Mankhwala a kapamba - mawonekedwe a makonzedwe awo

Kupweteka kwambiri pamimba, kusanza ndi ndulu, mseru ungasonyeze kapamba - kutupa kwa kapamba. M'matendawa, michere yomwe umapangidwa ndi thupi, mmalo mongomusiya duodenum, imakhalabe m'misempha ndikuyamba kuyigaya. Izi zimatsogolera kutulutsidwa kwa poizoni yemwe amatulutsidwa m'mitsempha, kufikira impso, mtima, mapapu, ubongo ndikuwononga minofu yake. Mankhwala omwe amwa mankhwalawa panthawi ya kapamba angapewe izi.

Zizindikiro za Pancreatitis

Kapamba amapanga michere yam'mimba ndi mahomoni omwe amawongolera mapuloteni, mafuta, metabolism - insulin, glucagon, somatostatin. Chiwalocho chimakhala ndi mawonekedwe obisika ndipo chimakhala m'mimba kumtunda, kumbuyo kwa m'mimba, chikugwirizana kwambiri ndi duodenum. Iron kulemera pafupifupi 70 g, kutalika kwake kumasiyana 14 mpaka 22 cm, m'lifupi - kuchokera 3 mpaka 9 cm, makulidwe - 2-3 cm.

Kutupa kwa pancreatic kumatha kuchitika m'mitundu yovuta komanso yosatha, mawonetsedwe azachipatala omwe ali osiyana. Pancreatitis pachimake ndi yakufa, chifukwa poizoni amatha kupweteka kwa minyewa ya gland ndi ziwalo zina, matenda, puritis. Ngakhale ndi chithandizo chanthawi yake ndi njira zamakono, kufa ndi 15%.

Palibe chithunzi chachipatala chomveka bwino mu pancreatitis yayikulu, chifukwa chake, mayeso owonjezera amafunikira kuti azindikire molondola. Mwanjira yodwala, matendawa amaboweka kapamba, omwe amayambitsa kupweteka kwa ziwalo zina, amasokoneza kayendedwe ka chakudya kudzera m'mimba ndi matumbo. Kuphatikiza apo, matendawa amadziwonetsera muzizindikiro zotsatirazi:

kupweteka kwapweteka pamimba, mpaka mbali yakumanzere, kumbuyo,
nseru
kusanza ndi bile, komwe sikubweretsa mpumulo,
ukufalikira
kusowa kwamadzi
khateyo limayamba, limodzi ndi chikasu pakhungu, mkodzo wakuda, ndowe zowala,
Nthawi zina, malo owoneka bwino amakhala pafupi ndi msomali kapena kumanzere kwam'mimba, nthawi zina amakhala ndi tinge yachikasu.

M'matenda osaneneka mu kapamba, kusintha kosasintha kumachitika. Amachepa, limachepa, maselo amasinthidwa ndi minyewa yolumikizana, chifukwa chomwe chiwalo chimaleka kukwaniritsa ntchito zake, ndipo kaphatikizidwe ka michere yam'mimba ndi mahomoni amachepa. Pancreatitis yodziwika bwino imadziwika ndi chithunzi cha matenda osachiritsika, zizindikiro zake zimatha kusokonezeka mosavuta ndi matenda ena am'mimba.

Matendawa amakula pang'onopang'ono ndipo sadzipangitsa kumverera kwa nthawi yayitali. Pathology imadziwoneka ngati ululu wammbuyo kapena wamkati pamimba, pafupi ndi hypochondrium yamanzere, imatha kupatsa kumbuyo kwakumbuyo. Matendawa amaphatikizidwa ndi mseru, kusanza, kugona, kutentha kwachisangalalo, kakomedwe kosakoma kamkamwa. Kutsekula m'mimba kumatha kusinthana ndi kudzimbidwa, limodzi ndi ndowe za chakudya chosalowetsedwa kutuluka. Kuonda kwambiri, maonekedwe a mafupa am'mimba amatha. Popeza kapamba amapanga insulin, pancreatitis yachilendo imakonda kuyenda ndi matenda a shuga.

Mankhwala achikulire a kapamba

Popeza mwazindikira Zizindikiro za kutupa kwa kapamba, muyenera kufunsa dokotala ndipo mupeze kafukufuku. Kenako, malinga ndi zotsatira za mayeserowa, adotolo adzalembera dongosolo la chithandizo. Amapereka zofunikira kuchita:

mpumulo wa zizindikiro zopweteka,
Kuchotsa kwa zotupa m'mimba kapamba ndi ziwalo zapafupi,
Kutha kwa matendawa chifukwa cha kuperewera kwa kapamba,
kupewa mavuto.

Mukayamba chithandizo, mukulira mwayi wopambana. Mankhwala onse a kapamba mu akulu ayenera kumwedwa monga momwe adanenera dokotala pomupatsa. Zochizira kapamba, antispasmodics, ma antacid, antienzyme, ndi N-2 blockers ndi omwe amapatsidwa. Muli ndi othandizira okhala ndi aprotinin polypeptide. Kufanana ndi kumwa mankhwala, njira zimayeretsedwa kuti ziyeretse thupi la pancreatic enzymes, zakudya.

Antispasmodics wa kapamba

Pofuna kuthetsa kupweteka pakukonda, antispasmodics amagwiritsidwa ntchito. Amakhala ndi nthawi yopumula minofu yosalala, yomwe imathandizira kuchotsedwa kwa ma enzymes pamodzi ndi ma ducts kuchokera ku kapamba. Ma antispasmodics ndiwongoyembekezera kwakanthawi: zochita zawo zikangotha, ululuwo ubwerera, ndiye kuti chithandizo chachikulu chikuyenera kukhala chofanana ndi kukonza ntchito ya thupi. Pakukokomeza, adokotala amatipatsa jakisoni wamkati kapena m'mitsempha, osagonja kawirikawiri. Pakutupa kosalekeza, mapiritsi amagwiritsidwa ntchito.

Kuti athetse ululu, No-Shpa (Hungary) kapena analogue Drotaverin nthawi zambiri amaloledwa. Zomwe zimagwiritsidwa ntchito mwa mankhwalawa ndi drotaverine hydrochloride. Chidacho chimathandizira kupindika kwam'mimba m'mimba, chimbudzi, kwamkati, bile, ndulu. Zotsatira za mankhwala pambuyo pakamwa makonzedwe amapezeka kotala la ola, pambuyo jekeseni - mphindi yachiwiri. Mu kutukusira pachimake kwa England, amadziwika:

jekeseni wa mu mnofu: 2 ml ya njira imodzi,
ndi jekeseni wovomerezeka wa 2 ml, mankhwalawo amadzimadziika ndi 8-10 ml ya njira yothandizira ya sodium chloride, jekeseni pang'onopang'ono mphindi zisanu,
mapiritsi: pafupifupi tsiku lililonse 80 mg, mlingo waukulu wa tsiku ndi tsiku ndi 240 mg.

Amatha kuthetsa kupweteka Papaverine, zomwe zimagwira ntchito zomwe zimafanana ndi dzina la mankhwalawa. Mankhwalawa amathandizanso minofu yosalala ya ziwalo zogaya chakudya m'mimba ndi kupuma, amachotsa ma spasm, omwe amachititsa kuti madzi azuluka mu kapamba. Opanga osiyanasiyana amasula mankhwalawo mwanjira ya mapiritsi, suppositories, jakisoni. Mankhwala a akulu:

mapiritsi: 40-60 mg 3-4 pa tsiku, pazipita tsiku lililonse ndi 0,6 ga,
subcutaneous ndi mu mnofu jakisoni wa kapamba: 0,5-2 ml yachiwiri peresenti yothetsera, muyeso umodzi umodzi ndi 5 ml, tsiku lililonse mlingo ndi 15 ml.

Platifillin amachepetsa kupindika kwam'mimba, kumachepetsa mphamvu ya minofu ya ndulu ndi chikhodzodzo. Opanga osiyanasiyana amapanga antispasmodic mwanjira ya mapiritsi kapena jakisoni. Pothandizanso kupweteka kwambiri, jakisoni amatchulidwa: yankho limayendetsedwa kamodzi kapena kawiri pa tsiku katatu, tsiku lonse limakhala 15 ml, mlingo umodzi osapitilira 5 ml.

Atropine imatsitsimutsa minofu yosalala yam'magazi, imalepheretsa chidwi cha acetylcholine, neurotransmitter yomwe imagwiritsa ntchito ma neuromuscular signation. Opanga osiyanasiyana amapanga mapiritsi ndi jakisoni. Kuti muchepetse kupweteka kwambiri, 1 ml ya yankho la 0,1% ya atropine sulfate imabayidwa katatu mpaka katatu patsiku. Mankhwalawa ali ndi chidwi pa mitsempha, mtima, chifukwa chake, uyenera kugwiritsidwa ntchito mosamala moyang'aniridwa ndi achipatala.

Enzymes ndi anti-enzyme akukonzekera kapamba

Kuti achepetse kuchuluka kwa madzi am'mimba, dokotalayo amatipatsa mankhwala omwe ali ndi zinthu zomwe zimalocha m'malo mwa michere yopangidwa ndi kapamba. Awa ndi amylase, omwe amathandizira kukonzanso kukhuthala kukhala ndimaswiti, komanso proteinase ndi lipase (yoyamba imaphwanya zida zapakati pa amino acid m'mapuloteni, chachiwiri - mafuta). Kukonzekera kwa enzyme kwa kapamba kumathandizira kapamba, kuthandizira kupewa kufooka, kupukusa chakudya moyenera, kuchotsa m'mimba, nseru, kutuphuka, ulemu.

