Chithandizo cha matenda ashuga polyneuropathy a m'munsi malekezero

Matenda a shuga a polyneuropathy am'munsi am'munsi ndi zovuta za mtundu 1 ndi mtundu wa 2 zomwe zimapangitsa moyo wa wodwala kukhala wosalephera. Kupsa ndi kuphika kupweteka, kumva kuwawa, miyendo, komanso kufooka kwa minofu - izi ndizowonetsera zazikulu zowonongeka kwa mitsempha kwa odwala omwe ali ndi matenda a shuga. Zonsezi zimachepetsa moyo wonse wa odwala. Pafupifupi palibe wodwala yemwe ali ndi endocrine pathology amene angapewe kugona usiku chifukwa cha vutoli. Pakapita nthawi, vutoli limakhudza ambiri aiwo. Ndipo kenako kuyesayesa kwakukulu kumayesedwa polimbana ndi matendawa, popeza chithandizo cha matenda ashuga a polyneuropathy a m'munsi am'munsi ndi ntchito yovuta kwambiri. Mankhwala akapanda kuyamba pa nthawi, wodwalayo amatha kusokonezeka, makamaka, necrosis ndi gangrene ya phazi, zomwe zimapangitsa kuti azidulidwa. Nkhaniyi idaperekedwa munjira zamakono zochizira matenda ashuga a polyneuropathy a m'munsi.

Kuti athane ndi zovuta za matenda a shuga, ndikofunika kuwona zovuta za chithandizo, zomwe zimatanthawuza kuti zimayenderana panthawi yomweyo pamaulalo onse amtundu wa pathogeneis (chitukuko). Ndipo kuwonongeka kwa zotumphukira zam'miyendo ndizosiyana ndi izi. Mfundo zofunika kwambiri zochizira kuwonongeka kwamitsempha yam'mapazi miyendo ndi endocrine pathology zitha kupangidwa motere:

Kukhazikika kwazomwe zimayambitsa kuchuluka kwa shuga m'magazi, ndiye kuti, kusunga zofunikira pafupipafupi monga momwe zingathere nthawi zonse, popanda kusinthasintha kwawoko
kugwiritsa ntchito mankhwala a antioxidant omwe amachepetsa zomwe zimapanga ma free radicals zomwe zimawononga mitsempha yaziphuphu,
kugwiritsidwa ntchito kwa metabolic ndi mtima kukonzekera komwe kumathandizira kubwezeretsa ulusi wamitsempha womwe wawonongeka kale ndikuletsa kugonjetsedwa kwa omwe sanakhudzidwepo,
kupweteka kokwanira
njira zosagwiritsa ntchito mankhwala.

Ganizirani mwatsatanetsatane kulumikizana kulikonse pakuchira.

Magazi amawongolera

Popeza kuwonjezeka kwa kuchuluka kwa shuga m'magazi ndiko chifukwa chachikulu chachitukuko cha matenda ashuga a m'munsi am'munsi, ndiye, mwanjira iyi, kufalikira kwa chizindikirochi ndikofunikira kwambiri kuti muchepetse kupita patsogolo kwa njirayi ndikusintha kukula kwa zomwe zilipo. Mtundu woyamba wa matenda a shuga 1 mellitus, mankhwala a insulin amalembedwa pa chifukwachi, ndipo mitundu 2 ya mapiritsi a shuga a mitundu yosiyanasiyana yamagulu (alpha-glucosidase inhibitors, biguanides ndi sulfonylureas). Kusankhidwa kwa mapiritsi a insulin kapena piritsi yotsitsa shuga ndi njira yodzikongoletsera kwambiri, chifukwa ndikofunikira kuti zitheke osati kuchepa chabe kwa kuchuluka kwa shuga m'magazi, komanso kuonetsetsa kuti kusasinthasintha kwakuthwa mu chizindikirochi (ndizovuta kuchita ndi insulini). Komanso, njirayi ndiyosangalatsa, ndiye kuti, mankhwalawa amasinthasintha nthawi zonse. Izi zimakhudzidwa ndi zinthu zambiri: zakudya zomwe wodwalayo amakonda, zomwe adakumana nazo matendawo, kupezeka kwa matenda olimba.

Ngakhale zitakhala kuti zakwaniritsa kuchuluka kwa glucose m'magazi, mwatsoka, nthawi zambiri izi sizokwanira kuthana ndi zisonyezo zowonongeka m'mitsempha yapamwamba. Kugonjetsedwa kwa mitsempha yodutsa pamlanduwu kuyimitsidwa, koma kuti athetse zomwe zilipo, munthu amayenera kugwiritsa ntchito mankhwala a magulu ena a mankhwala. Tilankhula za iwo pansipa.

Antioxidant mankhwala

Kukonzekera kwa alpha-lipoic (thioctic) ndi muyezo wagolide pakati pa antioxidants omwe amagwiritsidwa ntchito pochotsa kuwonongeka kwa mitsempha ya shuga. Awa ndi mankhwalawa monga Thiogamma, Espa-lipon, Thioctacid, Tiolept, Neuroleptone, Berlition. Zonsezi zimakhala ndi zinthu zomwezo, zimasiyana ndi wopanga. Kukonzekera kwa Thioctic acid kumadziunjikira mu ulusi wamanjenje, kuyamwa ma radicals aulere, ndikusintha thanzi la mitsempha yotumphera. Mlingo wofunikira wa mankhwala uyenera kukhala osachepera 600 mg. Njira ya mankhwalawa ndi yayitali ndipo imayambira milungu itatu mpaka miyezi isanu ndi umodzi, kutengera kutha kwa zizindikiro za matendawa. Njira zotsatirazi zochizira zimaganiziridwa kuti ndizothandiza kwambiri: masiku 10 mpaka 8, mlingo wa 600 mg umathandizidwa pa njira yothandizira ya sodium chloride, ndiye kuti 600 mg yomweyo amatengedwa pakamwa theka la ola musanadye maphunziro. Ndikulimbikitsidwa kubwereza maphunziro azachipatala, kuchuluka kwawo kumatengera umunthu wa matendawa.

