Osteoarthritis Mishonga
Vanhu vanopfuura mamiriyoni 27 muUnited States vane osteoarthritis . Kunyanya, maererano neCenters for Disease Control and Prevention (CDC), osteoarthritis inobata 13.9 muzana yevanhu vakuru vane makore makumi maviri nemaviri nekure uye 33.6 muzana yevanhu vakuru 65 nekure. Icho chinonyanyozivikanwa cherthritis. Mabvi , maoko , tsoka , zviuno , uye musana ndizvo zvinowanzobatwa ne osteoarthritis.
Vanhu vane zviratidzo zvehutachiona hwemaosteoarthritis vanoda kurapwa kwakanyatsogadzirisa kutarisa marwadzo akabatana, kuoma, kuvhara, uye zvimwe zviratidzo.
Zvimwe zvinangwa zvekurapa zvinosanganisira kuchengetedza kana kuvandudza basa pamwe chete, kuderedza hurema, nekuvandudza hupenyu hwehupenyu.
Vanhu vane chirwere ichi kazhinji vanovhiringidzwa nekusarudzwa kwakawanda kwekurapa-uye vakatendeseka, vangada kudarika izvo zvisingashandisi uye kutarisa pane zvinorevei. Hapana imwechete mhinduro kumunhu wose, asi vatsvakurudzi vakaburitsa mazano ekurapa osteoarthritis.
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Ndechipi Kusiyana pakati peArail naAleve?
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Kushandisa Viscosupplement Hyalgan Kubata Knee Osteoarthritis
Kune mishonga isiri-pharmacologic (isina-zvinodhaka) maitiro ekurapa kwewasteoarthritis, pharmacologic (zvinodhaka) mishonga, mishonga yepicalical, injra-intra-articular, mararamiro ekuchinja-uye sekupedzisira, kushandiswa.
Muna 2012, American College of Rheumatology (ACR), yakabudiswa pharmacologic uye isiri-pharmacologic mazano ekurapwa kwemaoko, hip, nemabvi. Dare remakiriniki rezvechipatara rakapa mazano anokurudzira, maitiro anotsigira, kana kuti kwete kukurudzirwa kwedzimwe nzira dzokurapa. Kuti uone sekusimbiswa kwakasimba, hukuru hwehupupuriro hwaidiwa, pamwe nehuchapupu hunofanirwa zvakakosha kuburikidza nezvengozi ipi neipi inobatanidza nekurapa.
Mutsigiro wehutano hwakakonzerwa nekushaikwa kwehutano hwakakwana huno uchapupu kana humwe uchapupu hwakanga husiri hwakasiyana kana uchitarisa zvikomborero pamwe nezvengozi. Kana pasina kukurudzirwa kwakapiwa, pane dambudziko risina kukwana kana kuti hapana dhiyabhorosi, yakarongedzwa kliniki miedzo.
Hand (Pharmacologic Treatment Options)
Hapana nharo dzakasimba dzakagadzirwa nenyanzvi dzinobatanidza neAACR munharaunda iyi yekurapa. Iyo nyanzvi yemamiriro ezvinhu yakakurudzira kushandiswa kweimwe kana kuti mamwe emhando dzinotevera dzokurapa:
- topical capsaicin
- nhau dzeNSAID , dzinosanganisira trolamine salicylate
- muromo NSAIDs , kusanganisira COX-2 inhibitors
- Ultram (tramadol)
Iyo nyanzvi yegadziriro yemamiriro ezvinhu yakarumbidza kuti zvinotevera hazvisashandisi:
- mishonga inoratidzira
- opioid analgesic mishonga
Uyewo, zvaive zvakagadzirirwa kuti vanhu vane osteoarthritis vane makore makumi maviri nemaviri kana kupfuura vakwanise kushandisa maNSAID emafaro panzvimbo peNSAID dzemuromo.
Hand (Non-Pharmacologic Treatment Options)
Ikoko kwakanga kusina uchapupu hwakakwana huripo hunoita kuti hurumende dzirumbidzwe zvakasimba mune izvi zvekurapa pamwe chete, asi huwandu huripo huripo hunoitwa huripo.
