
- Kushungurudza
- Diarrhea
- Fluid retention
Vamwe vanhu vanoitawo chiropa, zvinetso, mwoyo, uye kunyange neurological zvinetso kubva kushandiswa kweNSAID, zvichiita kuti zvive zvakakosha kugara muhukama hwepedyo nachiremba wako paunotora mishonga iyi.
Kunyange zvazvo NSAID dzose dzichiita sechishanda nenzira imwe chete, haisi dzose dzine mamiriro akafanana kune munhu wese. Mukuwedzera, varwere vanogona kuita zvakanaka pane imwe NSAID kwenguva yakati uye ipapo nekuda kwechikonzero chisingazivikanwe vangave kutanga kutora rubatsiro kubva kune iyo. Kushandura kune imwe NSAID inogona kubudisa zvinoda kuitika. Unofanirwa kushandisa NSAID imwechete panguva ipi zvayo.
Corticosteroids
Corticosteroids mahomoni akavanzwa nekodhekisi yegrenal gland. Synthetic shanduro dzemamolekoro aya anoshandiswa kurapwa semishonga inopesana nekuputika. Izwi rokuti "steroids" rinowanzosanzwisiswa uye kuvhiringidzika kunogona kuguma apo corticosteroids inokanganisa vanabolic steroids.
Corticosteroids yakagamuchirwa neDDA yekurapa lupus uye inowanzoitwa nemuromo. Munguva dzenguva yakaoma yekurwara, inogona kugoverwa mukati. Asi kana wave wakadzikama, mutemo wekutaura unofanirwa kuendeswazve. Nemhaka yokuti imishonga yakakosha, chiremba wako achatsvaga mubairo wakaderera nekunobatsira kukuru.
Lupus varwere vane zviratidzo zvisingavandudzi kana vasina kutarisirwa kuti vapindure kune NSAID kana antimalarials vangapiwa corticosteroid. Kunyange zvazvo corticosteroids ine mikana yakakomba, inobatsira zvikuru pakudzikisa kuputika, kubvisa musuru uye kurwadziwa pamwe chete uye kuneta, nekudzivisa zvirwere zvemuviri. Izvo zvinobatsirawo pakuronga hukuru hunobatanidzwa hunobatanidzwa ne lupus.
Kana imwe nguva zvirwere zvako zvave zvichiita kurapwa, chirwere chacho chinowanzogadzirirwa kusvikira chiito chakanyanya kudarika chine simba chinodzora basa rezvirwere zvinoitwa. Iwe unofanirwa kuongororwa zvakanyatsonaka munguva ino yeiraira kana kudzoka kwekubatana nekurwadziwa kwemisimba, fivhiri, uye kuneta zvinogona kuguma kana kuyerwa kwechiero.
Vamwe varwere vangada corticosteroids chete panguva dzekushanda dzechirwere ichi; avo vane chirwere chakakomba kana kuti humwe hutano hwakakosha huri kunogona kudikanwa kwenguva refu. Vanachiremba dzimwe nguva vanopa yakawanda kwazvo ye corticosteroid nemhino pamusoro penguva pfupi (mazuva), anonzi bolus therapy kana kuti chirwere chemhepo.
Mushure memakore akawanda echirticosteroid therapy, madhiragi haafaniri kumira pakarepo. Kutungamirirwa kwekorticosteroids kunokonzera muviri wako pachako kubudisa mahomoni adrenal kuenderera mberi kana kumira, uye kuwedzera kwekushaya simba kana kunyange adrenal crisis (iyo inogona kutyisa upenyu) inogona kuguma kana mushonga wacho wakamira pakarepo. Kunyora muroti kunobvumira muviri wako kuti udzoke zvakare uye utangezve kugadzirwa kwemahomoni chaiwo. Kana uchinge wapera ku corticosteroids, zvakanyanya kuoma kukuderedza chirwere kana kurega kushandiswa kwavo.