Mankhwala osokoneza bongo ndi a mtima

Poyamba pakati pa metabolic kukonzekera matenda a shuga a polyneuropathy a m'munsi malekezero ndi mavitamini B (B1, B6, B12). B1 imalimbikitsa kaphatikizidwe kazinthu zapadera (acetylcholine), komwe kukhudzidwa kwa mitsempha kumachokera. B6 imalepheretsa kudziunjikira kwa ma radicals aulere, amatenga nawo gawo pazinthu zingapo kufalitsa zikhumbo za mitsempha. B12 imathandizira kukonza minofu ya mitsempha, imathandizira kubwezeretsanso mawonekedwe owonongeka am'mitsempha yamafungo, ndipo imakhala ndi mphamvu ya analgesic. Si chinsinsi kuti kuphatikiza mavitamini awa amawonedwa kukhala othandiza kwambiri chifukwa cha kuthekera kwa zotsatira za wina ndi mnzake. Pankhaniyi, ndikofunikira kugwiritsa ntchito mawonekedwe osungunuka a vitamini B1 (benfotiamine), chifukwa mu mawonekedwe awa amalowera bwino m'malo a mitsempha. Mumsika wamankhwala, kuphatikiza kwa mankhwalawa kuli ponseponse. Awa ndi Milgamma, Compligam B, Neurobion, Kombilipen, Vitagamm. Nthawi zambiri, ndimatenda akulu, chithandizo chimayamba ndi mitundu ya jakisoni, kenako amasinthidwa pamapiritsi. Kutalika konse kogwiritsa ntchito ndi milungu 3-5.

Mwa zina mwa mankhwala a metabolic omwe ndikufuna nditchule Actovegin. Mankhwalawa amachokera ku magazi a ng'ombe ya ng'ombe, amasintha zakudya za minofu, amalimbikitsa njira zothandizira kubadwanso, kuphatikizapo mitsempha yomwe imakhudzidwa ndi matenda a shuga. Pali umboni wa mankhwala omwe amapezeka ndi insulin. Actovegin amathandizira kubwezeretsa chidwi, kuchepetsa ululu. Gawani Actovegin jakisoni wa 5-10 ml kudzera m'mitseko kwa masiku 10 mpaka 20, kenako ndikusintha kutenga piritsi (piritsi 1 katatu patsiku). Njira ya mankhwala mpaka milungu 6.

Mwa kukonzekera kwamasamba, Pentoxifylline (Trental, Vasonite) amawerengedwa kuti ndi othandiza kwambiri pakuwonongeka kwa mitsempha yamipweya yam'munsi. Mankhwala amateteza magazi kutuluka m'mapapo ake, amalimbikitsa kusintha kwachulukidwe, osasokoneza thanzi la mitsempha. Komanso antioxidants ndi metabolic mankhwala, Pentoxifylline ndikofunikira kuti ayambe kugwirira ntchito kudzera pamitsempha, kenako ndikusintha zotsatira pogwiritsa ntchito mitundu ya piritsi. Kuti mankhwalawa akhale ndi chithandizo chokwanira, ayenera kumwedwa kwa mwezi umodzi.

Kuthetsa ululu kokwanira

Vuto la ululu m'matendawa limakhala pafupi kwambiri pazizindikiro zonse za matendawa. Matenda a ululu amathetsa odwala, amasokoneza kugona tulo ndipo zimakhala zovuta kuchiza. Kupweteka kwa matenda ashuga ndi neuropathic, ndichifukwa chake ma pinkillers osavuta, mankhwala osapweteka a antiidal sakhala ndi vuto lililonse. Si odwala onse omwe amadziwa izi ndipo nthawi zambiri amagwiritsa ntchito mitundu ingapo ya mankhwalawa, yomwe imakhala yowopsa kwambiri pakukula kwa zovuta kuchokera m'mimba, duodenum, matumbo, chiwindi ndi dongosolo la magazi. Kuchepetsa ululu muzochitika zoterezi, ndikofunika kugwiritsa ntchito magulu otsatirawa a mankhwalawa:

antidepressants
anticonvulsants,
mankhwala osokoneza bongo
antiarrhythmic mankhwala
analgesics of the main action of non-opioid mfululizo,
opioids.

Pakati pa antidepressants, amitriptyline akhala akugwiritsidwa ntchito kwazaka zambiri. Yambani kutenga ndi 10-12,5 mg usiku, kenako mlingo wa mankhwalawo umakulitsidwa pang'onopang'ono ndi 10-12.5 mg kuti ukhale wogwira ntchito. Mlingo woyenera tsiku lililonse ndi 150 mg. Ngati ndi kotheka, mlingo wonse wa mankhwalawo ungagawidwe mu Mlingo wa 2-3 kapena kumwa usiku wonse. Ndondomeko yolandirira imayikidwa payekha. Imwani mankhwala osachepera miyezi 1.5-2. Ngati pazifukwa zina Amitriptyline sagwirizana ndi wodwalayo, ndiye kuti atembenuka mothandizidwa ndi Imipramine, mankhwala a gulu lomwelo la mankhwala. Ngati antidepressants a gulu la mankhwala awa adatsutsana mwa wodwalayo (mwachitsanzo, ngati vuto la mtima likusokonekera kapena kutsekeka kwa glaucoma), ndiye kuti ndizotheka kugwiritsa ntchito kusankha serotonin ndi norepinephrine reuptake inhibitors (Venlafaxine kuyambira 150 mpaka 225 mg patsiku, Duloxetine kuyambira 60 mpaka 120 mg patsiku) . Zotsatira za analgesic nthawi zambiri zimachitika osati sabata lachiwirili kuchokera poyambira kukonzekera. Ma antidepressants ena (Fluoxetine, Paroxetine, Sertraline, ndi ena otero) amathandizira kuchepa ndi matenda ashuga a polyneuropathy a m'munsi am'munsi pamlingaliro kuti ali ndi mphamvu yotsika ya analgesic. Kugwiritsa ntchito kwawo kuli koyenera ndi gawo linalake lokhumudwitsa komanso kulekerera bwino kwa antidepepressant.

Pakati pa anticonvulsants, carbamazepine (Finlepsin), Gabapentin (Neurontin, Gabagamm) ndi Pregabalin (Nyimbo) amagwiritsidwa ntchito ngati othandizira kupweteka. Carbamazepine ndi mankhwala achikale kwambiri poyerekeza ndi ena m'gululi, koma otsika mtengo kwambiri. Njira zonse zomwe alandila monga awa: 200 mg m'mawa ndi 400 mg madzulo, ngati kuli kotheka - 600 mg kawiri pa tsiku. Onse a Gabapentin ndi Pregabalin ndi mankhwala am'badwo wamakono wa anticonvulsants, omwe amathandiza kwambiri kuthana ndi ululu wa neuropathic. Gabapentin amayamba kutengedwa ndi 300 mg usiku, kenako 300 mg m'mawa ndi madzulo, kenako 300 mg katatu pa tsiku ndi zina zotero. Nthawi zambiri zotsatira zokwanira za analgesic zimawonedwa pa mlingo wa 1800 mg wa patsiku, wogawika m'magawo atatu, mu milandu yayikulu, mlingo utha kuwonjezeka mpaka 3600 mg tsiku lililonse. Pregabalin ndi mankhwala 75 mg 2 kawiri pa tsiku. Nthawi zambiri izi ndizokwanira kuti muchepetse ululu, koma muzochitika zapamwamba, mlingo umatha kufikira 600 mg patsiku. Nthawi zambiri, kuchepa kwa ululu kumachitika sabata yoyamba yamankhwala, kenako ndikulimbikitsidwa kuti muchepetse mulingo wothandiza (75 mg 2 kawiri pa tsiku).

Mankhwala okwiyitsa (Capsicam, Finalgon, Capsaicin) samakonda kugwiritsidwa ntchito machitidwe amasiku onse chifukwa choti zochita zawo zimachokera ku kuzimiririka kwa kupweteka kwa kupweteka. Ndiko kuti, poyamba, zikagwiritsiridwa ntchito pakhungu, zimayambitsa kuwonjezeka kwa ululu, ndipo patapita kanthawi - kuchepa. Ambiri a iwo amayambitsa kufupika pakhungu, kutentha kwambiri, komwe sikumathandizanso pakugwiritsa ntchito kwawo. Mwa mankhwala ochititsa dzanzi, ndi kotheka kugwiritsa ntchito Lidocaine mwa njira yofikira mkati mwa 5 mg / kg, komanso kugwiritsa ntchito mafuta, ma gels ndi Versatis patch 5% Lidocaine pakhungu la miyendo.

Mwa mankhwala othandizira antihypic mankhwala, Montiletine amagwiritsidwa ntchito mu 450-600 mg patsiku, ngakhale njira iyi yochiritsira si yotchuka.

Mwa ma analgesics osagwiritsa ntchito opioid omwe ali ndi vuto lapakati, Katadolone (Flupirtine) wagwiritsidwa ntchito posachedwapa pa 100 mg ya 200 mg katatu patsiku.

Ma opioid amathandizira pokhapokha ngati mankhwala omwe ali pamwambapa sagwira ntchito. Pachifukwa ichi, oxycodone (37-60 mg patsiku) ndi Tramadol amagwiritsidwa ntchito. Tramadol amayamba kuthira mankhwala a 25 mg 2 kawiri patsiku kapena 50 mg kamodzi pa usiku. Pakatha sabata, mlingo umatha kuwonjezeka mpaka 100 mg patsiku. Ngati vutolo silikuyenda bwino, ululuwo suchepa iota imodzi, ndiye kuti kuwonjezeranso kwa mlingo mpaka 100 mg 2-4 patsiku ndikotheka. Chithandizo cha Tramadol chimatha mwezi umodzi. Pali kuphatikiza kwa Tramadol ndi banal Paracetamol (Zaldiar), komwe kumaloleza kuchepetsa mlingo wa opioid womwe watengedwa. Zaldiar amagwiritsidwa ntchito piritsi limodzi 1-2 kamodzi pa tsiku, ngati kuli kotheka, onjezani mapiritsi 4 piritsi. Kuledzera kumatha kukhala kwa opioids, ndichifukwa chake awa ndi mankhwalawa omwe amatsitsidwa kuti apitirizebe.

Ndipo komabe palibe mankhwala omwe angatchulidwe muyezo wa kayendetsedwe ka zowawa pamatendawa. Nthawi zambiri mu mawonekedwe a monotherapy, amakhala osagwira. Kenako muyenera kuphatikiza ndi wina ndi mnzake kuti muthetse mphamvu zake. Kuphatikiza kofala kwambiri ndi mankhwala othana ndi anticonvulsant kapena anticonvulsant wokhala ndi opioid. Titha kunena kuti njira yothetsera ululu m'matendawa ndi luso lonse, chifukwa palibe njira yodziwika yodziwira chithandizo.

Mankhwala osagwiritsa ntchito mankhwala

Kuphatikiza pa njira zamankhwala zothana ndi matenda ashuga a polyneuropathy a m'munsi am'munsi, njira zamankhwala zimagwiritsidwa ntchito kwambiri pothandizira mankhwalawa (magnetotherapy, ma diadynamic currents, kukondoweza kwa magetsi, electrophoresis, balneotherapy, hyperbaric oxygenation, acupuncture). Zochizira zowawa, kukondoweza kwa msana kumatha kugwiritsidwa ntchito ndi kuphatikizira othandizira othandizira. Amawonetsedwa kwa odwala omwe ali ndi mitundu yothana ndi mankhwala.

Kuti tifotokozere mwachidule zonse pamwambapa, titha kunena kuti chithandizo cha matenda ashuga a polyneuropathy a m'munsi am'munsi ndi ntchito yovuta ngakhale kwa dokotala wodziwa ntchito, popeza palibe amene anganeneretu za matendawa komanso momwe angalandire chithandizo chamankhwala. Kuphatikiza apo, nthawi yayitali yochita mankhwalawa nthawi zambiri imakhala yabwino, odwala ayenera kumwa mankhwala kwa miyezi ingapo kuti asinthe zina. Komabe, matendawa amatha kutha. Kampeni inayake, poganizira zamankhwala zomwe zili muzochitika zilizonse, zimakupatsani mwayi wopambana munkhondo ndi matendawa.

Nenani zambiri. I. V. Gurieva pamutu "Kuzindikira ndi kuchiritsa matenda a matenda ashuga":

Kodi matenda ashuga a polyneuropathy ndi chiyani

Kuwonongeka kwa mitsempha ya zotumphukira kungayambitse zotsatira zosatsimikizika kwambiri, kuyambira pakusintha kwa phazi ndikumatha ndi imfa yadzidzidzi. Diabetesic neuropathy (ICD code 10: G63.2) imawerengedwa kuti ndi amodzi mwa matenda oopsa omwe amafunikira chithandizo chamankhwala mwachangu. Matendawa amakhudza onse amanjenje komanso azinthu zamagetsi, motero kulephera kwa aliyense wa iwo kumawopseza wodwalayo ndi zotsatira zakupha. Kuwonongeka kwakanthawi muubongo ndi chingwe cha msana kumachulukitsa ngozi ya kufa mwadzidzidzi.