Pa chithandizo cha pancreatic, mankhwala a enzyme okhala ndi pancreatin ndi mankhwala. Imaphwanya mafuta, mapuloteni ndi chakudya, ndikusintha amylase, lipase, proteinase:

Chikondwerero. Kuphatikiza pancreatin mu kapangidwe - hemicellulose, bovine bile Tingafinye. Mankhwala amalimbikitsa osati chimbudzi ndi chakudya, komanso kuwonongeka kwa utsi, kusintha kwa katulutsidwe ka bile, ndikuthandizira lipase. Mlingo: piritsi limodzi patsiku limodzi kapena chakudya.
Chiboni. Kutulutsa mawonekedwe - makapisozi 150, 300, 400 mg wa kapamba. Mlingo umatengera chithunzi cha matenda, omwe amatengedwa nthawi ya chakudya kapena itatha.
Panzinorm 10000 ndi 20000. Wopangidwa m'mapiritsi, kumwa piritsi 1 limodzi ndi zakudya katatu patsiku.
Chimbudzi. Kutulutsidwa mawonekedwe - dragees. Imwani mutatha kudya kapena nthawi ya chakudya 1-2 ma PC. katatu patsiku.
Mezim 10000 ndi 20000. Opangidwa m'mapiritsi, makapisozi, ma dragees. Tengani chakudya isanayambe kapena itatha 1-2 ma PC. kamodzi mpaka katatu patsiku.

Ndi edema ya pancreatic, ntchito yake iyenera kupanikizidwa. Kuti muchite izi, adotolo amafotokozera kukonzekera kwa antienzyme kukonzekera. Pakati pawo, Contrical kapena analogi yake Aprotinin iyenera kusiyanitsidwa. Amayambitsa proteinase, amalepheretsa kallikrein-kinin dongosolo - gulu lama mapuloteni omwe amatenga gawo limodzi pakukonzekera, kuwundana kwa magazi, komanso kupweteka.

Pancreas yoyaka imapangitsa kuti m'mimba pakhale hydrochloric acid yambiri. Kuchuluka kwa acidity kumazungulira tiziwalo tating'ono, kumayambitsa kupweteka kwambiri, kumapangitsa kuti michereyo izigaya. Kusintha mphamvu ya kukonzekera kwa enzyme ndi kupewa kuwonongeka kwa makoma am'mimba, madokotala amapereka ma antacid, omwe ntchito yawo ndi yothandiza kuti hydrochloric acid ikhale. Mankhwala a gululi amadziwika ndi envelopu athari, amateteza ku zotsatira zoyipa, kusintha kapangidwe ka bicarbonates, komanso kupewa flatulence.

Zida zazikulu zaantacid zomwe zimagwiritsidwa ntchito pochiza ziphuphu zakumwa ndizo mankhwala a magnesium ndi aluminium. Mankhwala oterewa amachepetsa kuchuluka kwa hydrochloric acid, kukhala ndi choleretic, mankhwala oletsa ululu, kukhala ndi zovuta, kusintha katulutsidwe wa bile, ndikuchotsa kapangidwe ka mpweya. Mankhwala okhala ngati mapiritsi musanayambe kugwiritsidwa ntchito amayenera kuphwanyidwa kapena kutafunidwa bwino. Kuti kukhazikika bwino kwa acid-base, otsatirawa ndi omwe atchulidwa:

Gel Almagel. Akuluakulu amayenera kumwa 1-2 tsp. patsiku theka la ola musanadye komanso pogona. Mlingo wapamwamba wa tsiku lililonse ndi 16 tsp. Njira ya mankhwala ndi milungu 2-3.
Kuyimitsidwa ndi mapiritsi Maalox. Imakhala ndi ma analgesic, kuimitsa ululu pamtunda wam'mimba. Mlingo - mapiritsi 2-3 kapena 15 ml ya kuyimitsidwa ola limodzi mutatha kudya komanso musanagone. Njira ya mankhwala ndi miyezi 2-3.
Mapiritsi a Gastracid. Mlingo: 1-2 mapiritsi 4 pa tsiku mukatha kudya musanayambe kugona. Njira yochiritsira salinso yopitilira milungu itatu.
Mapiritsi a Alumag. Imwani 1.5 maola pambuyo chakudya. Njira ya mankhwala ndi mwezi.
Gel ndi mapiritsi a Palmagel. Mlingo: Mapiritsi awiri kapena atatu kapena mphindi 5 mg ya kuyimitsidwa ola limodzi ndi theka mutatha kudya. Njira ya mankhwala ndi miyezi 2-3.

Ma H2 blockers

Mankhwala a kapamba nthawi imodzi ndi ma antacid, secretion inhibitors, blockers a H2-histamine receptors, ayenera kutumikiridwa. Mankhwalawa amapanga histamine insensitive gastric cell receptors omwe amapanga hydrochloric acid. Izi zimachepetsa kaphatikizidwe kake ndikulowa kwa lumen pamimba, zomwe zimathandiza pancreatitis. Mphamvu ya blockers pamthupi sikungokhala: zobisalira zoletsa zimapangitsa kuti mucosa wa gastric azigonjetsedwa ndi zinthu zamtopola, zimathandizira kuchira kwake.

Ma H2-blockers amayenera kumwedwa mosamala, pa mlingo wokhazikitsidwa ndi adokotala, chifukwa amatha kuyambitsa zovuta zambiri. Zovuta zambiri ndi mankhwala a m'badwo 1. Zochizira zikondamoyo zoyipa, mankhwalawa ndi awa:

Cimetidine. Mankhwalawa amatengedwa musanadye kapena nthawi ya chakudya. Kuzindikira kwakukulu m'magazi kumawonedwa pambuyo pa maola awiri. Awa ndi mankhwala a m'badwo woyamba, chifukwa chake, amatha kupweteketsa mavuto ena osiyanasiyana kuchokera ku ziwalo zosiyanasiyana. Pakati pawo - kutsegula m'mimba, kusokonezeka kwa mutu, kupweteka kwam'mimba, zotupa zamkati mwa dongosolo lamanjenje, kusintha kwa kapangidwe ka magazi, kunachepetsa chitetezo chokwanira. Pambuyo pa tsiku, 48% yazinthu zomwe zimagwira ntchito zimachoka m'thupi.
Ranitidine. Mankhwala ndi a m'badwo wachiwiri. Ntchito yake imakhala 60 times ya cimetidine. Mankhwalawa amatengedwa mosasamala kanthu ndi chakudya. Chogwiritsidwacho chimapereka zovuta zochepa, zomwe zimadziwika ndi nthawi yayitali yochitapo kanthu. Amalowa mwachangu m'magazi, kuphatikiza kwakukulu kumawonedwa pambuyo pa maola awiri. 40% ya zomwe zimagwira thupi zimachoka m'thupi pambuyo pa tsiku.
Mapiritsi a Famotidine. Mankhwala a m'badwo wachitatu, motero ogwira ntchito kwambiri kuposa Ranitidine, ali ndi zovuta zochepa ndipo amalekeredwa bwino. Chipangizocho chitha kutengedwa mosasamala kanthu ndi chakudya. Mulingo wapamwamba umawonedwa pambuyo pa ola limodzi, theka la moyo ndi maola 3.5, kugwirako kumatenga maola 12.

Kafukufuku waposachedwa awonetsa kuti ma H2-histamine receptor blockers ali ndi zovuta zambiri. Amalephera kupitiliza kuchuluka kwa acidity kwa maola opitilira 18, atalandira chithandizo mobwerezabwereza, thupi limazolowera mankhwalawo ndipo limatha kupirira, ndikuzolowera mankhwalawa. Kubwezerani kwakukulu kwa blockers ndikuti kugwiritsa ntchito kwawo kumayambitsa kukula kwa kapamba kapena kufalikira kwake.

Proton pump zoletsa

Posachedwa, H2-histamine receptor blockers ayambanso kugwiritsa ntchito mankhwala othandiza komanso otetezeka - proton pump inhibitors (PPIs). Kuchita kwawo ndikufuna kutsekereza ntchito za michere, yomwe imadziwika kuti "proton pump", yomwe imakhudzidwa mwachindunji ndi kaphatikizidwe ka hydrochloric acid. Ubwino wa IPP ndikuti samasokoneza bongo atatha kuletsa, akulephera kuyambitsa matenda a kapamba, chifukwa chochepa kwambiri.

Ma protein onse a proton pump ndi ma benzimidazole ofunikira, chifukwa chake, amadziwika ndi machitidwe ofanana. Zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimadziunjikira mobisa wam'madzi, pomwe, mothandizidwa ndi acidity yayikulu, imasinthidwa ndikuyamba kugwira ntchito, kutsekereza ntchito ya enzyme. IPPs imatha kuwongolera kapangidwe ka hydrochloric acid tsiku lonse, mosasamala zomwe zimapangitsa kuti amasulidwe.

Wothandizidwa kwambiri pagululi ndi Omeprozole, womwe ndi mankhwala ochepa omwe amapereka mofulumira hydrochloric acid synthesis. Mu kutupa kwambiri kapamba, mankhwalawa mankhwala 20 mg kamodzi patsiku, pobwerera - 40 mg / tsiku, aakulu - 60 mg / tsiku. Mukatha kugwiritsa ntchito Omeprozole, kupanga kwa hydrochloric acid kumachepetsedwa ndi 50%. Kuchepa kwa acidity kumayambira patatha maola awiri, mphamvu kwambiri imawonedwa patsiku lachinayi.

Chithandizo chothandiza cha kapamba ndi Pantoprazole, yemwe amagulitsidwa pansi pa mayina Nolpaza, Sanpraz, Ulsepan. Pantap. Mankhwalawa amagwira ntchito mosasamala chakudya, koma ndibwino kuti mutenge mphindi 10 chakudya chisanafike. Pazipita ndende ya magazi m'magazi amawona pambuyo 2, 5 maola, zotsatira kumatenga tsiku. Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

Zochizira pancreatitis, Rabeprazole (analogues - Pariet, Razo, Khairabesol) amagwiritsidwa ntchito ngati mankhwala ochizira. PPI imayamba kuletsa kupanga kwa hydrochloric acid mkati mwa ola limodzi mutatha kumwa mankhwalawo. Kutsika kwakukulu kwa acidity m'mimba kulembedwa patatha maola awiri kapena anayi pambuyo pa kumwa koyamba, zotsatira zokhazikika pambuyo masiku atatu a chithandizo. Patsiku loyamba, chindapusa cha acidity chimatsika ndi 61%, patsiku lachisanu ndi chitatu la chithandizo - ndi 88% ya manambala oyamba.

Mankhwala ena a kapamba

Nthawi zina, chifukwa cha kupweteka kwa kapamba, madotolo amatumiza mankhwala, omwe amachepetsa mphamvu ya mantha ndi kuchepetsa nkhawa. Mankhwalawa samangochepetsa kukhumudwa, komanso amathandizira zotsatira zamankhwala opweteka a kapamba. Mwa mankhwalawa mungadziwike:

Ndi kutupa kwa kapamba, adotolo atha kupereka mankhwala a mahomoni. Poletsa kupanga kwa pancreatic ndi madzi a m'mimba, Octreotide imagwiritsidwa ntchito - analogue of the somatostatin, yomwe imagwiritsidwa ntchito pochiza zotupa. Corticosteroids (mwachitsanzo, prednisone) amadziwika ngati matenda osachiritsika adayamba chifukwa cha matenda a autoimmune. Hormone chithandizo kwakanthawi, chifukwa chithandizo cha nthawi yayitali chimatha kuyambitsa mavuto ambiri.

Mu chifuwa chachikulu, chimbudzi nthawi zambiri chimawonedwa, limodzi ndi m'mimba. Kuperewera kwa enzyme kumachepetsa kugaya chakudya, chifukwa choti chakudya chimachedwa m'mimba, ndipo mabakiteriya omwe amayambitsa kuwola amakhalamo, zomwe zimayambitsa matenda otsegula m'mimba komanso kuphwanya. Ma sorbents amatha kuthana ndi vutoli. Smecta ndi kapamba amalepheretsa njirazi, kuchotsa kusapeza bwino komanso kukhazikika kwa chopondacho. Mankhwalawa amapanga nembanemba yoteteza pa mucosa, amaikapo poizoni ndi mabakiteriya ndikuwawonetsa pamodzi ndi ndowe.

Maantibayotiki amagwiritsidwa ntchito kupha tizilombo toyambitsa matenda omwe adatulutsa zovuta zakupatsirana: kupasuka kwa kapamba, kukondoweza kwa ndulu, kutupa kwa ma ducts a bile, maonekedwe a cysts, ndi matenda a bakiteriya. Mankhwala osokoneza bongo a pancreatitis pachimake amaperekedwa ndi jakisoni, popeza kuti kufalikira kuyenera kuchitapo kanthu mwachangu. Maantibayotiki amayenera kumwedwa pokhapokha ngati akuwongolera dokotala, chifukwa ndi okhawo omwe amatha kuwononga maselo a chamba komanso kuyambitsa kutupa. Pakati pa mankhwalawa akuyenera kufotokozedwa:

Ceftriaxone, cefotaxime kuchokera pagulu la cephalosporins,
Amoxiclav kuchokera ku gulu la penicillin,
Thienam kuchokera pagulu la thienamycin,
Ampioks - mankhwala osakanikirana ndi mankhwala a Ampicillin ndi Oxacillin,
Vancomycin pagulu la ma trousclic glycopeptides.

Pofuna kupewa edema ya pancreatic, chotsani michere yambiri ndi ziphe m'thupi, madokotala amamulembera okodzetsa - okodzetsa. Ndi kapamba, Furosemide ndi Diacarb amalembedwa limodzi ndi potaziyamu. Kumwa okodzetsa kuyenera kukhala kokhazikika monga momwe adauongolera adokotala, chifukwa kugwiritsa ntchito molakwika kumatha kuwononga maselo apachifinya, kupangitsa kuchuluka kwa creatinine ndi urea m'magazi, kuchepa kwamphamvu kwa magazi ndi zina.

Zambiri za kumwa mankhwala a kapamba

Dotolo ayenera kuyikiranso mankhwalawa ndikufotokozera kuti ndi mankhwala ati a kapamba omwe ayenera kumwa, omwe ndi omwe nthawi ya chakudya. Mwachitsanzo, mankhwala a enzymatic a kapamba amamwa nthawi yomweyo ndi kudya, pamene maantibayotiki amatengedwa pambuyo pake, proton pump inhibitors kamodzi patsiku. Ma painkiller amatha kutengedwa ngati pakufunika nthawi iliyonse, kuyang'anira mosamala mlingo womwe ukupezeka mu malangizo.

Mapiritsi onse okhala ndi kapamba ayenera kutsukidwa ndi madzi ambiri akumwa. Munthawi ya matendawa, mowa umaletsedwa mwamphamvu, poizoni wake amene amawononga maselo onse amthupi, kuphatikizapo kapamba. Kuphatikizidwa kwa mankhwalawa ndi ethanol kumakulitsa kuchuluka kwa chiwindi, impso, ndi ziwalo zina zam'mimba, zomwe zimayambitsa zovuta zazikulu.

Mankhwala aliwonse angayambitse zoyipa ndipo ali ndi contraindication, kotero musanagwiritse ntchito, muyenera kuwerenga malangizo ndikudziwitsa dokotala za matenda ena aliwonse. Ngati mankhwala a pancreatitis aputa zovuta ndi zovuta zina, ziyenera kutha pomwepo, ndikuthira mankhwala ndi chinthu chinanso chogwira ntchito.

Kutalika kwa nthawi ya mankhwalawa kwa mtundu uliwonse wa mankhwala ndiudokotala. Mwachitsanzo, maantibayotiki sangathe kuledzera kwa milungu yopitilira iwiri, popeza mabakiteriya amayamba kukhala osokoneza bongo ndipo mankhwala amakhala osagwira. Ndikosatheka kusokoneza chithandizo chamankhwala, chifukwa sikuti zimangochepetsa mphamvu ya chithandizo, komanso zimayambitsanso matenda.

Kuti mankhwalawa akhale othandiza, muyenera kutsatira zakudya. Mwanjira yamatendawa, kumenyedwa kwa njala kumasonyezedwa m'masiku awiri oyamba, mutatha kudya zakudya zamafuta ochepa. Mafuta, zonunkhira, amchere, tsabola, zakudya zosuta, zakudya zina zomwe zimapangitsa kuti madzi am'mimba azisungidwa, mapangidwe a mpweya m'matumbo amaletsedwa. Mu mtundu wa matenda, kugwiritsa ntchito kwawo kumakhala kochepa. Zakudya ziyenera kukhala zonyowa, mutha kuwotcha, kuphika, kuphika. Idyani zakudya zazing'ono 5-6 patsiku.

Malangizo ogwiritsira ntchito mankhwalawa

Creazim akuwonetsedwa zochizira exocrine pancreatic insuffence, pancreatitis yayitali, cystic fibrosis, kuchotsedwa kwa zolakwa za michere, komanso kukula kwa microflora ya pathogenic m'matumbo ang'onoang'ono. Mankhwala amatengedwa ngati kutsekeka wamba bile ndi zikondamoyo, zilonda zam'mimba, ndi chosaopsa neoplasms mu chiwalo, kuchitira chizindikiro cha kugaya chakudya pambuyo pakuchitika kwapamimba, kutsekeka kwa biliary, prigastrosis, cholecystectomy, chiwindi cirrhosis, matenda am'mimba.

Kapisolo ayenera kumezedwa lonse, kutsukidwa ndi madzi okwanira. Mlingo amasankhidwa payekhapayekha, poganizira kuopsa kwa kapangidwe ka kapamba, chakudya cha wodwalayo.

Nthawi zambiri amasonyezedwa kuti atenge limodzi la magawo atatu kapena theka la kumwa kamodzi musanadye, ena onse amadya ndi chakudya. Mlingo woyambirira wa mankhwalawa ndi 10000-20000 PIECES of lipase. Pakakhala kufunika kochepetsera steatorrhea, kuthandizira moyo wabwinobwino wamunthu, dokotala amasankha kuwonjezera kuchuluka kwa ndalama. Pankhaniyi, limodzi ndi chakudya chachikulu, muyenera kumamwa lipase 20000-70000ED, munthawi yakumwa - chakudya cham'phika 50,000.

Chithandizo cha cystic fibrosis zimatengera zisonyezo:

zaka ndi kulemera kwa wodwalayo
Zizindikiro
zotsatira zoyendetsa.

Mayiko okwanira 10,000 amaloledwa tsiku lililonse.

Ngati munthu akuvutika ndi kumeza, ndikulimbikitsidwa kuti mutsegule makapu, kuwonjezera zomwe zili m'mbale zamadzimadzi zomwe sizimafuna kutafuna. Kusakaniza komwe kumachitika kumatengedwa nthawi yomweyo, sikungasungidwe.

Kutalika kwa njira yochizira kumayambira masiku angapo mpaka miyezi ingapo, pamene kuphwanya kumachitika chifukwa cha zovuta zolakwika pakudya. Ngati mukufuna chithandizo chamankhwala chokhazikika, kumwa mapiritsi a Creazim kumatenga zaka zingapo.

Ngati wodwala wagwiritsa ntchito mankhwala ochulukirapo, chitukuko cha hyperuricuria (kuchuluka kwa kuchuluka kwa uric acid) ndi hyperuricemia (lactic acid diathesis) sichimalamulidwa.

Chizindikiro ichi ndi chofunikira, chikuwonetsa kukomoka kwa kumwa mapiritsi, ntchito ya adotolo kusintha njira yochiritsira, kupereka mankhwala ofananawo.

Njira zochizira pancreatitis, kutengera mtundu wa matendawa

Pachimake kapamba nthawi zambiri kumachitika chifukwa chomwa mowa mwauchidakwa, chakudya chochuluka kwambiri komanso chakudya chamafuta kwambiri chimapangitsa kuti kapamba azigwira ntchito moyenera - kwambiri mpaka amayamba kugaya minofu yake. Gawo la milandu yotereyi mchilankhulo cha ziwerengero zomwe zimatchulidwa Mowa Pancreatitis, yowerengera 55% ya odwala onse. Chachiwiri pafupipafupi chimakhala pachimake biliary kapambakupsinjika ndi mavuto mu biliary thirakiti ndi ndulu, yomwe imagwirizanitsidwa ndi kulumikizana kwamatumbo pakati pa bile ndi pancreatic ducts. Chowonadi ndi chakuti bile duct isanatsegule mu duodenum imalumikizana ndi duct yochokera ku kapamba. Kuchuluka kwa pachimake biliary pancreatitis ndi 26% mpaka 60% ya milandu yonse yamapapo pancreatitis, kufupika kwa nthawi yayipa mpaka 43% ya milandu. Choyambitsa chachikulu cha bancary pancreatitis ndikuwoneka kwa duct ya bile mu pancreatic duct ndikuwonjezeka kwa kukakamiza kwazinthu komanso kuchepa kwa michere kuchokera ku kapamba, komwe kumayambitsa kudzimbidwa kwake. Kapena, ngati mwala umaphimba ndulu, bile ikamapanikizika imayamba kulowa kapamba. Izi zimachitika 35% ya milandu pachimake kapamba. Milandu yotsala ndikuvulala, matenda, njira za autoimmune ndi zochitika zina zofananira.

Koma zilizonse zomwe zimayambitsa pancreatitis yayikulu, matendawa ndi akupha. Chifukwa chake, odwala nthawi zambiri omwe amakhala ndi zodandaula za ululu wolimba kwambiri, wosachepetsa, womanga m'chiuno chapamwamba, limodzi ndi kusanza komwe sikubweretsa mpumulo, amagonekedwa kuchipatala cha opaleshoni, komwe amathandizidwa. Vutoli ndikuti pafupifupi pafupifupi gawo limodzi mwa magawo asanu, mankhwalawa amayamba kapamba. Chifukwa cha kutupa, kutuluka kwachilendo kwa michere ya m'mimba kumasokonekera, ndipo m'malo mwa lumen yamatumbo, komwe iyenera kukhala, ma enzyme amalowa mu minyewa ya nduluyo ndikudzigaya zenizeni. Pali malo a necrosis - necrosis, omwe amayenera kuchotsedwa posachedwa. Kuphatikiza apo, zinthu zosemphana ndi minofu zimalowa m'magazi ndikuvulaza thupi.

Mlingo wofinya wa kapamba amachitidwa mwachikhalidwe monga njira yoyambira "yozizira, njala ndi mtendere":

chikhodzodzo cha ayezi chimayikidwa m'mimba
Zomwe zimachotsedwa pamimba ndi kafukufuku kenako zimaletsedwa kudya mpaka zotupa za pachimake zitazimira (mutha kumwa),
ikani malo ogona.

Kuphatikiza apo, kuchipatala chokhala ndi pancreatitis yovuta kwambiri, ma analgesics, antispasmodics ndi kulowetsedwa ndi mankhwala, amamuyika, wodontha, kuti amuchotsere ziwalo zomwe zimalowa mthupi.

Ngati pambuyo pa maphwando atatenga nthawi yayitali panali ululu wosalala, wosasunthika, kusanza, komanso m'mimba m'mimba mwake kumakhala kovuta komanso kowawa kwambiri - osayesa kuchitiridwa nokha, funsani dokotala nthawi yomweyo!

Ululu umadziwikanso chifukwa cha kukokoloka kwa chifuwa chachikulu, koma kulimba kwake sikokwanira ngati pachimake. Poyambirira kwamatenda, matendawa amapweteka nthawi iliyonse miyezi isanu ndi umodzi kapena chaka chimodzi kapena kuposerapo kawiri ndipo amatenga masiku khumi. Momwe maphunzirowa amathira, kupweteka kumachitika aliyense mpaka miyezi iwiri.

Matenda a kapamba Itha kuwoneka osati kokha motsutsana ndi maziko a kuledzera kosalekeza, ngakhale kuti ichi ndi chimodzi mwa zifukwa zazikulu. Amatha kuchitika chifukwa cha autoimmune, njira zoperewera zam'mimba, zomwe zimayambitsa kuchepetsedwa kwa kapamba komanso kusokonezeka kwazomwe zimachitika chifukwa cha michere, kulephera kwaimpso ndi zina.

Ndi kuchulukirachulukira kwa matenda a kapamba, kuzizira, njala ndi kupumulanso amathanso kulimbikitsidwa, koma kwenikweni kwa tsiku limodzi kapena awiri. Kuti muchepetse kupweteka pang'ono, gwiritsani ntchito ma pinkiller, omwe amasankhidwa ndi dokotala. Momwe akuvutikira kwambiri, opioid narcotic analgesics akhoza kutumikiridwa.

Kuti, kumbali imodzi, perekani mtendere kwa kapamba, ndipo winayo, kubwezera zovuta za ntchito, kukonzekera kwa ma pancreatic ndi mankhwala, koma makamaka mwa mawonekedwe a microforms. Mankhwalawa amathandizira kuthetsa ululu.

Chakudya chizikhala chambiri komanso chamagulu, komanso mapuloteni ambiri. Ndizomveka kuchepetsa mafuta kwambiri pokhapokha ngati wodwala amakhala ndi zotupa chifukwa chakuphwanya chimbudzi chawo, ngakhale ndi mankhwala omwe angapangidwe. Mtundu uliwonse wa mowa umaletsedwa kotheratu. Ndikulimbikitsidwa kuti musiye kusuta.

Chithandizo cha mankhwala a kapamba: magulu a mankhwala

Monga tafotokozera pamwambapa, chifuwa chachikulu cha pancreatitis chiyenera kuthandizidwa ndi dokotala kuchipatala cha opaleshoni. Amatha kulembera magulu otere mankhwala:

Ma analgesics (mainkelizi): kutengera kulimba kwa ululu, itha kukhala ma narcotic analgesics komanso amphamvu opanga ma noncotic omwe ali mu zipatala.
Antispasmodics: wonjezerani ma ducts ndikusintha kutuluka kwa pancreatic secretion. Kuphatikiza apo, ali ndi mphamvu ya analgesic, chifukwa amathandizira kuphipha kwa minofu yosalala ya ziwalo zamkati.
Pancreatic secretion inhibitorskuti ma enzymes ake aleke kuwononga minofu yawo. Mwa izi, magulu angapo a mankhwala amagwiritsidwa ntchito:
- kupanga somatostatin analogues - mahomoni omwe, kuwonjezera pa zoyambira (malamulo a kapangidwe ka kukula kwa mahomoni), amalepheretsa kugwira ntchito konse kwamatumbo, kuphatikiza ma enzyme,
- cytostatics - komanso choletsa ntchito ya m'mimba ndi zotupa,
- mankhwala kupondera chapamimba katulutsidwe: Blockers H2 ndi ma proton pump zoletsa.
Madzi ochulukirapo obwera kuchepetsa kuledzera ndi kubwezeretsanso kuyamwa.
Kukonzekera kwa makolo zakudya: popeza ndizosatheka kudya, komanso kugwiritsa ntchito mphamvu kwa thupi chifukwa cha kapamba kumafunikira pafupifupi 3,5 kcal patsiku, muyenera "kudyetsa" wodwalayo mwachindunji ndi amino acid omwe ali ndi mchere komanso mavitamini monga infusions (ma dropper).
Kutengera ndi zomwe wodwalayo ali nazo, adokotala amatha kukupatsirani mankhwala omwe amachepetsa magazi, magazi, ziwonetsero zina zamankhwala, mapapo, ziwalo zina.

Pochiza matenda a kapamba, mankhwalawa amayikidwa mu maphunziro ataliatali, onse mu gawo la exacerbation komanso kunja kwake. Choyamba, mankhwalawa amayikidwa kuti athetse zomwe zimayambitsa njirayi: oyang'anira otuluka a bilengati nthendayo yapweteketsedwa ndi matenda a m'mimba, mahomoniomwe amachepetsa ntchito ya chitetezo mthupi mu autoimmune pancreatitis, ndi zina. Kuthetsa mowa kwathunthu ndikulimbikitsidwa.