IAACR chigadziro chinokurudzira kuti vadzidzisi vezvehutano (avo vanonyanya kutarisira, chiremba wepanyama, kana mushandi wepamberi) vanofanira:
- kuongorora kukwanisa kwomurwere kuita mabasa ehupenyu hwezuva nezuva
- kupa murayiridzo muhutano hwekubatana
- kupa mishonga yekubatsira inoshandiswa kubatsira nemabasa ekugara kwezuva nezuva
- kupa murayiridzo wekushandiswa kwehutambo hwemhepo (kureva, kupisa uye kutonhora)
- inopa vanhu vane trapeziometacarpal joint osteoarthritis (chigadziko chechigunwe )
Hip (Pharmacologic Treatment Options)
Hapana nharo dzakasimba dzakagadzirwa nokuda kwokusarudzwa kwema pharmacologic kurapa hip osteoarthritis. Zvinorayira zvinosanganisira kushandiswa kweimwe yemishonga inotevera yekurapa kwokutanga:
- acetaminophen
- muromo NSAIDs
- tramadol
- intra-articular corticosteroid injections
Nyanzvi dzinoenderana nehutano dzinokurudzira kuti zvinotevera zvinoshandiswa pakushandisa zvisiri izvo zvinoshandiswa ku hip osteoarthritis:
Kwete kukurudzirwa kwakaitwa pamusoro pekushandiswa kwe:
- nhepfenyuro NSAIDs
- intra-articular hyaluronate injections
- Cymbalta (duloxetine)
- opioid analgesic mishonga
Hip (Kwete-Pharmacologic Treatment Options)
Nyanzvi dzinokurudzira zvakasimba kuti vanhu vane hip osteoarthritis:
- vanobatana mumoyo mutsva kana kushora nyika-based exercise, kana zvose zviri zviviri
- vanobatanidzwa mune zvekuita zvemvura
- kuora muviri, kana kuwandisa
Nyanzvi dzinoenderana nehurumende dzinokurudzira kuti vanhu vane hip osteoarthritis:
- vanobatanidzwa mune purogiramu yekuzvidzivirira
- gamuchira manotsi ekurapa (kushambadza) pamwe chete nekurovedza muviri
- kugamuchira kupindira kwepfungwa
- gamuchira murayiridzo pamusoro pekushandiswa kwemhepo inotyisa
- gamuchira uye kushandisa shanduro yekufamba , sezvinodiwa
Nyanzvi dzisina kupa purogiramu maererano nezvesarudzo dzinotevera:
- kuenzanisa muviri, woga kana kubatanidzwa nekusimbisa maitiro
- tai chi
- nyora therapy chete
Knee (Pharmacologic Treatment Options)
Hapana mazano akakurudzira ekurapa kwokutanga kwemabvi osteoarthritis akaitwa. Nyanzvi dzinoenderana nehurumende dzinokurudzira kuti chimwe chezvinotevera chishandiswe:
- acetaminophen
- muromo NSAIDs
- nhepfenyuro NSAIDs
- tramadol
- intra-articular corticosteroid injections
Nyanzvi dzinoenderana nehurumende dzinokurudzira kuti vanhu vane maziso osteoarthritis asasashandise:
- chondroitin sulfate
- glucosamine
- topical capsaicin
Kwete kukurudzirwa kwakagadzirwa nokuda kwekushandisa intra-articular hyaluronates, duloxetine, kana opioid analgesic mishonga.