Autonomic polyneuropathy

Matendawa ali ndi mitundu ingapo, iliyonse yomwe imagwirizana ndi tsamba linalake mthupi la munthu. Autonomic neuropathy mu shuga mellitus imadziwika ndi vuto la ziwalo zina kapena machitidwe athunthu, omwe angayambitse kukula kwa matenda monga orthostatic hypotension kapena osteoarthropathy. Mwa odwala, pali mitundu yosiyanasiyana ya visceral neuropathy, yomwe imakonda kwambiri ndi:

mawonekedwe a urogenital
mawonekedwe kupuma
mtima
mawonekedwe a sitima
mawonekedwe am'mimba.

Somatic polyneuropathy

Mavuto a mitsempha yokhudzana ndi kugwira ntchito kwa zotumphukira amadziwika m'mabwalo azachipatala ngati matenda omwe amakhudza thupi lonse. Somatic polyneuropathy sichidali chomvekera bwino, chifukwa sizotheka kudziwa zomwe zimachitika mu 25% ya milandu ngakhale mabungwe odziwika bwino asayansi.

Zomwe zimayambitsa Polyneuropathy

Matenda a shuga a polyneuropathy amatha kuchitika chifukwa cha zinthu zosiyanasiyana, zomwe ndizofunikira kwambiri ndizobwezeretsa shuga. Malinga ndi kafukufuku waposachedwa, chithandizo chamankhwala chochepetsera kugwiritsidwa ntchito kwa mankhwalawa chimathandizira kuti pakhale zovuta. Komabe, pali zifukwa zina za matenda ashuga polyneuropathy, mwachitsanzo, poyizoni ndi mankhwala osokoneza bongo kapena mankhwala osokoneza bongo. Nthawi zambiri pamachitika zinthu zomwe zimayambitsidwa chifukwa cha kuledzera (Vitamini akusowa). Kutsata kwadongosolo lotsatira kungayambitse matendawo:

collagenoses
ischemia
matenda oncological
uremia
hypothyroidism
matenda a chiwindi.

Gulu la polyneuropathy

Matendawa amalimbikitsa kukula kwa njira ya pathological m'thupi, yomwe imayambitsa zovuta zingapo, kuyambira pakufa ziwalo zam'mphepete mwa zovuta zamasamba. Mawonetseredwe oterewa akhoza kugawidwa osati kokha ndi etiological factor. Pali gulu lina la anthu odwala matenda ashuga polyneuropathy, omwe amaphatikiza mitundu iwiri - uku ndi kuwonongeka kwa makina ndi mtundu wa maselo amitsempha amitsempha.

Iliyonse ya iwo amagawidwa m'magulu angapo, mwachitsanzo, malingana ndi kuwonongeka kwa makina, vuto la neuropathic, demyelinating kapena axonal limasiyanitsidwa. Ma Pathologies okhudzana ndi mtundu wa mitsempha ya mitsempha ndi ochulukirapo; amaphatikizapo: zosakanikirana, zomvera, zotulutsa, zamagalimoto ndi sensorimotor. Nthawi zambiri kuposa ena, kupezeka kwa matenda a shuga a polyneuropathy, komwe kumayambitsa kufooka kwa chidwi chogwedezeka.

Polyneuropathy

Matenda a shuga ndi malo abwino kupangira matenda oopsa monga axonal motor polyneuropathy. Matendawa amatchulidwa kuti ndi vuto lodziwika bwino pakati pa anthu omwe ali ndi zotupa zam'mapapo kapena khansa. Zina zomwe zimalimbikitsa kukula kwa matenda a zam'madzi zimadziwikanso zamankhwala - uku ndikotengera kwa makolo kapena kusowa kwa vitamini B.

Matenda a shuga a polyneuropathy nthawi zambiri amakhala limodzi ndi zovuta m'munsi, komabe, nthawi zina matendawa amakhudza manja. Khungu la odwala lotere limatayika, limakhala louma komanso loyipa, monga momwe tingawonere poyang'ana zithunzi zochepa pa intaneti.

Mawonekedwe a polyneuropathy

Ndi kugonjetsedwa kwa gawo la ma neurons omwe amayendetsa kayendedwe ka mota, thupi la magwiridwe antchito lingasokonezedwe. Mphamvu ya matenda ashuga polyneuropathy imawerengedwa kuti ndi chifukwa cha zovuta izi, chifukwa chachikulu chomwe ndi kuchuluka kwa shuga m'magazi. Komabe, pali zochitika zina za etiology yina, monga chikhodzodzo cha neurogenic kapena kukonza mtembo.

Njira yowopsa kwambiri ya matenda a m'maganizo imawerengedwa kuti ndi kupanduka kwachilengedwe, chifukwa ndizosatheka kuchiritsa matenda. Kuwonongeka kwa miyendo ndi ma presis a minofu ndizizindikiro zazikulu zomwe zikuwonetsa kukula kwa matendawa. Wodwalayo amatha kumva kuti wayaka, kuyamwa, kapena kumva kugunda komwe kumachitika popanda chifukwa.

Distal polyneuropathy

Pali mitundu ingapo ya zotupa za CNS, monga distal kapena sensory-motor polyneuropathy. Fomu yoyamba ndikovuta kwambiri, komwe kumabweretsa kufa kwa minyewa yamitsempha. Pamapeto pake, njirayi imatha kuyambitsa kukhumudwa m'miyendo yam'munsi kapena yapamwamba, anisocoria, kapena strabismus. Zizindikiro zodziwika za matenda amaphatikizira:

minofu kukokana
uremic pruritus,
kuphwanya zolakwika za ana,
kupweteka kwambiri kumapazi,
kulimbikitsa minofu yolowerera.