Kuphatikiza apo, adotolo atha kukulemberani magulu oterewa monga:

Mankhwala opweteka (analgesics). Zitha kukhala ndalama zogulira zomwe mukufunika kuti mugwiritse ntchito, kapena kwa anzanu otsutsa. Njira yogwiritsira ntchito amatha kupitilira miyezi itatu.
Ma antidepressants ndi mapapu olimbitsa. Ndi kapamba, amalembedwa kuti asawongolere momwe akumvera, koma kuti apititse patsogolo zotsatira za opweteka. Amachepetsa chidwi chowonjezereka cha kupweteka komwe kumachitika ngati china chake chimapweteka kwambiri komanso kwanthawi yayitali (m'mankhwala, antidepressants amabwezeretsa ntchito za chitetezo cha mthupi), zomwe zimachepetsa nawonso mlingo wa analgesics.
Mankhwala a Antispasmodic. Sinthani kutuluka kwa pancreatic katulutsidwe, muchepetse kupsinjika mkati mwa ma ducts ndikuthandizira kuchepa kwa ululu.
Pancreatic Enzymes ku Microbeads - sizofunikira kwambiri kukonza chiwonetsero cha ziwalo (kusowa kwa ma enzymes kumawoneka pokhapokha 90% ya kapambayo awonongedwa), koma kuti apumulitsidwe. Popeza, ndi makina a mayankho, ma enzyme omwe adayambitsidwa kuchokera kunja amalepheretsa kupanga ma enzymes awo, ndichifukwa chake kukakamiza kwa ma gland kumachepa, kutanthauza kupweteka.
Mankhwala omwe amachepetsa acidity ya madzi a m'mimba, makamaka proton pump zoletsa. Musalowe m'thupi ndi wachibale wowonjezera m'mimba. Mu malo a zamchere, mulingo woyenera kwambiri umapangidwira zochitika za pancreatic ndi matumbo ensa.Komabe, pancreatitis yayikulu, kupatula kwa zamchere kumapangidwa m'mapamba. Ndipo zomwe zikubwera m'matumbo zimasunthira pH ya sing'anga m'matumbo kuchokera ku alkaline (pamwambapa 7 pH) kupita ku acidic side (pansipa 7 pH), yomwe ingayambitse kusokonezeka kwapakudya m'mimba. Nthawi yomweyo, bile sangasinthe (kutembenuka kukhala tinthu tating'onoting'ono kwambiri), lomwe limasokoneza chimbudzi chake. Ntchito yam'mimba yama enzymine nayo imachepetsedwa. Poletsa kupanga gastric acid, mankhwala amabwezeretsa m'mimba matumbo a alkaline.

Ma pancreatic michere amalembedwa mosalekeza, ngati ntchito ya chiwalo ili ndi vuto kotero kuti chimbudzi chitha. Munthu amayamba kuchepa thupi, atatha kudya amakhala ndi chidwi chofuna kunyoza, popeza mafuta osaphatikizidwa amakwiyitsa khoma lamatumbo, chopondacho chimakhala chambiri, fetid, chimayamba kuwala.

Zambiri

Mukamasankha kukonzekera kwa enzyme, munthu ayenera kuganizira mankhwala omwe ma enzyme amapezeka mu 2mm kukula kwake - pokhapokha ngati mankhwalawo amatha kusiya mimba nthawi yomweyo ndi chakudya.

Ndi kutulutsa kosalekeza komanso kusanja, mankhwala amakhazikika kuti achepetse kupangidwa kwa mpweya: sorbents, dimethicone.

Ngati kupangika kwa insulin chifukwa cha kutupa kwambiri ndi kufa kwa maselo a m'matumbo, jakisoni wa timadzi timeneti ndi wofunikira.

Chifukwa chake, pancreatitis yovuta komanso yodwala ndi matenda oopsa omwe amakhala ndi zovuta kwambiri ndipo amafunikira chithandizo chachitali komanso chopweteka. Chifukwa chake, osayang'ana njira zamankhwala pa intaneti, zitha kukhala zowopsa. Ndikofunikira kukaonana ndi dokotala panthawi ndikutsatira malangizo ake.

Kukonzekera kwa Pancreatic Enzyme

Pakati pa mankhwala amakono omwe amakhala ndi ma enzymes achilengedwe, Mikrasim® iyenera kudziwika. Imapezeka m'mabotolo okhala ndi mulingo wa 10,000 ndi 25,000 mayunitsi.

Pokonzekera Mikrasim® Enzymes imakhala yaying'ono kuposa 2 mm kukula kwake, wokutidwa ndi enteric wokutira. Ma Microgranules, nawonso, atsekedwa m'mapiritsi a gelatin. Mukakhala mu acid zomwe zimapezeka m'mimba, kapisozi kamasungunuka, ndipo ma micronanules amasakanikirana ndi chakudya, pambuyo pake amasiya m'mimba ndi izo. Kamodzi pa zamchere zam'mimba, ma microspheres amatulutsa michere. Chifukwa chake, michere yam'mimba ya kapamba wa mankhwala a Mikrasim® imachita ndendende komwe imatsimikiziridwa mwa thupi - mu lumen yaing'ono. Pazipita ntchito ya mankhwala zimatheka mwa theka la ola pambuyo makonzedwe.

Zomwe zimagwira zimagwirizana ndi zochitika za michere yam'mimba yachilengedwe: mapuloteni, ma amylase ndi lipases, zomwe ndizofunikira pakuwonongeka kwa mapuloteni, chakudya chamafuta ndi mafuta. Momwe zimakhudzana ndi mtanda wazakudya m'matumbo a lumen, ntchito ya michere imachepa, kenako zotsalazo zimachotsedwa m'thupi popanda kulowetsedwa m'magazi.

Ndikulimbikitsidwa kuti mutenge Mikrasim® chifukwa cha pancreatitis yayitali, kuchepa kwachinsinsi komwe kumachitika chifukwa cha zifukwa zosiyanasiyana. Mankhwalawa atha kulimbikitsidwa kwa anthu osapezeka ndi matenda am'mimba, omwe amakhala ndi dyspepsia, kutsekula m'mimba, kuphwanya zakudya zolakwika, monga kudya kwambiri, kudya mwachangu, kuphwanya kudya.

Mankhwalawa contraindicated mu pachimake kapamba ndi kuwonjezereka kwa matenda, komanso munthu tsankho kwa munthu zigawo zikuluzikulu.

Mankhwala Mikrazim® akuphatikizidwa pamndandanda wa mankhwala osokoneza bongo a Vital and Essential. Nambala yolembetsa yamankhwala ku State Register of Medicines ili ndi LS-000995 kuyambira pa Okutobala 18, 2011, yatsopano mpaka Januware 16, 2018.

Fomu yolemetsa

Asanayambe chithandizo cha matenda am'kati, dokotala amapanga njira yochizira, molingana ndi kuopsa kwa kapamba komanso thanzi la wodwalayo. Tiyenera kumvetsetsa kuti miyeso yakale, pakakhala kutupa kwa kapamba, palibe. Mankhwala a kapamba amasankhidwa payekha.

Choyamba, mu nthawi yayikulu ya kapamba, kupuma pabedi ndikofunikira. Chifukwa chake, ngati mawonekedwe owopsa a pachimake pamatenda amawonekera, ndiye kuti mankhwalawa amachitika kuchipatala kokha. Izi ndizofunikira, chifukwa kusintha kwa kutupa m'matumbo kumatha kubweretsa kusokonekera kwa ntchito zofunika zofunikira pamoyo.

Pakadutsa masiku atatu mumangofunika kumwa madziwo kuti mupewe kuchepa thupi, komanso muchotse zinthu zapoizoni m'thupi.

Kuti muchepetse vutoli ndi ululu wosaletseka, mankhwala ndi omwe amapatsidwa. Ndi mankhwala ati omwe ndi bwino kumwa kuti muthane ndi vutoli akhazikitsidwa ndi adokotala. Chilichonse chimadalira thanzi la wodwalayo, mawonekedwe ake komanso kuchuluka kwa zowonongeka zamkati.

Chithandizo cha kapamba chimakhala chovuta. Mankhwala amodzi sangachotse kutupa kapena kubwezeretsanso ntchito ya pancreatic.

Mwa mankhwala a pancreatitis pachimake, ma antienzymes amamasulidwa, ma pinkiller ndi kuchepetsa kukokana, maantibayotiki. Ndipo mankhwala a enzyme, mapiritsi ndi jakisoni omwe amachepetsa kupindika, mankhwala odana ndi kutupa amathandizira kuchiza pancreatitis. Kuphatikiza apo, ndikofunikira kugwiritsa ntchito othandizira omwe ali ndi choleretic, enveloping envelop, komanso mavitamini othandizira nawonso adzafunika.

Mankhwala ogwiritsidwa ntchito

Zizindikiro za matendawa zikawoneka, chithandizo mwa akulu chimachitika pokhapokha ngati wochiritsa amayesa mayeso angapo. Musanagwiritse ntchito mankhwalawa pancreatitis, pitani kwa dokotala yemwe akufotokozereni njira yothandizira odwala ponseponse. Kugwiritsira ntchito mankhwala osokoneza bongo ndi mankhwala othandizirana kumathandizira kukonza bwino, koma sizingathandize kuchotsa njira zake. Chifukwa cha wathanzi, zakudya zimatsimikiziridwa ndi zakudya zomwe zimaperekedwa.

Magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito pochiza pancreatitis:

Mankhwala mu mapiritsi, jakisoni, amene amathandizira kupuma komanso kukhala ndi mphamvu ya analgesic.
Maantacid.
Enzymatic ndi anti-enzymatic othandizira.
Ma H2-blockers a histamine receptors.
Magulu a mankhwala osokoneza bongo.

