Chibvumirano Chekushandira Kubva ku ACR uye EULAR
Mirayiridzo yekutungamirira kwepolymyalgia rheumatica (PMR) yakabudiswa munaSeptember 2015, sechikamu chekushandira pamwe pakati peAmerican College of Rheumatology (ACR) uye European League Against Rheumatism (EULAR). Iyo mirayiridzo ndiyo inotanga kugadziriswa kwenyika dzakawanda mazano ekurapa uye kutarisira varwere vane polymyalgia rheumatica.
Chii Chinonzi Polymyalgia Rheumatica?
Inofungidzirwa kuti vanenge 711 000 vekuAmerica vakuru vane polymyalgia rheumatica - chiitiko icho kazhinji chinowedzera zvishoma nezvishoma. Kunyange zviratidzo zvinogona kuitika nokukurumidza, izvo hazvisi zvepolymyalgia rheumatica. Zviratidzo zvinosanganisira kupararira kwehuputi hwehutachiona, uye chiuno nemapfudzi zvinowanzobatanidzwa, pamwe chete nemaoko ekumusoro, mutsipa, uye kuderedza shure. Kazhinji hapana kubata kwemajoini. Zvinokwanisika kuva nepolymyalgia rheumatica pamwe nechimwe chirwere cherheumatic . Pakave nekusiyana kukuru mukurapa kwepolymyalgia rheumatica, yakadai sekushandisa glucocorticoids kana zvirwere-kuchinja anti-rheumatic drugs (DMARDs) uye kwenguva yakareba sei.
Nheyo uye Mazano ekugadzirisa PMR
Iyo mirayiridzo ye 2015 yakabudiswa ne ACR uye EULAR inosanganisira mitemo yepamusoro uye mazano anoshanda ane chokuita nokuwana kurapwa, kutumira kune vanyori, kutevera varwere, uye maitiro chaiwo ekurapa.
Izvo zvakarongwa zvakarongerwa se:
- "zvakanyatsorudzirwa" apo humwe uchapupu hwakataura nezvebasa rinokosha risina ngozi
- "zvinogadziriswa" apo pakanga pasina humwe uchapupu hunyoro hwebatsiro kana apo kubatsirwa kwakanga kusingapfuuri zvakanyanya kuipa
Nheyo dzepamusoro dzinosanganisira:
- Kubvumirwa kwekusvika pakuziva kuti polymalgia rheumatica, nekliniki yekuongorora yakaita kuti isabvisa mamiriro ezvinhu anoshandisa polymyalgia rheumatica.
- Asati agadza kurapa, mhosho yose inofanira kunge yakave yakanyora zvikwata zvekuongorora ma laboratory.
- Zvichienderana nezviratidzo nezviratidzo, mimwe miedzo inofanira kupiwa kuti irege kushandura mamiriro ezvinhu. Kudyidzana kunofanira kutsungirirwa. Zvinokonzera njodzi yekudzokazve kana kurapa kwenguva yakareba zvinofanira kufungwa.
- Kufungidzirwa kunofanira kupiwa kune unyanzvi kutumira.
- Mishonga isarudzo inofanira kugoverwa nemurwere uye chiremba.
- Varwere vanofanira kuva nehurongwa hwehutano hwehutano hwepolymyalgia rheumatica.
- Varwere vanofanira kunge vane ruzivo rwezvedzidzo pamusoro pekurapa uye kutungamirirwa kwepolymyalgia rheumatica.
- Murwere mumwe nomumwe ari kurapwa nokuda kwepolymyalgia rheumatica inofanira kuongororwa achishandisa tsanangudzo chaiyo. Mugore rokutanga, varwere vanofanira kuonekwa masvondo mana kusvika ku8. Mugore rechipiri, kushanyirwa kunofanirwa kurongwa masvondo masere kusvika ku12. Kuongorora kunofanirwa kuve sekudikanwa kwekudzokazve kana kuti prednisone tapering.
- Varwere vanofanira kunge vachitaura zvakananga kune vashandi vavo vehutano hwehutano kuti vazive kuchinja, zvakadai semaroto kana zviitiko zvinotambudza.
Kunyatsotsanangurwa kwehutungamiri hwepolymyalgia rheumatica dzinosanganisira:
- Nhungamiro yakasimba yekushandiswa kweglucocorticoids panzvimbo yeNSAIDs (nonsteroidal anti-inflammatory drugs), kunze kwekanguva pfupi yeNSAIDs kana analgesics kune varwere vane marwadzo ane chokuita nemamwe mamiriro.
- Nhungamiro yakasimba yehuwandu hwehutano hwehutano hweglucocorticoid therapy (kureva, shandisa mushonga kwenguva shoma yakawanda inowanikwa kuwana mhinduro inoshanda).
- Kugutsikana kwechiitiko chemuviri wekutanga weglucocorticoid pakati pe 12,5 uye 25 mg prednisone yakaenzana zuva rega rega. Imwe yepamusoro inogona kuonekwa kune avo vari pangozi yakakura yekudzokazve uye pangozi yezviitiko zvinotambudza. Nhamba yakaderera inogona kufungwa kune avo vane comorbidities kana mungozi zvinokonzerwa nemigumisiro ine chokuita nekushandiswa kweglucocorticoids. Chirwere chekutanga chema 7.5 mg / zuva chakanga chakaora mwoyo, uye maitiro ekutanga e 30 mg / zuva akaodzwa mwoyo.
- Nhungamiro yakasimba yezvirongwa zvakasiyana-siyana zvekutengesa uye kuongorora nguva dzose. Purogiramu yakarongwa yekutanga kutengesa ndeyokutora kusvika pamuromo we 10 mg prednisone-yakaenzana nezuva pazuva vhiki 4 kusvika ku8. Nokuda kwezvezvekurapa, chirwere chinonzi prednisone chinofanira kuwedzerwa kusvika kumurairo murwere ari kutora asati adzoka zvakare ndokuderera zvishoma nezvishoma pamasvondo mana kusvika ku8 kusvika kumushandi apo kudzokera zvakare. Kana imwe nguva kuregererwa kuchiitika, zuva nezuva muromo we prednisone unogona kugadzirwa ne 1 mg masvondo mana kana 1.25 mg uchishandisa rimwe zuva rimwe zuva kusvikira prednisone iregererwa, zvichipa kuti kuregererwa hakugadziriswi.
- Kugadziriswa kwechikonzero chekushandiswa kwemuviri we methylprednisolone panzvimbo yepamusoro kana mumuromo glucocorticoids.
- Kugadziriswa kwemuviri kune imwe nhamo pane kugovera maitiro ezuva ose emuromo glucocorticoids.
- Mitezo inogadziriswa yekushandiswa kwekutanga kwe methotrexate kuwedzera kune glucocorticoids, kunyanya kune vamwe varwere.
- Nhungamiro yakasimba pamusoro pekushandiswa kweNATF blockers .
- Chirongwa chemuongorori wehutachiona hwemhando yega yega yekuchengetedza musimba mashoma uye basa, pamwe nekuderedza dambudziko rekuwira .
- Nhungamiro yakasimba pamusoro pekushandiswa kweChina mushonga wekugadzirira Yanghe uye Biqi.
Sources:
2015 Mazano ekufambisa kwePolymyalgia Rheumatica. Dejaco C. et al. Arthritis & Rheumatology Vol. 67 Nha. 10 October 2015.
http://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf
Polymyalgia Rheumatica. American College of Rheumatology. Yakavandudzwa June 2015.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica