Hepa Merz wa matenda a shuga: mankhwalawa a matenda a shuga a chiwindi

Yopezeka (13 nsanamira). . . Mwana-Pugh kalasi C - pachimake pancreatitis - mtundu 2 shuga mellitus - hepatitis C yosalephera etiology - kuti.

Mafuta a shuga a chiwindi ndi vuto lalikulu la matenda ashuga, omwe amayamba. Ngati ndi kotheka, chithandizo chidzalimbikitsidwa ndi heptral.

Heptral. Heptral. . Monga endocrinologist, ndimalembera odwala omwe ali ndi matenda a shuga, kunenepa kwambiri, kukana insulini, ndi hirsutism. Matenda a hepatral - PALIBE ZINSINSI ZONSE!

Senya, Heptral sizikhudza kagayidwe ka shuga. . Matenda a 2 a matenda ashuga ndi matenda apokhapokha.

Chithandizo cha matenda a chiwindi ndi shuga. Bwino ngati pali matenda enaake. Izi zikuphatikizapo Essentiale, Heptral, Hepatofalk, Hepa-Merz ndi ena.

Matenda a shuga - matenda ogwirizana ndi kusokonekera kwa glucose metabolism c. Mwambiri, mu matenda a chiwindi a hepatosis, masiku 10 a intravenous heptral maphunziro.

Kutsatira malangizowo mu malangizo ogwiritsira ntchito, mapiritsi a heptral ayenera kumwedwa pakamwa pakati pa chakudya m'mawa.

1. Heptral ya matenda a shuga ndi matenda a impso Osavomerezeka. 2. Kuchiritsa impso, ndikulimbikitsa kulumikizana ndi urologist, ndizothekanso.

Namwino akulakwitsa. Heptral imasungunuka ndi chosungunulira chapadera, chomwe. Moni Yaroslav. Ndili ndi matenda a shuga a mtundu wachi II.

Zaumoyo = Kukongola. Heptral - chiwindi chilichonse chimakhala ndi nkhani yake. . Matenda a shuga a Heptral - 100 PERCENT!

Ma analogi a Heptral okhala ndi mtengo wotsika. Heptral ndi wabwino komanso wogwira ntchito. Koma kusamala kuyenera kugwiritsidwa ntchito pamaso pa matenda ashuga.

Heptral - mankhwala opangidwa kuti ayeretse ndikubwezeretsa chiwindi, ali ndi ntchito yothandizira.

Heptral. Heptral ndi mankhwala opangidwa kuti ayeretse chiwindi.

Matenda a shuga. . Ndiye heptral ndi chiyani?

Matenda a shuga. . Heptral imalipira kuchepa kwa ademetionine, pomwe imalimbikitsa kupanga kwake mthupi.

sanali mowa steatohepatitis, matenda ashuga, heptral, nyukiliya, endo native kuledzera, mankhwala.

Malangizo a Heptral

Mankhwala a heptral, opangidwa ndi nthambi ya ku Italy ya American mankhwala opangira mankhwala Abbot, ali m'gulu la hepatoprotectors ndipo amagwiritsidwa ntchito makamaka pakuwonetsa mitundu ina ya chiwindi. Chifukwa chiyani "makamaka"? Chowonadi ndi chakuti mankhwala othandizira a heptral - ademethionine - amakhalanso ndi antidepressantant, chifukwa chake, mavuto okhumudwa amawonekanso mosiyanasiyana pakuwonetsa mankhwala. Komabe, "njira" yayikulu yochiritsira ya heptral ndi chitetezo cha chiwindi. Ndipo pazomwezi, mankhwalawa amaperekedwa ndi chilichonse chofunikira, monga: choleretic, cholekinetic, kukonzanso, kusinthitsa zinthu, anti-fibrosing, antioxidant ndi neuroprotective. Ademethionine ndi zinthu zachilengedwe zopangidwa m'chiwindi. Imayimiridwa kwambiri m'zinthu zonse zachilengedwe za thupi (zomwe zimapezeka kwambiri m'chiwindi ndi muubongo) ndipo zimagwira nawo machitidwe ambiri a metabolic, kuphatikizapo zitatu zofunika kwambiri: transmethylation, transulfurization ndi aminopropylation. Pazochitika za transmethylation (methylation), ademetionine "amapereka" gulu la methyl kwa kaphatikizidwe ka membrane phospholipids, neurotransmitters, mapuloteni, mahomoni, ndi zina zambiri. Pazochitika za trans sulfation, ndimtundu wa kapangidwe ka glutathione, cysteine, taurine, ndi acetylation coenzyme. Heptral, imakwaniritsa kusowa kwa ademetionine wachilengedwe ndikuyambitsa kubereka kwake mthupi, kumawonjezera zomwe zili L-glutamine mu chiwindi, cysteine ​​ndi taurine m'magazi am'magazi, komanso kufalitsa matenda a hepatic metabolism.Mankhwala kumawonjezera kupanga bile mu chiwindi: amateteza mapangidwe amkati phosphatidylcholine mu chiwindi maselo, amene kumawonjezera fluidity (kuyenda) ndi polarization maselo nembanemba. Izi zimakhudza mayendedwe a bile acid omwe amagwirizanitsidwa ndi zimagwira ma cell a chiwindi komanso amalimbikitsa kulimbikitsa kwotsirizira pamodzi ndi dongosolo la bile.

Pachifukwachi, heptral imagwiritsidwa ntchito bwino kupangika kwa bile. Ademethionine limodzi ndi ursodeoxycholic acid amadziwika kuti ndi mankhwala olimbikitsa kwambiri pokhudzana ndi kulumikizana ndi ma ulalo apamwamba mu pathogenesis ya intrahepatic (intralobular and interlobular) cholestasis. Heptral adatsimikizira ntchito zake mwachangu pakuchiritsa komanso kupewa kwa hepatopathies ogwirizana ndi mankhwala a hepatotoxic. Izi ndizofunikira kwambiri pochiza odwala khansa, pomwe kusiya kwa hepatotoxic mankhwala kumachepetsa mphamvu ya chemotherapy ndipo, chifukwa chake, imakulitsa kudalirika kwa moyo. Kukhazikitsa heptral kwa opioid osokoneza bongo omwe ali ndi hepatopathy kumayambitsa kuchepa kwa zizindikiro zochoka, kusintha kwa chiwindi ndi kusintha kwa kayendedwe ka microsomal oxidation. Chuma china cha heptral chomwe chimakhala chosiyana ndi hepatoprotector ndi antidepressant. Imayamba kuonekera kumapeto kwa sabata loyamba la kumwa mankhwalawa, ndikukhazikika mokwanira mkati mwa masabata awiri a pharmacotherapy. Heptral imathandizanso kuyambiranso kupsinjika kwamkati ndi ma neurotic omwe amalimbana ndi amitriptyline.

Heptral imapezeka m'mitundu iwiri ya mapiritsi: mapiritsi ndi lyophilisate pokonzekera yankho la intravenous and intramuscular management. Mapiritsi tikulimbikitsidwa kuti kumwedwa m'mawa pakati chakudya. Chofunikira kwambiri: mapiritsi ayenera kumwedwa kuchokera pamapaketi musanayambe kugwiritsidwa ntchito. Kuthamanga kwa phukusili ndizofunikira kuti mankhwalawa akhale abwino: ngati mtundu wa piritsiwo ndi wosiyana ndi zoyera (kufupikira pang'ono ndikuloledwa), ndiye kuti unalimba udasweka ndipo mankhwalawo sangagwiritsenso ntchito pazomwe akufuna. Njira yothetsera heptral kwa intravenous ndi intramuscular makonzedwe amakonzedwa musanayendetse ntchito pogwiritsa ntchito zosungunulira zomwe zimaphatikizidwa phukusi. Otsalira a mankhwalawa ayenera kutayidwa.

Madokotala amawunika za heptral

Kuchita bwino kuchokera pakudya koyamba, kusintha momwe muliri popanda psychoactivity. Ndikhazikitsa mtengo wapamwamba kwambiri momwe ndingathere, chifukwa kuchita bwino kumathamanga.

Kulephera kwa mafakitale ndi kusowa kwa analogu ndi zopitilira 2x.

Mankhwala abwino kwambiri pazovuta zovuta, okhala ndi dysmetabolic encephalopathy yokhala ndi zinthu zina zokhala ndi nkhawa. Ndikupangira pambuyo pa ONMK.

Hepatoprotector yekhayo yokhala ndi kutsimikizika kogwira ntchito. Imagwira ntchito bwino ndi steatohepatosis ndi steatohepatitis. Ili ndi mphamvu yothandizira. Olekerera bwino ndi odwala. Imakhala ndi choleretic yofatsa. Choyipa chokha ndi mtengo wa mankhwalawo.

The bioavailability wa piritsi ndi 5%.

Hepatoprotector woyenera kwambiri, wogwiritsidwa ntchito kwambiri chifukwa cha hepatitis osiyanasiyana, mafuta a hepatoses wamafuta ndi matenda ena a chiwindi. Njira yosavuta yotulutsira, kugwiritsa ntchito kumene ndikofunikira, kumapangitsa wodwala kukhala wambiri.

Mtengo wokwera mtengo wa mankhwalawa umapangitsa kuti odwala ambiri asamavutike.

Izi sizothandiza hepatoprotector chabwino, komanso mankhwala omwe ali ndi zotsatira za antipsychotic. Ndi kuwonongeka kwa chiwindi ndi ubongo motsutsana ndi maziko a kuledzera kwamkati ndi exo native, zomwe zimayambitsa dysmetabolic encephalopathy kwambiri shuga mellitus, mowa wothandizira, mawonekedwe abwino amawonekera motsutsana ndi maziko a njira yophatikizira - magawo amomwe amachititsa magazi kumachepetsa, kupsinjika kwa odwala kumachepetsedwa, ndipo ambiri akukhala bwino. Palibe zotsatira zoyipa, zimalekeredwa bwino.

Mtengo wokwera wa mankhwala, koma umagwirizana ndi mtunduwo.

Mankhwala "Heptral" ali m'gulu la hepatoprotectors ndipo amagwiritsidwa ntchito makamaka pamankhwala osiyanasiyana a chiwindi. Chifukwa chiyani "makamaka"? Chowonadi ndi chakuti wophatikizira wa Heptral, ademetionine, amakhalanso ndi antidepressant ntchito, ndichifukwa chake zovuta zowonekera zimawonekeranso muzowonetsa zingapo posankha mankhwala. Amapezeka m'mitundu iwiri ya mapiritsi: mapiritsi ndi lyophilisate pakukonzekera njira yothetsera mtsempha wamkati ndi mu mnofu makonzedwe.

Mankhwala osangalatsa, nthawi zambiri ndimagwiritsa ntchito ngati gawo la zovuta piritsi la piritsi komanso jakisoni nthawi zina, ngati gawo lamankhwala olimbitsa.

Sindikupeza zolakwa, kupatula mtengo wake, koma mankhwala abwino nthawi zambiri samakhala otsika mtengo.

Ngakhale mawonekedwe a somatic, ali ndi modekha psychoactive.

Fomu. Kuchulukitsa kwa phwando. Kugwiritsa ntchito mosavuta.

Hepatoprotector yabwino kwambiri, m'malingaliro anga, ndi ntchito zingapo, makamaka zotupa za chiwindi, mafuta a hepatoses, omwe amatsagana ndi kuwonjezereka kwa transaminases, zotsatira zake sizinatenge nthawi kuti zikubwera, mphamvu zabwino zimawonedwa mwachangu.

Mankhwala abwino, ndimagwiritsa ntchito kwa zaka zingapo. Zotsatira zoyipa sizimachitika.

Monga endocrinologist, ndimapereka mankhwala kwa odwala omwe ali ndi matenda a shuga, kunenepa kwambiri, kukana insulini, hirsutism ndi zina zokhudzana ndi endocrine komanso matenda, monga dermatologist ndimapereka mankhwala a psoriasis.

Imodzi mwabwino kwambiri hepatoprotectors. Makamaka makamaka kwa chiwindi cha mowa, amachepetsa kukhumudwa kwa pambuyo. Poyerekeza ndi maziko a mapangidwe a mtsempha, njira yotsimikizika mwachangu imawonekera, magawo amomwe ammagazi amathandizika, ndikuwoneka bwino kwa odwala.

Mtengo ndiwokwera kuposa wa hepatoprotectors ofanana.

Mankhwalawa amanenedwa ngati achire mu chiwindi matenda monga chiwindi, matenda enaake komanso ena ambiri.

Pakalipano, mankhwala othandiza kwambiri pochiza matenda a chiwindi. Fomu la piritsi limagwiritsidwa ntchito jekeseni. Mtengo wake ndi wokwera. Koma mulimonse, ndi mankhwala osankhidwa.

Mankhwala amagwiritsidwa ntchito osiyanasiyana matenda ndi matenda a chiwindi, kuphatikizapo oncological njira zosiyanasiyana etiologies. Mankhwalawa ndi okwera mtengo, koma "wogwira ntchito kwenikweni," ndiwofunikira ndalama. Muzochita zanga, ndimagwiritsa ntchito jaundice yamavuto osiyanasiyana, kuwonongeka kwa chiwindi cha metastatic Zotsatira zabwino zimatheka msanga: magawo amtundu wa chiwindi amatha kusintha bwino, momwe wodwalayo alili. Nthawi zambiri, chithandizo cha odwala omwe ali ndi vuto lalikulu sichikwanira popanda kugwiritsa ntchito mankhwalawa. Ndikulimbikitsa.

Kuthandiza kwa hepatoprotector. Zodabwitsa pa mankhwalawa mafuta hepatosis, kuwonongeka kwa chiwindi. Pafupifupi maphunzirowa, zizindikiro za ma labotale, zotsatira za ma ultrasound zimasinthidwa, mkhalidwe waumoyo umakhala bwino, zomwe zimapangitsa kuti poizoni wa poizoni wazipweteka.

Zochuluka kwambiri. Si wodwala aliyense amene angakwanitse. Ngakhale, nditapatsidwa njira yochepa ya chithandizo, poyerekeza ndi magulu ena a hepatoprotectors, mwina kungakhale koyenera kusankha mankhwalawa ngati chinthu choyambirira.

Imodzi mwazabwino kwambiri hepatoprotectors ndimadalira. Kuchita mwachangu kwa mankhwalawa, makamaka ndi hepatitis. Mankhwalawa ndi achangu komanso abwino mokwanira, osakhala ndi mavuto. Mankhwalawa amaphatikizidwa ndi mankhwala aliwonse.

Tsoka ilo, sizololedwa ali aang'ono. Sikuti aliyense angathe kulipirira, malinga ndi mtengo wake.

Folk yothetsera "kuyeretsa" chiwindi.

Mtengo umachulukitsidwa mobwerezabwereza.

Mankhwala omwe ali ndi mphamvu yolimbikitsa, komanso chifukwa cha oyamba ndi ena: antidepressant ndi zina zamphamvu. Chitsanzo cha kuphatikiza kwa mankhwala achilendo ndi zotsatira zamphamvu za placebo chifukwa cha mtengo wokwera kwambiri.Pali mitundu yotsika mtengo, komanso kuphatikiza kwaulere kwa mankhwala ena omwe amathandizanso chimodzimodzi.

Heptral imawerengedwa kwa odwala monga amodzi a hepatoprotectors othandiza kwambiri. Imabwezeretsa bwino ntchito ya chiwindi ndipo imakhala ndi vuto lothana ndi vuto. Mwanjira yovomerezeka, kugwiritsa ntchito mankhwalawa kumakhala kothandiza kwambiri. Heptral ndi mankhwala okwera mtengo, koma ogwira ntchito ake sangatsutsidwe.

Mankhwala apadera omwe ayesedwa mwachipatala ndikuwatsimikizira kuti ndi othandiza. Ndimawerengera odwala pambuyo pa chemotherapy kuti muchepetse hepatotoxicity. Amabwezeretsa ntchito ya chiwindi, zotsatira zake zimawonedwa ndi kusanthula kwa michere ya chiwindi, komanso motsutsana ndi khungu.

Oyenera odwala khansa.

Mankhwala "Ademethionine" (dzina lamalonda "Heptral") lakhala likugwiritsidwa ntchito kwa zaka zambiri mu hepatology. Mosiyana ndi ena otchedwa hepatoprotectors, Heptral sanangotchulapo zoyipa zomwe zimapangitsa kuti matenda a seramu transaminases akhale othandizanso, komanso ndi antidepressant yothandiza kwambiri. Mankhwalawa amaphatikizidwa mwachindunji ndi mankhwala osakhazikika opatsirana mwa matenda a chiwindi. Kugwiritsa ntchito bwino kwa "Ademethionine" ndikugwiritsa ntchito ziwembu zochokera pakulowerera mkati mwa mankhwalawa ndikusintha kwake pakamwa.

"Heptral" - hepatoprotector, ali ndi ntchito yothandizira. Ili ndi choleretic ndi cholekinetic kwenikweni. Ili ndi detoxifying, kubwezeretsa, antioxidant, anti-fibrosing ndi neuroprotective katundu.

Mtengo wa ambiri sapezeka. Mankhwala othandizira amagwiritsidwa ntchito pama pathologies ambiri, koma si aliyense angakwanitse.

Heptral ndi imodzi mwazabwino kwambiri za hepatoprotectors mpaka pano. Ndimagwiritsa ntchito moyenera mukamachiritsa odwala pambuyo pa chemotherapy, mankhwalawa poizoni wa hepatic komanso chifukwa cha kukondweretsa. Pali mitundu ingapo yotulutsidwa, zomwe zimapangitsa kuti odwala asamavute mankhwalawo.

Mu owerengeka ochepa odwala, zovuta zimawonedwa.

Hepatoprotector yabwino komanso yothandiza. Imagwira ntchito mwachangu komanso moyenera. Fomu ya piritsi ndiyowonekeratu kuti siyothandiza poyerekeza ndi yomwe ingabayike. Panalibe kusiyana pakati pa kuyendetsa bwino magazi ndi ma intramuscular.

Mtengo ndiwokwera kwambiri. M'mayiko ambiri, adomethionine, yogwira heptral si mankhwala - imawerengedwa ngati chakudya chowonjezera. Maziko aumboni wa kugwiritsa ntchito kwa heptral mankhwala mu matenda a chiwindi ndi ochepa.

Monga mukudziwa, chithandizo cha mitundu yoopsa ya psoriasis imaphatikizapo kugwiritsa ntchito kwa nthawi yayitali kwa ma immunosuppressants, omwe amachititsa kuti chiwindi chizituluka komanso kupangika kwa foci ya fibrosis mmenemo. Heptral imafotokozedwa ngati njira yothandizira kuti muchepetse zovuta zomwe zimagwira mu chiwindi. Kuphatikiza apo, heptral ndi mankhwala ochepetsa nkhawa. Odwala omwe ali ndi psoriasis, zotupa zambiri pakhungu zimachepetsa moyo, komanso kupsinjika, komwe kumayambitsa chizolowezi chodzikhumudwitsa kwa nthawi yayitali komanso kudzipatula pagulu. Heptral amalimbana bwino ndi zoterezi.

Pali zovuta zambiri mu mawonekedwe a jekeseni wa Heptral, motero ndikupangira kugwiritsa ntchito yankho malinga ndi malangizo kuchipatala kapena tsiku la chipatala kwa masiku 14, ndikusinthira ku fomu ya piritsi ndikupitilirabe masiku ena 14.

Heptral bwino komanso kuthana ndi ntchitoyi mwachangu, zotsatira zake zimapezeka pafupifupi onse.

Muyezo wagolide wochizira zotupa zamtundu uliwonse umapereka mwachangu komanso mwamphamvu. Timagwiritsa ntchito nthawi zonse m'malingaliro okonzekera komanso ofunika, psycology, psychotherapy. Chofunika mankhwala mankhwalawa uchidakwa. Kwambiri kwa chiwindi cha hepatitis yovuta kwambiri komanso yopanda matenda, komanso matenda enaake komanso kunenepa.

Mtengo wake ndi wokwera ndipo, mwatsoka, si aliyense amene ali ndi ndalama zokwanira kuchitira zabwino.Kanayi pa mchitidwe ndinakumana ndi ziwopsezo zimachitika komanso kutsutsana ndi mtsempha wamitsempha. Panalibe kutengera mtundu wa piritsi.

Ndizotheka kugwiritsa ntchito mitundu yosiyanasiyana ya kukhumudwa, kuphatikiza kwa kupsinjika ndi kuwonongeka kwa chiwindi.

Mwinanso mankhwala othandizira kwambiri a hepatoprotective pa mankhwalawa a hepatitis a etiology iliyonse, komanso cirrhosis ya chiwindi. Ndili ndi chidziwitso chochuluka pakugwiritsa ntchito ademetionine m'machitidwe anga, ndipo sanandikhumudwitse! Chokhacho chomwe chimasokoneza ndikuwulutsa kwatsopano m'kuwala komanso kutsika kwapang'onopang'ono kwa mapiritsiwo kusanachitike kulowetsedwa.

Ndipo zoona - mtengo. Ndikufuna kutumiza mankhwalawa pafupipafupi kwa odwala osauka, omwe samapezeka pamitengo yotere ndikufunika kogwiritsa ntchito mankhwalawa kwa nthawi yayitali.

Mankhwala adatsimikizira mbali yabwino: ndibwino kugwiritsa ntchito, monga hepatic encephalopathies, ndi cholestasis, pochizira matenda a chiwindi ndi hepatitis ya chiwindi, napezanso kugwiritsidwa ntchito kwake mu DGR, kuti muchepetse kubwezeretsanso kwa bile, ndi zina zambiri!

Mtengo wake ndiwovomerezeka, koma ndikufuna mtengo wotsika chifukwa mankhwalawa amagwiritsidwa ntchito kwambiri, koma si aliyense amene angakwanitse kugula.

Ndemanga za wodwala wa Heptral

Kukakamiza pafupifupi munthu aliyense kuti awone dokotala, ngakhale atakhala kuti akupweteka kwambiri, ndizosatheka. Bwenzi langa labwino lidakumana ndi mavuto a mowa, omwe adalithetsa zovuta komanso popanda thandizo lakunja. Koma chiwindi chimayamba kupweteka kwambiri (ndimamutsimikizira kuti anali kudwala kale, samangomva ngati ali ndi "degree"), ndipo kukhumudwa ndi kusachita chidwi zidawonekera, adayamba kuwopsa, ngakhale nthawi zambiri amakwiya. Adayesa mitundu yosiyanasiyana ya mankhwala, makamaka opezeka pa intaneti. Koma kupita patsogolo kwakukulu kunachitika pokhapokha atamwa heptral, omwe adalangizidwa ndi dokotala wabwino.

Mowa - uli ngati njoka yomwe imakukuta chaka chilichonse, tsiku lililonse komanso ola lililonse. Choyamba, imagunda chiwindi, kupsinjika kwa nthawi yayitali, kuwonda kwambiri, mavuto ndi khungu, tsitsi, ndi misomali imayamba. Wokhala ndi poizoni wopumira pafupipafupi ndipo koposa zonse, mumamvetsa zonsezi, koma simungathe kuyima. Komabe ndidapeza mphamvu ndipo ndidaganiza zothana ndi njoka yobiriwirayi kamodzi, ndidagwiritsa ntchito Heptral kuti ndikonzenso chiwindi - ndikukuuzani, sindinayembekezere zoterezi, mutatha mwezi umodzi nditatha ndidayamba kumva ngati fungo la zaka zingapo pakamwa, kuwonda kosalekeza kumachoka, osasiya chilichonse. Mankhwala ozizira!

Pambuyo pakugwiritsa ntchito mankhwala kwa nthawi yayitali komanso yolimbana ndi vuto limodzi la ziwalo zofunika (chiwindi), dokotala yemwe adakhalapo, atayang'ana mayesowo, adalimbikitsa Heptral. Adalamula kuti atole madzi khumi. Mankhwala, ndiyenera kunena, siotsika mtengo, koma othandiza kwambiri. Osachepera zotsatira zomaliza atasiya maphunziro awo adadabwitsa ngakhale adotolo ophunzirawo, ndipo ndidamva bwino, koma osati pomwepo, monga adokotala adanena, izi ndizabwinobwino. Ndikupangira. Khalani athanzi.

Chithandizo chokhacho chanzeru. Tithokoze, posachedwa ndidayamba kumva zotsatira zabwino. Ndimalola, pandekha, ndimayesetsa molingana ndi malangizo. Panali milandu pomwe kusaphunzira bwino kumwa mankhwalawa, kumwa nthawi yolakwika (komanso kangapo), kumva kufooka pang'ono, kulephera kudya, komanso kutentha kwa thupi mpaka 36.9. Zodabwitsa kwambiri, inde, koma ndi thupi langa. Ndipo, mwambiri, sindinayambe kumwa mankhwalawa kwa nthawi yayitali, vutoli silinakhalepobe labwino, koma chilichonse ndichokhazikika, ndiye kuti, pamlingo womwewo. Koma, monga adotolo adalonjeza, zotsatira zabwino sizingawoneke kuposa kale mutawagwiritsa ntchito miyezi iwiri ndi theka. Tiyeni tiwone.

Mankhwalawa, ngakhale ali okwera mtengo, koma ndi oyenera. Musanatenge, ndikwabwino kukaonana ndi dokotala, osadzilimbitsa mtima!

Miyezi ingapo yapitayo, amalume anga anapezeka ndi khansa ya chikhodzodzo, kuwunika kokwanira kunaonetsa kuti anali ndi matenda a chiwindi C, omwe sanawaganizire. Chemotherapy adalembedwa, motsutsana ndi kumbuyo kwa izi, ALT ndi AST adayamba kudutsa padenga, kutenga mawonekedwe apakamwa ofunikira a phospholipids sizinathandize. Dotolo adalemba a Heptor chifukwa anali m'chipatala momwe amamuthandizira. Poti taphunzira zonse mwatsatanetsatane za mankhwalawa, tinagula Heptral, chifukwa ndi mankhwala oyambira omwe ali ndi chitsimikiziro chokwanira, ndipo momwe mukumvera, sizowonjezera pazoyesazo, timafunikira chofunikira, komanso chofunikira kwambiri. Heptral adatithandizira kwambiri, makamaka atangotsala atatu, ALT ndi AST adayamba kuchepa koma mosakhalitsa. Droppers anapatsidwa kwa milungu iwiri, kenako anamwa mapiritsi tsiku lililonse 800 mg kwa miyezi 1.5. Tsopano tikuwona kusinthaku kwa chotupacho, koma kuti chiwonetsero cha chiwindi chiwonjezeke, akupitilizabe maphunziro a Heptral.

Zomwe ndakumana nazo ndi Heptral ndizosangalatsa. Kwa nthawi yayitali ndinali ndimavuto akulu amowa. Mwanjira ina, ndinakwanitsa kuthana ndi mavuto anga amisala (ngakhale sanali ovuta). Koma thupi lidakhalabe m'mabwinja, makamaka chiwindi. Adokotala adandilangizira Heptral. Patatha mwezi wovomerezeka, moyo wanga unayamba kuyenda bwino. Kulakalaka kunawonekera, mawonekedwe ake adakhala otumbululuka pinki m'malo mwa earthy. Ndipo mkhalidwe wachilengedwe wasintha kwambiri. Heptral anathandizira njira yochira. Dokotala wanga adati ndipange mankhwala osokoneza bongo. Ndikuganiza kuti ziyenera kuthandiza.

Tsiku labwino kwa onse. Ndikufuna kugawana nawo zomwe ndidakumana nazo momwe ndidamwa mankhwalawa. Tsoka ilo, chiwindi changa sichili cholimba kwambiri m'thupi langa. Anamwa mankhwala osiyanasiyana, sanathandize, ndiye adokotala anamupatsa Heptral. Anayamba kutenga, malinga ndi malangizo omwe adokotala adapereka. Zotsatira zake zidazindikirika atatha kutenga Heptral, ndiwothandiza kwambiri. Ndizomvetsa chisoni kuti sindimadziwa za iye kale, sindikadavutika pachabe kwa nthawi yayitali. Chimodzi mwazabwino, ndikodula, koma ndikuganiza kuti thanzi limodula. Tsopano sindimavutika ndi kufooka komanso kusowa kudya, nseru, kutulutsa magazi komanso kusinthasintha. Ndikupangira kwa aliyense, thanzi ndi chisangalalo kwa inu!

Ndinayenera kukumana ndi Heptral pa nthawi yomwe ali ndi pakati, pomwe kusanthula kwa zamankhwala osokoneza bongo kudutsa muyeso. Popeza ndinali ndi cholecystitis yosatha, ndinayesa kugwiritsa ntchito mankhwala osiyanasiyana, koma pamenepa anali opanda ntchito, chifukwa dokotala atandiuza kuti ndidziwe mankhwalawa, tinene kuti panali zovuta zina zokhudza matendawa. Koma ndiyenera kunena kuti sanakhale opanda maziko. Mankhwalawa alidi abwino, ngakhale mukufunika kumwa mosamala, amadziwika ndi ine ola limodzi ndi theka mutatha kudya ndi ola limodzi ndi theka musanadye chakudya chatsopano, apo ayi zimapangitsa kupweteka m'mimba ndikumamva kupweteka. Pambuyo panjira yotenga Heptral, mafashoni a hepatic adatsika kwambiri. Koma mwa mphindi: si aliyense amene angakwanitse kugula, popeza mankhwalawa ndi okwera mtengo, koma sindinadandaula.

Ndikufuna kugawana nawo ntchito yogwiritsa ntchito zinthu zambiri ngati Heptral kuchokera ku kampani yopanga mankhwala Abbott ndikudziuza pang'ono ndekha. Poyamba, kwa zaka zambiri, ndendende 15, lembani matenda ashuga 1. Makina onse mthupi amavutika ndi ululuwu, koma chabwino pali malamulo ena, omwe mungathe kuchepetsa mavuto pang'ono. Mwachitsanzo, malamulo ngati otenga njira obwereza osachepera masiku 10 pachaka, bwino koposa miyezi isanu ndi umodzi, koma si aliyense ali ndi mwayi. Maphunzirowa amayenera kukhala ndi mavitamini a B, chifukwa ichi ndiye chakudya chachikulu cha matupi a mitsempha m'thupi lonse. Amakonzekeranso ndi alpha-lipoic acid - alipo ambiri pamsika tsopano, pali zambiri zoti musankhe, zotsika mtengo kapena zotsika mtengo. Ndipo chimodzi mwazinthu zofunikira kwambiri zomwe ndangotsala nazo kwazaka zambiri ndi Heptral wochokera ku Abbott. Mwachidule, ndizopadera. Ntchito yake yayikulu kwa anthu omwe ali ndi matenda osiyanasiyana ndi, hepatoprotective.Popeza chiwindi ndi mtundu wina wa fyuluta, ndipo fyuluta iliyonse imafunika kukonza, kuyeretsa komanso kusamalira. Kupanda kutero, mukulitsa vuto lanu mpaka matenda enaake, ndikhulupirireni, zimachitika osati pakati pa zidakhwa kapena anthu osowa pokhala. Chofunikira chachikulu cha Heptral, monga momwe taonera malangizo, ndi ademethionine. Idapangidwa osati kale kwambiri, koma idakwanitsa kudzitsimikizira mmaiko ambiri komanso ndi odwala osiyanasiyana, monga khungu lobwezeretsa chiwindi. Pambuyo pake, ndinamwa mankhwala ambiri a hepatoprotective mu mawonekedwe a jakisoni ndi mapiritsi. Ndipo aliyense anali kundikhumudwitsa, chifukwa mwina palibe chomwe chinachitika, kapena amangogwira ngati mankhwala a choleretic. Mutu wapadera ndi mankhwala odziwika bwino a Essentseale. Mukasewera pa intaneti pang'ono, mudzapeza zambiri, zomwe zimatsimikiziridwa kale ndi makampani ambiri odziimira komanso madokotala, kuti iyi ndiye njira yayikulu pakati pa mankhwala othandizira hepatoprotective. Zambiri zomwe zatsimikizidwa pamalondawa ndizongopeka chabe za omwe adapanga Essentseale okha. Koma kubwerera ku Heptral. Mulinso ndi l-lysine. Ichi ndi amino acid. Pazonse, makamaka ma amino acid omwenso ali ndi mphamvu "yokhudzana" ndi mavitamini. Koma, mosiyana ndi mavitamini, m'thupi iwo eni sakhala opangidwa, kapena opangidwa ochepa kwambiri, ndipo ndizosatheka kuwapeza ndi chakudya. Ndekha, moyo wanga unakhala bwino kwambiri nditayamba kumwa amino acid padera. Chifukwa chake, nditapeza dzina l lysine ku Heptral, ndidakondwera kwambiri. Ochita masewera adzayamikiranso L-lysine, chifukwa ntchito yake yayikulu ndikuthandizira kupanga mapuloteni. Heptral amalengezedwanso ngati woponderezedwa. Ngati mukukhala ndi mavuto akulu okhumudwa, ndiye kuti sindikanapanga kubetcha kwathunthu pa Heptral, inde. Koma mosakayikira amapereka nkhawa zochepa. Kodi ndingapangire kuti? Anthu okhala ndi totupa kumbuyo kapena kumaso kwawo, ziphuphu zakumaso kapena zakuda. Ngati mukufuna chifukwa, ndikuwoneka kuti kulibe, zikutanthauza kuti chiwindi chanu chimatsekeka (chilengedwe, chakudya, mowa ndi nkhawa). Kuwombera phukusi la Heptral ndipo idzakhala chipulumutso chanu kwanthawi yayitali. About Heptral: kukonzekera palokha kumakhala ndi zochulukirapo zamadzimadzi ndi zochulukirapo ndi ufa. Chimodzi chikuwonjezeredwa kwa chinzake, ndipo tsopano muli ndi syringe yofunika m'manja mwanu. Simufunikanso kuchepetsa chilichonse - wopangayo asankha kale zonse za inu. Inemwini, ndimakonda kukankhidwa pamitsempha. Izi sizichitika ndi kukoka, koma kudzera mumtsinje kwambiri, pang'onopang'ono kwambiri. Poyambitsa, mutha kumva kupundula m'makachisi, nseru, kukoma kwa mankhwalawa mkamwa. Musawope kuyimitsa pang'ono mukamapereka mankhwalawa ndipo, koposa zonse, kumbukirani kuti izi ziyenera kuchitika pang'onopang'ono. Ndikofunikira kugwiritsa ntchito mankhwala onse kamodzi kapena kutaya chotsalacho, sichikhala nthawi yayitali. Pambuyo pa kukhazikitsa mankhwalawa, ndikofunikira kuti mugone kapena mukhale kwa mphindi pafupifupi 5. Koma panokha, sinditero. Pambuyo pa maphunziridwe a Heptral, ndimamva, mu ndege, kuti metabolism yanga ndiyabwino. Ngakhale kugona kwanga ndi khungu langa zidakhala bwino. Kuphatikiza zotsatirazi, ndikulangiza aliyense kuti agule Heptral mu fomu ya piritsi. Mtengo wake sunandiyimitseko, chifukwa maphunziro osachepera kamodzi pachaka amakulitsa moyo wanga!

Adatenga Heptral kudzera m'mitsempha - ndinamva bwino, ndimapiritsi, ndimamwa mapiritsi 2 patsiku, patatha masiku atatu mavuto atayamba: kusokonekera, kupweteka mutu, kusowa kudya, kusowa tulo, dotolo anasamutsa piritsi limodzi patsiku. Sindinapereke zopendabe mpaka pano. Mtengo wake ndi wokwera mtengo pang'ono.