Mankhwala enieni, kuchuluka ndi kuchuluka kwake kumayendetsedwa ndi adokotala. Izi ndichifukwa choti ndi chithandizo chamankhwala a chifuwa chachikulu chimaletsedwa kumwa mankhwala ambiri.

Ngati maselo omwe ali ndi vuto la kupanga insulini ya mahomoni adakhudzidwa ndikuwonongeka kwa gland, kukonzekera kwa insulini kumaphatikizidwa mu phukusi lodziwika. Mankhwala oyenera amasankhidwa ndi endocrinologist.

Chithandizo chotere chimakhala choyambitsa zotsatira zosayembekezereka. Minyewa ikayamba kupsa, singathe kuchiritsidwa ndi mankhwala ena okha. Zakudya zopatsa thanzi ndizofunikira, kutsatira moyo wolondola.

Onetsetsani kuti mukutsatira zomwe dokotalayo akuwonetsa, chifukwa ngati sicholondola kuchiza matenda amtundu wa kapamba, zimayambira koopsa.

Ndikofunika, mukamamwa mankhwala kutsatira malangizo omwe akupatsidwa malangizo omwe angagwiritsidwe ntchito.

Kusintha acidity m'mimba ndikuwongolera magwiridwe antchito, mutha kugwiritsa ntchito kukonzekera kwa enzyme ndi antienzyme. Mankhwala, mlingo wawo umasankhidwa ndi adokotala okha.

Pankhaniyi, kulandiridwa kwa njira zosiyanirazi ndikofunikira.

Mankhwala a enzyme amakhudza thupi motere:

amathandizira kugwetsa mapuloteni, mafuta ndi chakudya,
kusefukira, kutulutsa ndi kupweteka m'mimba kumachepa,
imalimbikitsa mayamwidwe ndi kutengera zinthu zopindulitsa kuchokera kuzinthu zomwe zatha,
kumasula England, kukonza mkhalidwe wa wodwalayo.

Enzymes imagwira ntchito ngati mankhwalawa amathandizira pakhungu. Dokotala amawunika momwe mankhwalawo amathandizira, ndikusiya kuti agwiritse ntchito kapena kuikonzanso ndi yofanana.

Ndikofunika kumwa mankhwala a enzyme a pancreatic pancreatitis ndi chakudya, kapena mutangomaliza kumene. Ngati mumagunda mapiritsi pamimba yopanda kanthu, kuthekera kwakukulu kwa chiwalo ndi kotheka.

Kukonzekera kwamtundu wapamwamba, kwakapangidwe kamphamvu kumakhala ndi zotulutsa kuchokera ku zola za ng'ombe, zomwe ndizofanana ndi zomwe zimapangidwa ndi gland ya munthu - pancreatin. Zimathandizira kuphwanya zakudya m'mamolekyu omwe matumbo ndi m'mimba zimayamwa ndikuyamwa.

Ngati mumalandira pancreatin wokwanira, thupi lidzakulipira chifukwa cha kuchepa kwa kapamba. Zinthu zonse zomwe zimabwera ndi chakudya zimakhala ndi digestibility yabwino, ndipo wodwalayo samakumana ndi vuto lotopa komanso kusowa kwa vitamini.

Mankhwalawa kapamba, mapiritsi amatchulidwa:

Chikondwerero.
Mezim.
Chiboni.
Pancreatin
Panzinorm.
Chimbudzi.

Mankhwalawa ndi enzymatic. Ali ndi njira zosiyanasiyana zothandizira ndi kupangika, choncho katswiriyo akuwonetsa kuti ndibwino kuchitira mankhwalawa kapamba panthawi inayake:

kuchuluka kwa kutukusira kwa England
kusintha kwa ziwalo zina - ndulu, matumbo, chiwindi.

Mukamagwiritsa ntchito antienzyme, mankhwalawa:

kuledzera kwa thupi,
ululu wammbuyo umachepa
thanzi la wodwalayo likukula
ngozi ya imfa yafupika,
chitukuko cha edema ndi minofu necrosis chatsekedwa.

Mankhwala otsatirawa a gululi amadziwika:

Kukonzekera kwa antenzyme kumathandizira kuchipatala mkati mwa minofu kapena mu mtsempha m'masiku oyamba pambuyo poti matenda ayambika. Mankhwala oterowo ndikofunikira kuti muchepetse kutulutsa kwa minofu yambiri chifukwa cha kutulutsidwa kwa katemera wa pancreatic.

Nthawi zambiri odwala amagwiritsa ntchito njira za wowerengeka pochiza matenda, chifukwa ndi zachilengedwe ndipo samakhala ndi mavuto ndikuwathetsa mavutowo. Komabe, kulandiridwanso sikungatheke popanda kuvomerezedwa ndi dokotala.

Chimodzi mwazithandizo zodziwika bwino ndi chaga. Amaloledwa kugwiritsidwa ntchito pochiza matenda am'mimba, kapamba pokhapokha atazindikira komanso kutsatira malangizo a dokotala.

Chaga pancreatitis imatha kuthandizidwa pokhapokha matendawa atadwala, chifukwa kufalikira kumatha kukulitsa kubisalira kwa England.

Chaga wa gland nthawi zambiri amatchulidwa ngati tiyi. Chifukwa cha chida ichi:

kuthetsa zizindikiro za matenda - nseru, chizungulire,
bwezeretsani minofu yanga,
Chotsani poizoni m'thupi,
kuchuluka hemoglobin,
kupewa kukula kwa tizilombo toyambitsa matenda.

Mankhwala opangidwa ndi bowa mu mawonekedwe a mapiritsi kapena otulutsa okhazikika amagulitsidwa m'matangadza. Chaga amapezeka mosiyanasiyana pokonzekera mankhwalawa a pancreatitis of the homeopathic sipekitiramu, Badakh. Komabe, kulowetsedwa kwachilengedwe kumakhala kothandiza kwambiri.

Kupanga kulowetsedwa, chaga chimatsukidwa ndikutumizidwa kumadzi otentha. Chifukwa chake bowa ndi maola angapo. Kenako imaphwanyidwa, ndipo bowa umatsanuliridwanso ndi madzi otenthetsedwa. Sungani chida chotere osapitilira masiku 4. Kuchiza ndi kumwa kumachitika mu 3 waukulu magawo 200 magalamu patsiku.

Ngati mumwa mankhwalawa mukachulukana, mavuto amabuka. Chaga saloledwa pancreatitis ngati pali zilonda zam'mimba kapena m'mimba.

Kupangidwa kwatsopano kwamankhwala ogulitsa kunyumba

Ndi kuchulukana kwa kapamba, m`pofunika kuchita kwakanthawi kuletsa kupanga chapamimba madzi. Njirayi ndiyosakhalitsa, motero pangafunike kuiyambitsa, pakuchita bwino kwa chimbudzi.

Mankhwala othandizira kukokoloka kwa kapamba:

Gulu la anti-kutupa mankhwala lidzafunikira vuto la kutupa kwambiri. Koma kumwa mapiritsi otere a kapamba ndi osafunika, chifukwa ndizotheka kuphonya mphamvu zenizeni za matendawa.

Kuphatikiza apo, mankhwalawa ali ndi zovuta komanso osankhidwa kwa masiku opitilira 10:

Kutenga ndikuchotsa zinthu zovulaza m'thupi, polimbana ndi microclora yamatumbo a pathogenic, mankhwala omwe ali ndi zotsatira zingapo za Polyphepan ndi mankhwala. Mankhwalawa ali pachibadwa. Enterosgel ndi mawonekedwe ake. Nthawi zambiri amagwiritsidwa ntchito pochiza pancreatitis. Mankhwalawa aledzera limodzi ndi njira zina zochizira matenda omwe amayambitsidwa ndi poyizoni.

Ndi matumbo owonongeka, dysbiosis, chiwonetsero cha matupi awo Acipol chingathandize. Kubwezeretsa matumbo kukhala abwinobwino.

Sinthani chimbudzi chokhazikitsidwa ndi Iberogast. Mankhwala amathandiziranso ndipo amakhala ndi choleretic.

Chimodzi mwazamankhwala omwe amachokera ku zitsamba ndi Flamin. Mankhwalawa ndi cholekinetic, amathandizanso kupindika komanso kutupa, amathandizira kukulitsa kuchuluka kwa bile. Mankhwala ofanana ndi awa:

Musanayambe chithandizo, muyenera kumvetsetsa mapiritsi oti mumwa kapamba, chifukwa chake amathandiza, kudziwa za zovuta zina, contraindication. Chifukwa chake, ndikofunikira kufunsa dokotala za izi.

Zothandiza decoction

Kuthandizira ntchito ya gland mu matenda osachiritsika a kapamba, anthu amawagwiritsa ntchito monga mankhwala azitsamba ndi zotsalazo. Imwani concoction wa wosafa, chowawa chowawa. Zothandiza pa ntchito ya secretion wa chapamimba madzi - parsley, muzu wake.

Ma deco ndi ovuta, kuphatikiza mitundu ingapo ya zitsamba. Chinthu chachikulu mu mankhwalawa ndikutsatira mlingo ndi kapangidwe.

Panthawi yobwezeretsa, decoction wa anyezi wobiriwira ndi parsley, wort ndi St. Mu kutupa kwambiri, peppermint yarrow ndi sinamoni amagwiritsidwa ntchito.