Corticosteroids inoshandiswa kurapa lupus inosanganisira:
- Prednisone (Sterapred) -inowanzowanzobata chirwere; ona zvimwe pasi apa
- Hydrocortisone (Cortef, Hydrocortone)
- Methylprednisolone (Medrol)
- Dexamethasone (Decadron)
Corticosteroids inowanikwa se:
- Mafisi ezvinyorwa kana mafuta (nokuda kwechivara cheganda)
- Mahwendefa emumuromo
- Liquid solutions
- Steroid shots (chirwere chemukati kana intravenous injections)
Mhedziso dzenguva pfupi dzekristicosteroids dzinogona kusanganisira:
- Kuwedzera kwezvinetso mumaziso (glaucoma)
- Kuzvimba
- High blood pressure
- Kuwedzera kudya kudya
- Kuwedzera kwehuwandu
Nguva yakareba yemigumisiro ye corticosteroids inogona kusanganisira:
- Cataracts
- High sugar shuga (chirwere cheshuga)
- Zvirwere
- Mafupa akaremara kana kuora (osteoporosis uye osteonecrosis)
- Nguva yakareba yemaronda kuporesa
- Ganda reThinner iri nyore kukuvadza
- Stretch marks
Kazhinji, iyo yakakosha mibare uye iyo yakatora nguva yakareba, inowedzera dambudziko uye kuoma kwemigumisiro . Kana ukashandisa corticosteroids, unofanirwa kutaura nachiremba wako nezvekutora supplemental calcium uye vitamini D kana mishonga kuti uderedze ngozi ye osteoporosis.
Zvimwe paPrednisone
Prednisone ndiyo inonzi corticosteroid iyo vanachiremba vanorayira, voga kana pamwe chete nemamwe mishonga, asi inowanzoshandiswa semishonga yenguva pfupi. Iyo inoshanda zvikuru mukurapa maitiro anoshanda lupus uye zviratidzo zvinowanzomira nokukurumidza. Vaya vane mazoro maduku e-active lupus vangave vasingadi mishonga zvachose.
Taura nachiremba wako kana iwe uchikudziridza chimwe chezviratidzo zvinotevera izvo zvisingaendi kana kuti zvakanyanya paunotora prednisone:
- Headaches
- Chizutu
- Dambudziko rekurara kana kurara
- Inappropriate happiness
- Kuchinja kukuru kune mafungiro
- Kuchinja munhu
- Kutinhira maziso
- Acne
- Wakachena, ganda rakashata
- Mabhanji matsvuku kana ruvara rwepepuru kana mitsetse pasi peganda
- Zvishoma nezvishoma kuporesa kwekacheka uye matambudziko
- Bvudzi rinowedzera kukura
- Kuchinja munzira iyo mafuta inopararira pamuviri
- Kuneta zvakanyanya
- Matumbo asina simba
- Nguva dzisina kufanira kana dzisipo kumwedzi
- Kupera kwechido chepabonde
- Kushungurudza
- Kuwedzera kwekutuka
Bvunza chiremba wako pakarepo kana iwe uchinge uine chero chipi chezviratidzo zvinotevera paunotora prednisone:
- Zviratidzo zvinetso
- Kutambudzika kweziso, kubwinya, kana kuputika
- Hora, fivha, chills, kukomba, kana zvimwe zviratidzo zvehutachiona
- Kugumburwa
- Kuora mwoyo
- Kurasikirwa kwekutaurirana neichoicho
- Kusanganiswa
- Tsvina inokwidza kana kusimbisa
- Kugumburwa kwemaoko ausingagoni kudzora
- Unhu, kupisa kana kumira mumeso, maoko, makumbo, tsoka, kana maoko
- Kushungurudza mudumbu
- Kudzora
- Lightheadedness
- Kusagadzikana kwepfungwa
- Kamwe kamwe-kamwe kuwedzera kuwanda
- Kuchema kana kurwadziwa mudumbu
- Kuoma kufema kufema
- Mapundu
- Hives
- Itching
Immunosuppressives / DMARDs (Zvirwere-Kuchinja Mishonga Inorwisa Rheumatic)
Immunosuppressives nedzimwe zvirwere-kuchinja anti-rheumatic drugs (DMARDs) zvinoshandiswa "kunze-label" (zvinoreva kuti hazvina kubvumirwa neDFA mukurapa lupus) nokuda kwezviitiko zvakakomba, zvemuitiro we lupus umo zvikamu zvikuru zvakadai seitsvo zvinokanganisa kana mukati mazvo kune huturu hwakanyanya kuputika kana kusagadzikana kweArthritis. Immunosuppressives inogonawo kushandiswa kuderedza kana dzimwe nguva kubvisa kudiwa kwe corticosteroids, nekudaro kukudzivirira kubva kune zvisingabatsiri zvinokonzera kwenguva yakareba corticosteroid therapy. Immunosuppressives kudzivirira simba rako rekuzvidzivirira pamuviri nenzira dzakasiyana-siyana.