Matenda a ululu amatha kufikira nthawi zovuta pamene wodwala sangathe kusuntha kapena kuchita mtundu wina. Pakupanga zovuta za distal, zizindikiro za paresthesia zimawonedwa, kuphimba m'chiuno, mwendo wapamwamba komanso ngakhale mapewa. Zala zakumapeto ndizomwe zimayamba kuvutika, chifukwa ndi izi zimayamba kupitilira kwa mawonekedwe osawoneka a shuga.

Gawo la matenda ashuga polyneuropathy

Matenda ena ndi ovuta kuzindikira m'mayambiriro a chitukuko kotero pokhapokha mothandizidwa ndi zida zapadera ndizotheka kutsimikizira kuti matendawa ndi omwe ali. Neuropathy mu shuga ali ndi magawo atatu a chitukuko, chilichonse chomwe chimaphatikizapo zizindikiro zina. Poyamba, mawonetseredwewo kulibe, koma mu gawo lachiwiri zizindikilo zonse za kukhazikikanso kwa matenda zimadziwika - kuwonongeka kwakukuru kapena kwamphamvu kwa ulusi wina wamaubongo:

zachikazi
zasayansi
oculomotor
atatu.

Odwala ambiri amakumana ndi kuchepa kwa mitsempha, kupweteka kwambiri, kuwotcha, kumva kulira, ndi zina zambiri. Anthu achikulire modabwitsa amayamba kuchepetsa thupi, zomwe zimadziwikanso ndi odwala omwe akudwala matenda a shuga. Gawo lachitatu la matendawa limafunikira kale njira zochizira. Nthawi zina, pakufunika kuti pakhale kuchitapo kanthu kuti muthandize kuchotsa zilonda zam'mimba kapena zironda, zomwe poyamba zimaziwitsidwa kumadera akumunsi a thupi.

Matenda a matenda ashuga polyneuropathy

Sizingatheke kuzindikira mtundu wa zovuta ndikuti ndi gulu linalake la matenda popanda zida zapadera. Wodwala amayenera kupereka mayankho atsatanetsatane okhudza thanzi kapena kudandaula pakugwira ntchito kwa ziwalo zamagulu. Pambuyo pa anamnesis, mudzafunika kugwiritsa ntchito zida zama neurologist kuti mupeze matenda a shuga kuti mupeze kuchuluka kwa shuga m'magazi ndikupanga njira zina:

encephalopolneuropathy,
kuphunzira Achilles Reflex,
electromyography
ECG
Echocardiography,
Ultrasound
kusanthula kwapadera kwa mkodzo.

Momwe mungachitire ndi neuropathy

Chithandizo cha mankhwalawa chimaphatikizapo njira yolumikizirana yothetsera vutoli pambuyo pofotokoza zonse zomwe zidachitika kale. Ndikofunika kudziwa zomwe zimayambitsa matendawa atayamba, pambuyo pake ndikotheka kuyamba kulandira chithandizo cha polyneuropathy mu shuga mellitus. Madokotala amapereka mankhwala a glucocorticoid kuti athane ndi zochita za autoimmune mthupi, kuwonjezera apo, odwala amamwa mankhwala potengera mchere wa potaziyamu ndikutsatira zakudya zama protein. Mankhwala onse amakhala ndi mavitamini ambiri am'magulu B ndi C, ndipo mankhwala opatsirana mthupi amachitidwa motsatana.

Kutsitsa magazi

Pali njira zingapo zochepetsera shuga m'magazi, mwa anthu, omwe amagwiritsidwa ntchito pochiza odwala matenda ashuga. Madokotala amalimbikitsa kuti musangogwiritsa ntchito mankhwala ochepetsa shuga wamagazi, komanso kusintha kwathunthu chakudya. Zakudya zomwe zimadyedwa masana siziyenera kulowetsa chakudya chambiri chamafuta ambiri. Odwala saloledwa kudya zakudya monga pasitala kapena mbatata. Masamba omwe amatha kutsitsa shuga ayenera kutenga malo awo.

Alpha Lipoic Acid wa Matenda A shuga

Thioctic acid imakhudzidwa mwachindunji pakayendetsedwe ka kagayidwe kazachilengedwe ndi mphamvu ya thupi. Katunduyu amatengedwa ngati antioxidant wamphamvu kwambiri, amathandiza kugwetsa glucose komanso amathandizira zotsatira zoyipa zamagetsi. Alpha lipoic acid imagulitsidwa ngati chowonjezera chodyera ndipo imagwiritsidwa ntchito pochiritsa matenda oyipa a mtima kapena chiwindi. Ma antioxidant amathandizira kayendedwe ka glucose, chifukwa komwe kamayamwa.

Odziletsa a shuga

Gulu lazinthuzi limagwiritsidwa ntchito moyenera kuchiritsa odwala omwe ali ndi matenda oopsa. Ma A inhibitors a shuga ndi mankhwala osokoneza bongo omwe amateteza thupi la wodwalayo. Amalepheretsa kupititsa patsogolo kwa matendawa, motero, ndi mankhwala oyamba osankha kwa anthu omwe ali ndi gawo lililonse la matenda ashuga. Komabe, kutenga ACE zoletsa kumatha kuyambitsa zovuta monga asymptomatic glycemia kapena hyperglycemia.

Mankhwala osokoneza bongo oletsa kuponderezana

Mankhwala osapweteka a anti-steroidal nthawi zambiri amagwiritsidwa ntchito pothandizira kupweteka kwamankhwala. Mankhwalawa amadziwika kuti ndi othandiza kwambiri pakati pa oimira ena othandizira odwala, komabe, kudya kosalamulirika kwa NSAIDs kupweteka kumatha kuyambitsa zovuta zoyipa kuchokera m'thupi la wodwalayo. Pofuna kupewa mavuto obwera, madokotala amayendera pafupipafupi matenda a wodwalayo.

Actovegin wa polyneuropathy

Mankhwala a antioxidant amathandizira kukonza zovuta zam'mitsempha m'mitsempha, ndipo pazaka zingapo zapitazi akhala akugwiritsidwa ntchito pochiza matenda ashuga. Actovegin chithandizo cha matenda ashuga polyneuropathy ndi otetezeka chifukwa mankhwalawa samayambitsa mavuto. Pakupita kwa zaka zingapo, palibe chilichonse chomwe chidalembedwa chokhudza mankhwalawa;

Chithandizo cha polyneuropathy a m'munsi malezala azitsamba

Chithandizo cha mankhwala povomerezeka ndi dokotala chitha kuthandizidwa ndi njira zina zamankhwala monga njira zowonjezera. Pali maphikidwe angapo ogwira mtima, ena omwe amapangidwira pakamwa, pomwe ena ndi a ntchito wamba. Choyipa kwambiri ndikupondaponda pamasamba ndi mapesi a zikungu ndi mapazi opanda kanthu. Mankhwala a polyneuropathy ndi wowerengeka azitsamba azitha kugwiritsidwa ntchito pokhapokha ngati akuwongolera ndi katswiri.

Kupewa kwa polyneuropathy

Maonekedwe a matenda obadwa nawo sangathe kupewedwa, komabe, pazochitika zina zonse, kupewa matenda ashuga a m'mimba ndi njira yofunikira kwambiri yochizira. Mfundo zazikuluzikulu zamankhwala ndicholinga chothetsa zomwe zimayambitsa matenda. Kuti muchite bwino, wodwalayo ayenera kudya zakudya zapadera ndikuyamba kuchita masewera olimbitsa thupi, zomwe zimaphatikizapo kusewera masewera olimbitsa thupi.

Njira ya mwadzidzidzi

Nthawi zambiri, matenda amakhudzana ndi m'munsi komanso m'munsi mwa munthu. Pankhaniyi, minyewa imagwira ntchito kwambiri imachepa, pamakhala kuwonongeka kwa magazi m'magazi omwe adakhudza matendawa. Pali kuchepa kumvetsetsa.

Matenda a shuga a polyneuropathy amachititsa kupweteka kwambiri m'miyendo. Nthendayo imayamba kukhudza minyewa yayitali, kenako imafalikira m'thupi lonse.

Kuwonetsera kwa zizindikiro kumayamba ndi malekezero apansi, ndiye matendawa amakula kuchokera pansi mpaka pansi.

Matenda a shuga a polyneuropathy (chomwe ndi, amveka bwino atawerenga nkhaniyi) ndiofala kwambiri. Ndi chitukuko chake, kupweteka kwambiri m'miyendo kumachitika, mphamvu zawo zimachepa. Ngati njira za panthawi yake sizitengedwe, kupita patsogolo kwa matenda kumawonedwa. Kuti ndiye vuto lalikulu la matenda a shuga a mtundu woyamba ndi wachiwiri.

Matenda a shuga a polyneuropathy a m'munsi am'munsi nthawi yake imakhudza ulusi wamitsempha yosiyanasiyana, ndikuwongolera kufalitsa kwa zikhumbo za somatic komanso autonomic mantha system.

Chifukwa chake, ndi matenda a shuga a m'mellitus omwe amakhala olimbikitsa pakukula kwa polyneuropathy. Ndipo zovuta zofananira zimayamba nthawi zambiri - mwaoposa theka la anthu odwala matenda ashuga. Mwachitsanzo, ngati wodwala wadwala zaka zisanu, ndiye kuti polyneuropathy imayamba milandu khumi ndi isanu. Ngati munthu akudwala matenda a shuga kwa nthawi yayitali, mwachitsanzo, zaka makumi atatu, ndiye kuti mwayi wokhala ndi vuto umafikira 70%.

Kukula kwa matenda am'mimba kumayambira ngati kuchuluka kwa glucose kulipo m'magazi. Thupi limayesetsa kwambiri kuthetsa shuga. Pali njira ziwiri zazikulu zomwe mungagwiritsire ntchito chakudya. Momwe tingachitire odwala matenda ashuga a polyneuropathy am'munsi, tiona pansipa.

Zotsatira zake, mapangidwe a ma neurons amasintha. Amataya liwiro komanso kulimba kwa kufalikira kwa zikopa za mitsempha. Zotsatira zake, kuchuluka kwa hemoglobin ya glycated imakwera - njira yomwe mpweya wopatsidwira mpweya umasokonekera. Umu ndi momwe odwala matenda ashuga a m'magawo am'mbuyomu amakulira.

Zizindikiro

Matendawa amadziwika ndi kupezeka kwamavuto m'ntchito zakuthwa, zamagalimoto ndi zamagalimoto. Mwa odwala osiyanasiyana, zizindikiro zimawoneka payekhapayekha, koma nthawi zambiri zimakhala zosiyanasiyana mosiyanasiyana. Kuphatikiza apo, zizindikiro zosiyanasiyana zimatha kuchitika nthawi imodzi. Zizindikiro za matendawa amatchulidwa motere:

Zizindikiro zazing'ono.
Zizindikiro zakuthwa.
Zizindikiro zowonetsera.
Swift Symbomatology.

Chithandizo cha matenda a shuga

Choyamba, kudwala kumatha kudziwika ndi maonekedwe osapweteka. Mawonekedwe a wodwala amachepa, kufooka m'miyendo kumawonekera, ndipo kuchuluka kwa chidwi kumasintha. Kuphatikiza apo, odwala nthawi zambiri amazindikira zovuta zamasamba.

Ngati mumanga mothandizidwa ndi matendawa, ndiye kuti polyneuropathy imatha kukhala yovuta, subacute, aakulu.

Kuchotsa zomverera zosasangalatsa kumatha kukhala kovuta kwambiri chifukwa chokana kwawo ma analgesics achikhalidwe. Mawonekedwe owawa amatha kukhala ocheperako, oyaka, osweka kwambiri.

Kumva kupweteka kumatha kuchitika pawokha kapena chifukwa cha zomwe ochita akukumana nawo osiyanasiyana. Matenda a shuga a polyneuropathy am'munsi amawonedwa ngati "miyendo yosasuntha". Izi zikutanthauza kuti mawonekedwe a ululu amatha kukhudzidwa ndi mawonekedwe a circadian: kupweteka kumatha kudziwonetsa kokha madzulo.

Pankhaniyi, kusintha kwina, monga kuyenda, kutikita minofu, kupepuka kapena kutikita mtima kwambiri, kumatha kuchepetsa kusasangalala. Matendawa "osapumira" adapeza dzina chifukwa chakuti kusuntha kumasokoneza kugona mokwanira. Pofika m'mawa, ululu umatha, ndipo pofika madzulo umayambanso.

Magawo a pathology

Chizindikiro cha matendawa chimadalira gawo lachitukuko cha matendawa ndipo amatha kuwonekera m'njira zosiyanasiyana:

Gawo loyamba limadziwika ndi kusapezeka kwa madandaulo aliwonse kuchokera kwa wodwala. Dokotala amatha kuzindikira matendawa. Imadziwoneka ngati mawonekedwe a kugwedezeka, kutsika kosachedwa kugontha, kutentha. Gawo loyamba silimadziwika kwenikweni, koma ngati mumayesedwa pafupipafupi, ndiye kuti ndizotheka kuzindikira. Kuthandiza odwala matenda a shuga a matenda a shuga panthawi imeneyi kungakhale kothandiza kwambiri.
Gawo lachiwiri, kupweteka kwapadera kumadziwika. Nthawi zambiri zimagwirizanitsidwa ndi kuvulala, overstrain ndi sprains. Zizindikiro za gawo lachiwiri zimaphatikizaponso dzanzi nthawi zambiri kuposa m'munsi, koma nthawi zina miyendo yam'mwamba. Kuchepa kwakanthawi. Kuphatikiza apo, thanzi limakulirakulira, ndipo poyenda, miyendo yolemera imamveka.Chithandizo cha matenda a shuga a polyneuropathy mu gawo lachiwiri amatha kupewa zovuta.
Gawo lachitatu limadziwika ndi dzanzi nthawi zonse komanso kuchepa kwa chidwi cha chidwi chakunja. Tiyenera kudziwa kuti zotupa zosiyanasiyana zimatha kupezeka, kuphatikiza zilonda zam'mimba zitha kupakika pakhungu.

Kuphatikiza apo, zizindikiro zazikulu za polyneuropathy zimaphatikizapo kupweteka molumikizana ndi chidendene, chomwe chimafalikira kuyambira kumapazi mpaka kumapazi. Kuwotcha kumapazi ndi kuchulukitsidwa kwawo sikusiyanitsidwa.

Chithandizo cha neuropathy mu shuga

Chithandizo cha matendawa chimayenera kukhala chokwanira, kuphatikiza mankhwala, kutikita minofu ndi kutikita minofu.

Mfundo ya mankhwalawa imadalira kwathunthu pazifukwa zomwe matendawa adayambira. Mwachitsanzo, ngati polyneuropathy ikuwoneka chifukwa cha chibadwa cholandira, ndiye kuti mankhwalawo adzakhala operewera, ndiye kuti, cholinga chake ndi kuchotsa zizindikirocho.

Lamulo lofunika kwambiri pochiza matenda ashuga polyneuropathy ndi matenda a shuga.

Mankhwala

Ndikothekanso kuchiritsa kupsinjika kotereku nthawi zina, komabe, ndikofunikira kuchita maphunziro. Izi zimachepetsa ululu ndikusintha moyo wa wodwalayo:

Pamaso pa ululu waukulu, ndikofunikira kumwa mankhwala osokoneza bongo. Nthawi zambiri, akatswiri amalimbikitsa kumwa mankhwala monga Tramadol kapena Analgin.
Pofuna kupititsa magazi ku minyewa yamitsempha, madokotala amalimbikitsa kumwa mankhwala kuchokera ku gulu la ma neuroprotectors, monga Mildronate, Piracetam. Nthawi zina, amalimbikitsidwa kumwa mankhwala a mtima, monga Trental, Pentoxifylline. Ndi mankhwala ena ati omwe amagwiritsidwa ntchito pochiza matenda a shuga?
Kupititsa patsogolo kufalikira kwa mitsempha ku minofu, chithandizo cha vitamini chikuwonetsedwa.
Pofuna kubwezeretsa madwala, ndikotheka kugwiritsa ntchito jakisoni wa alpha-lipoic acid.
Kulowa kwa glucose ku mitsempha ya mitsempha kumalepheretsedwa ndi ma aldose reductase inhibitors.
Muyenera kumwa mankhwalawa omwe ali ndi calcium ndi potaziyamu.

Ngati zizindikiro za matenda a shuga a matenda ashuga sizinatchulidwebe, ndiye kuti zimatha kuchepetsedwa ndi njira zina zochiritsira.

Kuchiza ndi wowerengeka azitsamba

Tiyenera kudziwa kuti kugwiritsa ntchito mankhwalawa kwa anthu onse kuyenera kuvomerezedwa ndi dokotala. Kupanda kutero, zotsatira zosakonzekera zitha kuchitika.

Pakati pa njira zochizira polyneuropathy, munthu amatha kusiyanitsa:

Masamba oyenda mwatsopano akhungu. Njira yake ndi yosinthika, koma yothandiza.
Tincture wa Rosemary. Kuti mukonze, thirani masamba a chomera ndi vodika ndikuumirira kwa masiku osachepera makumi awiri. Kulowetsedwa koteroko kuyenera kupukutidwa malo owonongeka.

Njira zakuzindikira za matenda ashuga a polyneuropathy

Pafupifupi odwala onse omwe ali ndi matenda a shuga amadwala matendawa. Ndikotheka kuzindikira matenda am'mimba a shuga a m'munsi kwambiri nthawi zambiri m'magawo omaliza. Komabe, ngati mumayang'anitsitsa thanzi lanu ndikuwona dokotala pafupipafupi, ndiye kuti izi zikuwoneka kuti ndizotheka kuzindikira ngakhale pang'onopang'ono ndikuyimitsa kukula kwake mtsogolo. Nthawi zina, zotsatira zosasangalatsa zitha kupewedwa kwathunthu.

Matendawa amakula nthawi yayitali, ndiye kuti, zizindikiro zodziwikiratu zoyambirira zimatha kuwonekera patangotha zaka ziwiri kapena zitatu atayamba kukula. Nthawi zambiri pamakhala zinthu zina zomwe munthu amapita kwa katswiri pazifukwa zina, ndipo amapezeka ndi matenda a shuga komanso matenda ashuga a m'munsi.

Chithandizo chiyenera kusankhidwa ndi endocrinologist.

Kuzindikira matendawa kumatha kudalira madandaulo ena a wodwalayo, komanso kutengera ndi zovuta zamankhwala.

Njira zochizira matenda a polyneuropathy

Ndi vuto lofananalo lomwe limakhudza miyendo, madokotala nthawi zambiri amalimbikitsa kuchita masewera olimbitsa thupi osiyanasiyana. Zimathandizira kubwezeretsa minofu ndikuthandizira magazi. Pofuna kuti magazi azithamanga, kusuntha kwamiyendo tsiku lililonse ndi miyendo kuyenera kuchitidwa, komanso kusinthasintha ndi miyendo.