Cholagogue ndi pancreatitis imasinthidwa ndi zitsamba zomwe zimakhala ndi zofatsa. Zitsamba zimasankhidwa payekha.

Muzu wa Burdock, chicory.
Chiuno cha Rose.
Chi Turmeric
Milandu yoyesedwa.
Aloe

Kugwiritsa ntchito zitsamba kapena chindapusa kumathetsa kukhalapo kwa ziwengo kwa iwo.

Ndi zopweteka kwambiri

Minyewa ikayamba kufinya, wodwalayo amayamba kupweteka kwambiri kuchokera kumanzere pansi pa nthiti, pamimba chapamwamba. Vutoli limakhala losalephera kotero kuti nkosatheka kuyimirira, kukhala, kuyankhula, kupuma. Zimachitika kuti ululu umakhudza msana, pakati pamapewa, phesi lakumbuyo. Magawo awa akuwonetsa kuti ndi gawo liti lomwe limakhudzidwa.

Pofuna kuthetsa ululu wammbuyo, mankhwalawa amagwiritsidwa ntchito pancreatitis:

gulu lomwe siliri la steroidal - Paracetamol, Ibuprofen,
olimbikitsa kuchitapo kanthu analgesics - Baralgin, Analgin.

Kuchepetsa ululu ndi mawonekedwe ake osavutikira, mankhwala a narcotic analgesics, omwe amaperekedwa intramuscularly:

Opaleshoni amaletsedwa kugwiritsa ntchito pafupipafupi, ngakhale pakhale kuti palibe zosokoneza bongo mwa iwo ndipo sizimayambitsa chizolowezi.

Ma anesthetics antispasmodics amagwiritsidwa ntchito ngati pakufunika kuthandizira ma spasms ndikuwongolera ntchito ya enzymatic excretion:

Drotaverinum.
Spazmalgon.
Palibe-shpa.
Spasmol.
Riabal.

Mankhwalawa matendawa ali ndi zotsatirazi:

thandizani wodwalayo pothetsa ululu,
Kuchepetsa katundu pathupi, kuthandiza kukonza zotulutsa.

Zimathandizira kuthana ndi matendawa kumatanthauza kuti kupewa kapena kufooketsa mphamvu ya acetylcholine, cholinomimetic agents.

Mankhwala amasokoneza kukakamira kwa pathological mumitsempha ya ubongo ndi ubongo.

Nthawi yogwira ntchito yokumba m'mimba imabweranso yachilendo:

Mankhwala oteteza khungu

Mapiritsi a pancreatitis monga Essential Forte amagwiritsidwa ntchito kubwezeretsa maselo a chiwindi. Mankhwala amagwiritsidwa ntchito limodzi ndi poika mankhwala osokoneza bongo.

Fotokozani mankhwalawa 1 kapisozi katatu pa tsiku ndi chakudya. Mankhwalawa amagwiritsidwa ntchito m'maphunziro omwe adokotala adawafotokozera. Imakhala ndi phindu pa kagayidwe, imakhala ndi zotsatira zoyipa zochepa.Mankhwala osokoneza bongo saopseza thanzi lathu.

Mankhwala a kapamba akuluakulu amakhala ndi ma fanizo otsatirawa:

Mankhwala akamagwiritsa ntchito

Zochizira kapamba, maantibayotiki amaikidwa mankhwala osagwiritsidwa ntchito kwambiri pokhapokha atayesedwa kwathunthu.

M'm zipatala, mankhwala opha maantibayotiki amagwiritsidwa ntchito ngati ma jakisoni ngati dokotala akuwona kuti vutoli likufunika komanso wodwala akufunika chisamaliro chofunikira. Maantibayotiki othandizira pancreatitis pachimake amathandizidwa kuti athetse kutupa, kuti athandizire thupi momwe angathere:

Chithandizo cha matenda oopsa, mwinanso kugwiritsa ntchito mankhwala opha pakamwa:

Ndikofunika kukumbukira kuti mankhwalawa amatengedwa pokhapokha ngati adokotala adayikidwa.

Momwe mungatenge ndi kapamba

Gawani kusintha chimbudzi, chotsani zopweteka, sinthani ntchito zapamba. Thupi limaleka kupanga ma enzyme ofunikira kuti chakudya chithe. Pancreatin amapanga kufooka kwa michere, kuphatikiza ntchito ya m'mimba. Mapiritsi amatengedwa ngati matenda osiyanasiyana am'mimba, komanso kupewa kutulutsa, chitukuko cha matendawa mwa anthu athanzi motsogozedwa ndi zonunkhira, mafuta, zakudya zamchere.

Inde, mutha kumwa mankhwalawa ndi kapamba, koma muyenera kuchita izi molondola. Sizoletsedwa kuchita mankhwala osokoneza bongo, panthawi yowonjezera. Pancreatin ndi njira yochizira matenda osachiritsika. Nthawi zambiri zotchulidwa kusintha kagayidwe pambuyo povulala kapena kuwapewa.

Zinthu zomwe sizikugwira zimagwira matumbo, zimapukusidwa osasinthika ndi ndowe. Amayamba kuchita mphindi zochepa, ntchito yayitali imawonedwa pambuyo pa mphindi 45. Enzone zimaphwanya mafuta, wowuma, mapuloteni, ndikuthandizira kugaya chakudya. Chifukwa cha magwiridwe antchito am'mimba, kupsinjika, kutulutsa, mseru, kutentha pa chifuwa, kupindika, kutsokomola kumatha.

Pancreatitis yayikulu, mankhwalawa amatengedwa nthawi iliyonse mukatha kudya, chifukwa kapamba sangathe kupanga michere yofunikira. Ndi chithunzi choyenera chachipatala, popewa kutulutsa madzi akumwa, amamwa mankhwalawa katatu patsiku. The achire zotsatira zimachitika pafupifupi nthawi yomweyo, koma kuti akwaniritse chikhululukiro chokhazikika, kubwezeretsa ntchito za pancreatic. Pamafunika milungu iwiri kapena isanu.

Amapezeka mu mawonekedwe a mapiritsi, makapisozi, ma dragees. Zinthu zogwira - lipase, amylase, proteinase. Gawo lirilonse limagwira ntchito zake, chifukwa chake, piritsi limaphwanya mafuta, mapuloteni, mafuta kapena mafuta. Chipolopolo chapadera chimateteza zomwe zimagwira ku acidic chilengedwe, mphamvu ya madzi am'mimba.

Fotokozerani ntchito zachinsinsi zosakwanira. Vutoli limachitika ndi matenda osiyanasiyana am'mimba, komanso kuphwanya kwazolowera boma, kugwiritsa ntchito zakudya zamafuta, poyizoni, matumbo.

Zizindikiro Zambiri:

Matenda a kapamba
Matenda otupa am'mimba,
Cystic fibrosis - matenda amtundu wokhala ndi zotchinga za ma pancreatic ducts,
Kuyendetsa,
Matenda a m'mimba ndi chimbudzi chimbudzi,
Khalidwe labwino.

Imwani mapiritsi amayamba ngati:

Kulemera m'mimba
Kubwula
Kutsekula m'mimba kapena kudzimbidwa,
Kutupa
Kuchepetsa mseru
Zachisangalalo
Kutentha kwa mtima.

Nthawi zambiri mawonekedwe osakhazikika amatengedwa kuti alepheretse chakudya chamadzulo, chakudya chamagulu, komanso zakudya zamafuta, zonunkhira, zamchere, zamafuta.

Contraindication

Ndi zoletsedwa kutenga pamaso pa tsankho pamagawo ake. Amawonetsedwa ndi kuwonjezeka kwa zizindikiro zosasangalatsa, zotupa za pakhungu. Iwo contraindicated kuchita mankhwala pachimake kapamba kapena pa exacerbation aakulu. Osamapereka mapiritsi kwa ana ochepera zaka ziwiri. Gwiritsani ntchito mosamala mukakhala ndi pakati, kudyetsa. Chithandizo chimakhala chovomerezeka ngati phindu lomwe likuyembekezeka limakhala lalikulu kwambiri kuposa vuto lomwe likuyembekezeka. Palibe zoletsa zina.

Mavuto

Mankhwalawa amalekeredwa bwino samayambitsa mavuto ngati agwiritsidwa ntchito moyenera. Zochitika zoyipa zimachitika ndi kugwiritsa ntchito mankhwalawa mosasamala, mankhwala osokoneza bongo. Chizindikiro choyamba chakuti chithandizo chikuyenera kuimitsidwa ndi kutsekula m'mimba, kufalikira kwa zizindikiro za kapamba. Kuphatikiza apo, kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kungayambitse:

Zotupa,
Kuchuluka kwa uric acid mkodzo,
Kuchepetsa matumbo aang'ono,
Kulepheretsa
Maonekedwe a zilonda zam'mimba,
Matumbo osakwiya.

Nthawi zambiri, matendawo amakhazikika pang'onopang'ono atatha kumwa mankhwalawa, nthawi zina chithandizo chofunikira chimafunikira, ngakhale opareshoni. Pancreatin yokha siyowononga thupi. Ma metabolites ake amasiya thupi mwachangu, osasokoneza ntchito za machitidwe, ziwalo. Kugwiritsa ntchito molakwika mankhwalawa kumabweretsa zotsatira zowopsa.