Immunosuppressives uye DMARD zvinogona kuva nemigumisiro yakakomba zvakare. Zvisinei, migumisiro yemigumisiro inobva pane chirwere chaunotora uye kazhinji chinogona kuchinjwa kuburikidza nekuderedza chirwere kana kumira mishonga pasi pekurudzirwa kwachiremba. Iyi mishonga inogona kupiwa nemuromo kana kuiswa mukana (kuisa chirwere ichi mumhino dzako kuburikidza nediki duku).
Kune njodzi dzakawanda dzakakomba dzine chokuita nekushandisa immunosuppressives uye DMARD. Izvi zvinosanganisira:
- Immunosuppression
- Kuwedzerwa kunzwisisika kune utachiona
- Bone marrow kuderedza
- Kuvandudzwa kwemhirizhonga
Zvimwe zvakasiyana-siyana zvekudzivirira muviri zvinodhaka uye zvimwe zvirwere-kuchinja anti-rheumatic drugs zvinowanika kurapa lupus. Zvose izvi zvinoshanda kune boka rezvinodhaka zvinoshandiswa sechipiri chekudzivirirwa pamusoro pemapus uye mamwe maitiro eArthritis. Kunyange zvazvo vane nzira dzakasiyana dzekuita, rudzi rumwe norumwe runoshanda kuderedza kana kudzivirira maitiro ezvirwere zvemuviri.
Immunosuppressives uye DMARD zvinoshandiswa kurapa lupus zvinosanganisira:
- Cyclophosphamide (Cytoxan)
- Mycophenolate mofetil (CellCept): Mishonga iyi inowanzoshandiswa ne lupus nephritis kana kurapwa-resistant systemic lupus erythematosus, iyo nzira yakakura ye lupus, uye inobatsira kuderedza kuyerwa kwe steroid iwe ungada.
- Azathioprine (Imuran, Azasan): Azathioprin inoshanda nekudzivisa kugadziriswa kwegene uye kushandiswa kweT cell kushandiswa. Kubva pane murine (mouse uye rat) uye zvidzidzo zvevanhu, azathioprine inonzi inofara immunosuppressive agent. Zvisinei, inodhura kupfuura mamwe majekiseni uye inogona kushandiswa pane steroid. Kunyanya, azatioprine inoshanda zvakanaka mushure mekunge kupiwa mushonga ne cyclophosphamide kana mycophenolate.
- Methotrexate (Rheumatrex)
Zvimwe zvinokonzerwa nemishonga iyi inogona kusanganisira:
- Nausea
- Kudzora
- Kuora bvudzi
- Zvinetso zvechando
- Yakaderedza kubereka
- Kuwedzerwa njodzi yekenza uye utachiona
Ngozi yemigumisiro inowedzera nehurefu hwehutano. Sezvimwe nezvimwe zvirwere zve lupus, kune ngozi yekudzoka zvakare mushure mokunge ma immunosuppressives amiswa.
Biologics
Benlysta (belimumab) imwe mishonga inogamuchirwa neDAA yekurapa kwekushanda, autoantibody-positive lupus kune varwere vari kugamuchira kurapwa kwakakwana kusanganisira corticosteroids, antimalarials, immunosuppressives, uye NSAIDs (nonsteroidal anti-inflammatory drugs). Benlysta inoshandiswa sekudzivirira mukati uye inotanga kushandisa mushonga weB-lymphocyte stimulator (BLyS) protein, iyo inofanira kuderedza nhamba yemasero asina kuchena B-dambudziko mu lupus.