Ngati odwala matenda ashuga a polyneuropathy am'munsi amatsika kwambiri (zomwe tidawunikira) ali pachiwonetsero choyambirira cha chitukuko chake, ndiye kuti kutikita minofu ndi njira yabwino kwambiri yolimbikitsira mankhwalawa. Komabe, ndi ochepa omwe amatha kuchezera katswiri wazomangamanga wokhazikika. Pachifukwa ichi, mu gawo loyambirira, mukuyenera kukumbukira momwe zochita zake zimachitikira, ndipo kenako muzichita nokha kutulutsa tsitsi kwanu. Njirayi imapeza zotsatira zabwino, nthawi zina ngakhale kuchotsa kwathunthu matendawa.

Zochita zolimbitsa thupi

Nazi njira zingapo zosavuta zomwe ziyenera kuchitidwa tsiku ndi tsiku:

Muyenera kugwira zala zanu ndi manja ndikuzikoka kwa masekondi khumi. Pambuyo pa izi, muyenera kupanga zoyenda mozungulira pamapazi. Mapeto ake, muyenera kumeta zala zanu zonse ndi phazi lanu ndi mayendedwe owala.
Ntchito iyi iyenera kuchitika poimirira. Muyenera kukweza zala zanu mosamala, kenako ndikulungunula pang'ono ndi thupi mpaka zidendene. Bwerezani izi kawiri. Tiyenera kukumbukira kuti masewera olimbitsa thupi otere ayenera kuchitidwa mosamala. Kufunika koteroko kumachitika chifukwa chakuti kuyenda nthawi yayitali makamaka makamaka kuthamanga kumalephera chifukwa cha matenda.
Pakukhazikika, ndikofunikira kuti mutsamire pa mkono, ndikugwada mwendo umodzi pa bondo, ndikuwukuta mbali zosiyanasiyana. Zochita izi ndizophweka, koma zosafunikira kwa polyneuropathy.
Zochita izi zimachitika chimodzimodzi, ndikusiyana kumodzi - muyenera kung'amba chidendene pansi. Kuchita zolimbitsa thupi kotereku kumathandiza kuti magazi aziyenda bwino.
Ndikofunikira kukweza mwendo, kenako ndikuwugwetsa ndikusasuntha popanda kukhudza pansi. Bwerezani katatu kapena katatu. Kuchita izi kumathandizanso kuthamanga kwa magazi, kumathandizira minofu.
Kuchita masewera olimbitsa thupi kumafunikira mpira wolimbitsa thupi. M'malo apamwamba, muyenera kuyika miyendo pa mpira, kenako kuzungulira kangapo. Kuchita masewera olimbitsa thupi kumathandiza kuti mapazi apumule.
Pokhala pampando, muyenera kuyika phazi limodzi pa bondo la mwendo wina ndikuzungulira mkono ndi dzanja lanu. Kuchita masewera olimbitsa thupi kotereku ndizopambana kwambiri kuchititsa kutikita minofu yodziyimira pawokha, chifukwa ndikosavuta kwambiri kukhalanso chimodzimodzi.
Ndikofunikira kuphatikiza mapazi pamodzi, kuwagwira ndi manja anu ndikusunthira mawondo anu mmwamba ndi pansi. Kuchita masewera olimbitsa thupi ndi kovuta, simuyenera kuichita kawiri konse.

Ndikofunikanso kuchita kutikita minofu ndi zizindikiro za matenda ashuga polyneuropathy. Njira zotsatirazi zingagwiritse ntchito:

Pukuta miyendo ndi m'mphepete mwa manja.
Timakanikiza nkhonya pakati pa phazi, ndipo ndi dzanja lina timakanikiza phazi kuchokera panja.
Mapiri amapaka phazi, makamaka m'munsi.
Kugwira chidendene pang'ono, timasinthana ndi phazi mosiyanasiyana.
Potozani phazi mbali zosiyanasiyana.
Massage phazi ndi chala chanu.
Timagwira zoyenda mozungulira ndi zithupi kumapazi.
Pakani zala zanu kuyambira chidendene mpaka kumapazi.

Ndikofunika kukumbukira kuti kutikita minofu sikuyenera kupitanso mphindi zisanu, ndipo masewera olimbitsa thupi azikhala opepuka komanso osakhalitsa. Ndibwino kangapo patsiku.

Ndikofunika kuchita ndi physiotherapy ndi polyneuropathy. Komabe, amawapatsa mankhwala atatsiriza maphunziro a mankhwala.

Ndemanga za odwala omwe adalandira chithandizo chamankhwala

Odwala omwe adalandira chithandizo chamankhwala osiyanasiyana amalangizidwa kuti asanyalanyaze kupita kwa katswiri ngati kuli koyambirira kwa matendawa. Chithandizo choyenera chitha kuperekedwa ndi katswiri woyenerera wa endocrinologist kapena akatswiri.

Katswiriyu apereka njira yoyezetsa magazi mobwerezabwereza kuti adziwe kuchuluka kwa shuga ndipo amalimbikitsa kufunafuna upangiri kuchokera kwa akatswiri amatsenga kuti atsimikizire matendawa. Pambuyo pa izi, dokotala wopezekapo amatha, kutengera zotsatira za mayeso, kupereka chithandizo chokwanira. Sikoyenera kulandira chithandizo chamankhwala kunyumba - izi sizingokupulumutsirani zowawa zokha, komanso zingayambitse zotsatira zowopsa.

Njira zochitira masewera olimbitsa thupi zomwe zingathandize kuchepetsa ululu, kukhazikitsa ma microcirculation, ndikuyendetsa njira za metabolic mu minyewa ya minyewa zimatha kuthana ndi zizindikiro za matenda ashuga a polyneuropathy am'munsi. Komabe, physiotherapy ikhoza kukhazikitsidwa ngati chithandizo chowonjezereka panthawi ya mankhwala othandizira kuti muwonjezere zotsatira.

Kuphatikiza apo, odwala amapereka lipoti labwino la zolimbitsa thupi zolimbitsa thupi, kuwalola kuti athetse zamatsenga ndikuyamba kuyenda popanda kupweteka komanso momasuka ndi matenda ashuga a polyneuropathy. Ndi chiyani, inu tsopano mukudziwa.