Heptral kudzera m'mitsempha mwanga adandithandizira bwino ndimafuta a hepatosis. Koma jakisoni osatha adandimaliza. Ndinasinthira mapiritsi ndipo ndinakhumudwa - m'malo mwake ndi ofooka. Zotsatira zake, anasinthanso kupita ku Tioktatsid molumikizana ndi Maksar. Maksar ndi hepatoprotector wopangidwa ndi mbewu, wopanda vuto lililonse komanso wobwezeretsanso maselo a chiwindi. Zotsatira za chithandizo sizinatenge nthawi. Ndikumva bwino!

Ndili ndi poizoni wa hepatitis wa ma antibayotiki. Alt ndi ast mpaka heptral 320 ndi 150. Jekeseni wamitsempha kwa masiku 10, 800 mg aliyense. tsiku ndi tsiku.Pambuyo pake, zizindikirozo zidatsikira ku 147 ndi pafupifupi 70. Poyamba, flatulence anali wamphamvu, masiku atatu oyamba. Panalibe kugona, m'malo mwake, kunayamba kugona. M'mapiritsi, ndikuganiza kuti ndizopanda ntchito, chifukwa akunena kuti bioavailability ndi 5%, jakisoni 95%. Minus yekha, yemwe ndi wokwera mtengo, amatenga 1750 ma ampoules asanu.

Heptral ndinam'tsatira. Maphunzirowa anali masiku 15. Adagonekedwa kuchipatala. Kuchokera pa jakisoni wachiwiri, kutentha kwanga kunatsika ndipo sikunadzukenso. Kusanthula kunayamba kuyenda bwino. Tsopano ndimamwa mapiritsi. Amalandira chithandizo kwa nthawi yayitali ndikuzindikiridwa ndipo ndimamva chisoni kuti mankhwalawa ndi okwera mtengo kwambiri.

Sizinandithandizire, ndimangomamwa mapiritsi. Ndinkakonda a Maksar, m'malingaliro anga, ndiwothandiza kwambiri. Sindingafanane ndi majekeseni, koma mawonekedwe am'mapiritsi - ndithudi. Maksar ndi hepatoprotector pazomera zomera. Zizindikiro zanga mukamaliza maphunziro. Zowona ndi thioctonic acid.

Popeza ndimadwala matenda oopsa a hepatitis C kwa nthawi yayitali, ndikofunikira kumwa mankhwala ena nthawi ndi nthawi. Pamodzi ndi ena, adatenga Heptral. Ndikunena kuti mankhwalawa ndi amphamvu komanso othandiza. Kuphatikiza pakuchira msanga ma enzymes a chiwindi, amathandizanso ngati mankhwala ochepetsa mphamvu ya matenda. Izi ndizophatikiza. Koma, moona, mankhwalawo ndiwamphamvu kwambiri kotero adalekereredwa zovuta. Ndikufunanso kudziwa kuti Heptral ndiokwera mtengo kwambiri, ndipo ineyo pandekha sindikhala ndi mwayi wopeza ndalama mosalekeza. Pazonse, Heptral ndi njira yabwino yothandizira yomwe imathandizira ngakhale matenda a cirrhosis ndi hepatic cholestasis. Ndikupangira kwa iwo omwe angathe kugula ndalama zokwanira. Mtengo wake mwina ndiwokhawo woipa. Kupanda kutero, mtengo wake ndi 5.

Mankhwala amathandiza ndi hepatic colic. Ngakhale m'mawu osokoneza bongo za matenda awa palibe mawu. Momwe nditha kunyamula, kotero ndimadutsa maphunziro a masiku atatu. Ndimamwa piritsi limodzi katatu patsiku. Mwa njira, zimathandizira kukhumudwa, "imagwira ntchito" ngati mankhwala ochepetsa nkhawa. Chida chapadera.

Anatenga "Heptral" munthawi ya chithandizo cha chiwindi. Panalibe zotsatirapo konse, ziwengo zokha. Ndilowetsa ndi sodium chloride, ma ampoules 5, ndinayimitsa chithandizo panjira yachitatuyo. Munjira yonse, sindilekerera mankhwalawa. Ndakhumudwitsidwa, adalengezedwa kwa ine, ndipo zidakhala zonama. "Heptral" ndizovuta kulekerera ndi thupi ndipo silingatengere lokha. Pokhapokha poyang'aniridwa ndi achipatala.

Mankhwala amathandiza ndi hepatic colic. Ngakhale m'mawu osokoneza bongo za matenda awa palibe mawu. Momwe nditha kunyamula, kotero ndimadutsa maphunziro a masiku atatu. Ndimamwa piritsi limodzi katatu patsiku. Mwa njira, zimathandizira kukhumudwa, "imagwira ntchito" ngati mankhwala ochepetsa nkhawa. Chida chapadera.

Nthawi yapakati, ndinakumana ndi matenda monga cholestasis wapakati. Adayesera kuchitira ndi chilichonse, koma palibe chomwe chidathandiza. Chiwindi chidakana, zisonyezo za ALT ndi AST, zayamba kale kwambiri, zafika pamfundo yovuta. Adali m'mimba kwambiri asanabadwe. Pofuna kukhala wathanzi, wanga ndi ana adalembedwa Heptral. M'masiku awiri atangomwa mankhwalawa, zizindikirazo zidagwa kwambiri - pafupifupi nthawi 1.5, kuyimitsidwa kudayamba kuchepa, ndimatha kugona kale, osakwiya usiku wonse. Akadapanda kuti mankhwalawa, sizikudziwika kuti zonse zitha bwanji. Chifukwa cha Heptral, kuperekera kunachitika pa nthawi yake, sindinawone zotsatira zoyipa za kumwa mankhwalawa, zonse zili bwino ndi ine ndi ana. Ana adabadwa popanda jaundice. Chiwindi changa chimagwira ntchito ngati kale.