Zvimwe Zvimwe zveLupus Types
Kana wakamboonekwa kuti une discoid kana subacute cutaneous lupus, mamiriro ezvinhu anowanzoparadzaniswa nemagadzirirwo emuitiro we-systic lupus erythematosus (SLE), mapepa ako anofanira kutanga aporerwa nepamusoro uye ane simba rinowedzera-corticosteroid kana mafuta. Izvi zvinogona kushandiswa kune zvipembenene usiku usati waenda kunorara; ganda rakarapwa rinofanira kufukidzwa nemapurogiramu epurasitiki kana tambo yeCordran. Kana mabhesi asara asina chifukidzo chakadai, marticosteroid marusi uye gelo zvinofanira kushandiswa kaviri pazuva.
Imwe nzira yekuwana nayo nzvimbo iyo inokonzerwa ne-subacute uye discoid cutaneous lupum ndiro kushandisa sodemicurin inhibitors sepimecrolimus cream kana tacrolimus mafuta. Kana zvipembenene zvako zvisingapindirani kune corticosteroids kana calcineurin inhibitors, chiremba wako anogona kuedza kuvhara corticosteroid mumaperembudzi ako.
Kana pasina imwe yemishonga iyi ichishanda, chiremba wako angangoedza chirongwa chekuita. Mushonga wekutanga-mutsara unosanganisira antimalarials akadai se hydroxychloroquine sulfate, chloroquine, kana quinacrine. Izvi zvinoshanda kune vanhu vakawanda.
Kana zvipembenene zvisinganyengeri, chiremba wako anogona kuedza chimwe chezvinhu izvi zvinorapwa:
- An immunosuppressive, zvakadai se methotrexate kana mycophenolate mofetil (MMF)
- A retinaid systemic, yakadai se isotretinoin kana acitretin
- Dapsone, sulfonamide
- Thalidomide, nhengo yemunyanzvi yemuviri
Imwe inogona kuitika kwakashata yemishonga yehutachiona ndeye psoriasis, iyo imwe rudzi rwechirwere cheganda rine zviratidzo zvakafanana zvinopesana uye zvinowanikwa pasi remapus. Isotretinoin uye thalidomide zvose zviri zviviri, izvo zvinoreva kuti mishonga iyi inogona kukuvadza fetus, saka usatora izvi kana uri nepamuviri kana kufunga nezvekuita pamuviri.
Kuwedzera Mushonga Muchirapa
Nemhaka yehupenyu uye mari yezvinodhaka zvinoshandiswa kurapa lupus uye zvingave nemigumisiro yakakomba, varwere vakawanda vanotsvaka nzira dzakasiyana kana dzokuwedzera dzokurapa chirwere ichi. Dzimwe nzira dzakasiyana dzinosanganisira:
- Zvokudya zvakakosha
- Herbal anowedzera
- Mafuta ehove anowedzera
- Chiropractic care
- Homeopathy
- Acupuncture
- Tai Chi
- Massage therapy
- Biofeedback
- Kufungisisa
Kunyange zvazvo nzira idzi dzingave dzisina kukuvadza mukati mavo uye dzinogona kubatsira nedzimwe zviratidzo zvako kana zvichisanganiswa nesarudzo yako yenguva dzose, hapana tsvakurudzo kusvika kune iye zvino inoratidza kuti inokanganisa chirwere chetachiona kana kudzivirira chigadziriswa. Muzvokwadi, mishonga inowedzera inogona kunge inokuvadza, inogona kuita kuti lupus zvirwere zviwedzere uye / kana kupindira nemishonga yako yemishonga.
Nguva dzose bvunza chiremba wako usati watanga chero kupi zvayo kuwedzera kana kurapa kumwe, uye iva nechokwadi chokuti unoramba uchitora mishonga yawakagadzirirwa.
> Sources:
> Clarke J. Pakutanga Kutungamirirwa kweDiscoid Lupus uye Subacute Lupus Yakagadzirwa. Kusvika pari zvino. Yakapindurwa musi waMay 16, 2017.
> Clarke J. Mutungamiri weChirangaridzo Dhavhidha Lupus uye Subacute Yakagadzirwa Lupus. Kusvika pari zvino. Yakapedzwa musi waJanuary 11, 2017.
> MedlinePlus. Prednisone. US National Library of Medicine. Yakapedzwa musi waNovember 15, 2015.
> Wallace DJ. Kuratidzwa kweMutungamiri uye Kuparara kweSystemic Lupus Erythematosus muVakuru. Kusvika pari zvino. Yakapedzwa musi waJanuary 24, 2018.