Ndi kuperewera kotheratu pancreatic, chosowa cha lipase cha tsiku ndi tsiku ndi magawo 400,000. Vutoli limachitika kawirikawiri kwambiri, motero, mlingo woyenera umasankhidwa payekhapayekha. Yambani ndi mlingo wocheperako - piritsi limodzi pa chakudya chilichonse. Patsiku, munthu wamkulu amaloledwa kutenga 18 zidutswa. Popanda kukaonana ndi katswiri, palibe mapiritsi oposa 4 patsiku amaloledwa. Kutalika kwa mankhwalawa kumatengera kutha kwa matendawa, njira yocheperako ndi masiku 7, pafupifupi mwezi.

Buku lamalangizo

Mapiritsi amayenera kuledzera kwathunthu popanda kutafuna. Kuletsedwa kugawa, kuthyola. Kupanda kutero, luso limachepa. Zopindulitsa sizikhala zopanda gawo ndi acidic chilengedwe. Imwani zamadzi zambiri. Madzi abwino kwambiri opanda mchere wokhala ndi kaboni. Gwiritsani ntchito chakudya kapena mukatha kudya. Pancreatin imaphatikizidwa ndi mankhwala ena othandizira pancreatitis, wowerengeka azitsamba.

Pancreatin pachimake

Akatswiri amathandizira kudziwa mankhwalawa pamene kugaya chakudya kumagaya. Ponena za ma contraindication, ziyenera kukumbukiridwa kuti chithunzi cha chipatala panthawi yowonjezera ndi chosiyana. Ngati kusanza kufooketsa, kutsegula m'mimba kwambiri kumawonedwa, muyenera kulumikizana ndi katswiri. Pankhaniyi, ma dropper a osiyana magwiritsidwe omwe amapangira, mankhwala ochepetsa acidity, mankhwala ena ambiri. Masiku oyambira adatha kufa ndi njala, ndiye kuti palibe chifukwa chotengera Pancreatin.

Ngati kukokoloka kuli ngati kuchotsedwa kwa mawonekedwe owopsa - kusanza popanda kusanza, kutulutsa magazi, kusefukira kwam'mimba, kuwonda pamimba, kutentha kwa pamtima, kupindika, Pancreatin amaloledwa kumwa, koma Mlingo wovomerezeka - pafupifupi mapiritsi 4 patsiku. Pankhaniyi, nthawi ya chithandizo sidzaposa mwezi umodzi. Mofananamo, muyenera kutsatira zakudya, moyo wabwino.

Akatswiri ena salimbikitsa kugwiritsa ntchito pancreatin munthawi ya kukokoloka, chifukwa ntchito ya enzymatic isanakwane imayambitsa kukhumudwa kwa mucosa, kutupa, ndi kugaya chakudya. Mu thupi lathanzi, kapamba amapanga ma enzyme osagwira ntchito. Amadutsa m'mimba modekha, adamulowetsa m'matumbo, amayamba kugaya chakudya. Mu kapamba, ma enzymes amagwira ntchito m'mimba, kuyamba kugaya mucosa. Chifukwa chake kutupa, kuchuluka kwa gastritis, mavuto ammimba.

Pancreatin wodwala

Mapiritsi amagwiritsidwa ntchito popewa kufalikira mukakumana ndi zinthu zoyipa - kuwonongeka kwamanjenje, kutopa, chakudya, mowa, kusokoneza, maantibayotiki. Komanso ndiyambireni maphunzirowo pang'onopang'ono kuwonetsa matendawa - nseru, kutuphuka, ulemu, kutsegula m'mimba. Ngati chilichonse chachitika molingana ndi malamulo, ma antacid ndi ma proton pump zoletsa ayenera kutengedwa nthawi yowonjezera kuti achulukane acidity ndikubwezeretsa mucosa. Pambuyo pakutha kwa zizindikiro zopweteka, pancreatin imatengedwa. Koma kenako funso limadzuka, bwanji mumamwa, kwakukulu, ngati zimbudzi zimabwezeretseka.

Zoyenera, mankhwala amapatsidwa mankhwala a pathological pancreatic insufficiency, pomwe sangathe kupanga michere yofunikira. Vuto ndilakuti palibe chithandizo chokwanira cha matenda ammimba. Pambuyo pakuchulukitsa koyamba, amabwereranso m'mbuyo pambuyo pake matendawa amakhala osachiritsika. Therapy, yomwe imatchedwa yoyenera, chifukwa chake, sichoncho.

Ndi kapamba, cholecystitis

Kutupa kwa ndulu nthawi zambiri kumayendera ndi kapamba, chifukwa chake mankhwalawa amachitika ndi matenda. Njira yapamwamba ndi mapiritsi 4 patsiku pazovuta zam'mimba zomwe zilipo. Musanagwiritse ntchito mankhwalawa, muyenera kufunsa katswiri. Kudzichitira nokha kumadzetsa mavuto.

Malangizo apadera:

Ndi chithandizo chokhalitsa, kukonzekera kwachitsulo kumayikidwa limodzi.
Kugwiritsa ntchito pamodzi mankhwala a antacid kumachepetsa mphamvu ya kapamba. Ngati nkosatheka kusintha chiwembucho, kupuma pakati pa kumwa mankhwala kumachitika kwa maola osachepera awiri.
Mankhwalawa a kapamba, Domrid, Omez nthawi zambiri amakhazikitsidwa. Mutha kupita nawo limodzi ndi Pancreatin. Mankhwala oyamba aledzera mphindi 20 asanadye, michere - panthawi ya chakudya.
Mukachotsa ndulu, ndikulimbikitsidwa kuti mumwe Pancreatin kuti mupukutse chimbudzi.

Kuti mukwaniritse chithandizo chamankhwala mwachangu, muyenera kutsatira zakudya, kukhala ndi moyo wathanzi. Mwina ndiye kuti simuyenera kutenga michere kwakanthawi kochepa.

Pancreatin amapangidwa ndi opanga osiyanasiyana, ndipo amadziwika pamtengo wake. Mutha kugula mankhwalawo ku pharmacy iliyonse kapena pa intaneti. Mtengo wa ma phukusi umachokera ku ma ruble 40. Mpaka 120 rub. Khala kutali ndi dzuwa. Alumali moyo 3 zaka.

Mankhwalawa atha kuperekera mitundu yambiri ya ofanana ndi chinthu chimodzi kapena zomwe zikufanana.

Mapiritsi a Enteric-sungunuka ndi pancreatin yogwira pophika. Zimalandiridwa panthawi, pambuyo, musanadye, 2 ma PC. Mlingo wa tsiku ndi tsiku umafikira 18 zidutswa, amasankhidwa payekha. Mwa contraindication opanga, opanga amawonetsa tsankho la munthu, pachimake kapamba.

Amapangidwa momwe amapangira makapisozi osiyanasiyana omwe ali ndi mankhwala osiyanasiyana. Chipolopolo chapamwamba chimateteza ma enzymes ku mphamvu za acidic. Simalowetsedwa ndi matumbo, omwe amachotsa ndowe. Zimakhazikitsidwa ndi pancreatin hydrochloride. Zizindikiro, contraindication ndi ofanana.

Zinthu zomwe zimagwiritsidwa ntchito ndi mankhwala a enzyme ndi proteinase, amylase, lipase. Amaphwanya mafuta, chakudya, mapuloteni, amathandizira kugaya chakudya. Amamwa pakudya kapena pambuyo pake. Mlingo amasankhidwa payekha. Chenjezo limaperekedwa kwa azimayi oyembekezera komanso oyembekezera. Kutsutsana mwachindunji ndiko kusalolera payekhapayekha pazinthuzo.

Mwambiri, ma analogu onse ali ndi magwiritsidwe ofanana, amakhala ndi zinthu zomwezo.

Zofananira zina:

Mtengo wa analogues umachokera ku ma ruble 50. Mpaka 1000 rub. Zimagawidwa popanda mankhwala, koma upangiri waluso ndiwofunika.

Okondedwa owerenga, malingaliro anu ndiofunika kwambiri kwa ife - chifukwa chake, tidzakhala okondwa kuwunika pancreatin ndi pancreatic pancreatitis mu ndemanga, ndizothandizanso kwa ogwiritsa ntchito ena tsambali.

Alina:

“Ine ndi mwana wanga wamwamuna tidagonekedwa m'chipatala. Kutsegula m'mimba sikunayime, tsiku loyamba linali kusanza. Panthawiyo anali ndi zaka 5. Otsitsa osiyanasiyana anaperekedwa, maantibayotiki adalandira, Domrid, Colicid, Atoxil, Regidron, Nifuroxazide, Lactiale, Pancreatin adayikidwa. Chifukwa chomwe izi zidalembedwera, kwa ine tsopano ndi chinsinsi. Zikuonekeratu kuti kusintha chimbudzi, koma pambuyo poyizoni, thupi limabwezeretseka. ”

Svetlana:

“Kuphatikiza apo pancreatitis, ndimakhalanso ndi gastritis. Katswiri wofufuza atatha kunena kuti asamwe Pancreatin, m'malo mwake Mezim. Adalongosola izi poti kumapeto kwake ziwalozi zimasefedwa kwambiri, zotsatira zoyipa ndizochepa, musamakwiyitse mucosa wam'mimba, kugwira ntchito yawo modekha. Mezim amakhala pamwamba mwadongosolo, wotsatsa kulikonse. Nthawi yomweyo, apongozi anga anali ndi gastroenterologist, adanenanso kuti ku Pancreatin, membala wam'mimba umateteza kwambiri, motero umagwira bwino. Mezim amachotsedwa, samalowa m'mimba, kotero osagwiritsa ntchito. Ndi amene akhulupirire. Komanso, zinali zokayikitsa ngati ma enzyme amenewa amachita kapena ayi. Nthawi zambiri, amapatsidwa mankhwala ena pamodzi ndi ena. ”