Knee (Kwete-Pharmacologic Treatment Options)
Nyanzvi dzinokurudzira zvakasimba zvinotevera zvisati zviri-pharmacologic maitiro ekurapa kwevanhu vane mazoro osteoarthritis:
- vanobatana mune zvekuita zvemaitiro kana kupikisa pasi-based exercise, kana zvose zviri zviviri
- vanobatanidzwa mune zvekuita zvemvura
- kuora muviri, kana kuwandisa
Nyanzvi dzinoenderana nehutano dzinokurudzira kuti vanhu vane mazoro ehesteoarthritis:
- vanobatanidzwa mune purogiramu yekuzvidzivirira
- gamuchira mazano ekurapa pamwe chete nekurevedza muviri
- kugamuchira kupindira kwepfungwa
- shandisa midzi-inotungamirirwa patellar taping
- kupfeka zvakaputirwa insoles insoles (kana kuongorora is lateral compartment osteoarthritis)
- kupfeka mushure mekukanganiswa kwemastaundi akaomeswa insoles (kana kuongororwa ndeyemukati makamuri osteoarthritis)
- gamuchira murayiridzo pamusoro pekushandiswa kwemhepo inotyisa
- gamuchira uye kushandisa mazano ekufamba, kana akaratidzwa
- vanobatanidzwa mune chirongwa chechi tai
Kwete kukurudzira kwakapiwa:
- kuenzanisa muviri, ndoga kana kusanganiswa nekusimbisa basa
- wearing lateral wedged insoles
- kugamuchira zvinyorwa zvokurapa chete
- kupfeka mabheji
- uchishandisa laterally-yakatungamirirwa patellar taping
Ikoko kwaivewo nemaitiro maviri ekurapwa aive akafanirwa kukurudzirwa KUNA chete kune vanhu vane mazondo osteoarthritis vane maitiro asinganzwisisiki uye kurwadziwa kwakanyanya uye avo vanofanirwa kugadziriswa kwegondo rose asi vasingadi kana kuti vasingakwanisi kuita izvi:
- rraditional Chinese acupuncture
- transcutaneous electrical stimulation
Kurapa Kwevamwe Joints
Kunyange zvazvo tsoka uye musana, pamwe chete nemamwe majoini, zvakanga zvisingabatanidzwi mukurapa mazano kubva kuAmerican College of Rheumatology, dzakawanda dzemirayiridzo dzinoshanda kune chero hutano hwakakanganiswa-kunyanya pharmacologic mazano. Osteoarthritis yepempa inoitika apo kune kuora kwema discs pakati pemiti yemitete. Vanhu vakawanda vane matambudziko ekudzikisa dambudziko havadi kuvhiyiwa uye vanobatsirwa zvakakwana nemishonga inogadzirisa. Kana zviyero zvinodzivirira zvichishaya, zvisinei, zvingasarudzwa zvinogona kusanganisira lumbar laminectomy, discectomy, kana spinal fusion .
Sezvimwe nemamwe majoini, kurapwa kwetsoka osteoarthritis kunotanga kuregererwa kwezviratidzo. Kupfeka nhengo dzemitambo kana zvitsigiro zvetsoka zvingabatsira. Kurasikirwa uremu kana kuwandisa kwepamusoro kuchabatsira masangano ose ekuremedza. Kana kurapwa kwakachengetedzwa kusingakwanisi kubudisa mhinduro yakakwana, kuvhiyiwa kunogona kuonekwa sekupedzisira kushandiswa. Arthroscopy , arthrodesis (fusion), kana arthroplasty (kubatanidza kushandiswa) inogona kutaridzirwa, zvichienderana nesangano rinobatanidzwa mutsoka kana maziso. Chinangwa chekuvhiya kwetsoka ndechokubvisa marwadzo nekuvandudza basa rekubatana.
Shoko Rinobva
IAmerican College yeRheumatology inorayira kuti kurapwa kwemaoko, hip, uye mabheti osteoarthritis kunobva pauchapupu hwaivepo huripo muna 2010. Nyanzvi yezvenyanzvi yaisanganisira vanachiremba vokurapa, physatrists, geriatricians, rheumatologists , chirwere chechiremba, uyewo masayendisiti uye therapists. Dare rakaungana rakapa maonero evanhu vakawanda kuti vaongorore zvakakwana uchapupu.
Zvinokurudzirwa zvakakosha nokuti kune maitiro akawanda ekurapa osteoarthritis-uye mazano pamusoro pekutanga kwatinofanira. Vanhu vazhinji vanofungidzirwa vane osteoarthritis vanoshandisa musanganiswa wemapirmacologic uye kwete-pharmacologic maitiro ekurapa.
wakakupa iyo bhuku rinotsanangurwa nokuti iri nyore kunzwisisa uye richakubvumira kuti ukurukure maitiro ako okutanga ekurapa nechiremba wako. Kana mhinduro yako isingakwanisi, iwe unogonawo kuona zviri nyore dzimwe mimwe nzira. Uye, kune mishonga chaiyo, kune zvibatanidzwa kune mamwe mashoko akazara.
> Sources:
> Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 Zvikurudzira zveKushandiswa kweAngpharmacologic uye Pharmacologic Therapies muOsteoarthritis yeHoko, Hip, uye Knee. Arthritis Care and Research . 2012; Vol. 64 Nha. 4, mapeji 465-474.
> Kalunian KC. Pakutanga Pharmacologic Therapy yeOsteoarthritis. Kusvika pari zvino. Yakapedzwa musi waMay 19, 2016.
> Moskowitz RW, et al. Osteoarthritis - Kuongororwa uye Kurapa / Surgical Management. Shanduro yechina. LWW.