Ndimalola "Heptral", chifukwa chidzagwira cholecystitis. Izi zimachitika nthawi ndi nthawi, makamaka munthawi yophukira kapena yophukira. Mankhwalawa amathandizira modabwitsa, koma pali chinthu chimodzi - mapilitsi atatha kusokonezeka m'mimba, ndimamva kudwala kangapo, kotero ndinasankha kupereka jakisoni intramuscularly, itha kugwiritsidwa ntchito monga choncho. Njirayi ndiyabwino kwambiri kwa ine, imalowetsedwa m'magazi mwachangu, imayamba kuchita zinthu mwachangu ndipo palibe mavuto. Pamodzi ndi mankhwala ena a matendawa, Heptral adziyambitsa yokha bwino. Mankhwala okwera mtengo, koma ndibwino kugwiritsa ntchito ndalama ndikupeza zotsatira zomwe mukufuna.

Mankhwala othandiza komanso othandizadi kuti musunge chiwindi. Ndimatenga maphunziro chaka chilichonse kuti ndikonzenso chiwindi, chomwe ndimakhala nacho mavuto kuyambira zaka 25 zokhudzana ndi zovuta komanso zopweteka. Mtengo ndi wokwera, koma umagwirizana kwathunthu ndi mtunduwo, ndikuwona kuwongoleka kowonekera patatha sabata limodzi chiyambireni chithandizo.

Mankhwala othandiza kwambiri. Wachibale wanga ali ndi hepatitis C. Mwa mankhwala onse omwe adamwa, Heptral ndi othandiza kwambiri. Kumwa mankhwalawa 2 pachaka, kupewa, kapena kufalikira. Pakapita nthawi yachiwiri - kulandiridwa kwachitatu, kusintha kumadziwika. Kulakalaka kumawonekera ndipo wodwalayo amayamba kulemera, zomwe zimakhala zovuta ndi matenda ake. Komanso, luso logwira ntchito limasintha, ulesi ndi kutopa zimatha. Komabe, mankhwalawa ndiokwera mtengo kwambiri, nthawi zina mumayenera kugwiritsa ntchito mankhwala otsika mtengo.

Zotsatira za pharmacological

Hepatoprotector, ali ndi antidepressant ntchito. Ili ndi choleretic ndi cholekinetic kwenikweni. Ili ndi detoxifying, kubwezeretsa, antioxidant, anti-fibrosing ndi neuroprotective katundu.

Zimakwanira chifukwa cha kuchepa kwa ademethionine ndikuthandizira kupanga kwake m'thupi, komwe kumapezeka m'thupi lonse. Kuphatikizika kwakukulu kwa ademetionine kumadziwika m'chiwindi ndi muubongo. Imagwira gawo lofunikira mu kagayidwe kachakudya ka thupi, limatenga gawo lofunikira pazochita zosiyanasiyana: kusintha kwa transmethylation, transulfurization, transamination. Pazochitika za transmethylation, ademetionine imapereka gulu la methyl kuti liphatikizidwe ndi phospholipids of cell membrane, ma neurotransmitters, ma nucleic acids, mapuloteni, mahomoni, etc. Mukutulutsa kwa ademethionine, ndiwofotokozera wa cysteine, taurine, glutathione deloationation. kusintha kwazinthu ziwalo zamkati mwa tricarboxylic acid ndikubwezeretsanso mphamvu ya khungu).

Amawonjezera zomwe glutamine mu chiwindi, cysteine ​​ndi taurine mu plasma, amachepetsa zomwe zimapezeka mu methionine mu seramu, matenda a metabolic a chiwindi. Pambuyo pa decarboxylation, imatenga nawo mbali mu aminopropylation momwe amatsogolera polyamines - putrescine (cholimbikitsa masinthidwe amtundu wa cell and hepatocyte proliferation), spermidine ndi spermine, zomwe ndi gawo limodzi la mawonekedwe a ribosome, omwe amachepetsa chiopsezo cha fibrosis.

Imakhala ndi choleretic. Ademethionine amakhalanso kaphatikizidwe wa amkati phosphatidylcholine mu hepatocytes, womwe umawonjezera madzi amadzimadzi komanso polarization wa nembanemba. Izi zimathandizira ntchito ya mayendedwe a bile acid omwe amagwirizanitsidwa ndi nembanemba ya hepatocyte ndipo imalimbikitsa gawo la bile acid kulowa mu bile. Kugwiritsa ndi intrahepatic (intralobular ndi interlobular) zosintha za cholestasis (kuphwanya kaphatikizidwe ndi bile kuyerera). Ademethionine amachepetsa kuwonongeka kwa ma asidi a bile mu hepatocytes mwa kuwagwirizanitsa ndikuwadzaza. Kulumikizana ndi taurine kumawonjezera kusungunuka kwa bile acid komanso kuchotsedwa kwa hepatocyte. Njira ya kuwonongeka kwa bile acids kumapangitsa kuti impso zitheke, imathandizira kudutsaku kudzera mu nembanemba ya hepatocytes ndi excretion ndi bile. Kuphatikiza apo, sodium yamadzimadzi yeniyeni imateteza chiwindi cha cell chiwindi kuti zisawononge poizoni wa as-sulfated bile acids (m'matchulidwe omwe amapezeka mu hepatocytes ndi intrahepatic cholestasis). Odwala omwe amachepetsa matenda a chiwindi (cirrhosis, hepatitis) omwe ali ndi intrahepatic cholestasis syndrome, ademetionin amachepetsa kuopsa kwa khungu kuyimitsidwa ndi kusintha kwamitundu yodziwika bwino, kuphatikizapo mulingo wa bilirubin mwachindunji, zamchere phosphatase ntchito, aminotransferase. Mphamvu ya choleretic ndi hepatoprotective imatha mpaka miyezi itatu atasiya kulandira chithandizo.

Zawonetsedwa kuti ndizothandiza mu hepatopathies yoyambitsidwa ndi mankhwala a hepatotoxic.

Mankhwala kwa odwala omwe ali ndi vuto la opioid lomwe limayendetsedwa ndi kuwonongeka kwa chiwindi kumabweretsa kukonzanso kwa mawonekedwe amtundu wa chiwonetsero cha kusiyanasiyana, kusintha kwa magwiridwe antchito a chiwindi, ndi microsomal oxidation njira.

Ntchito ya antidepressant imawonekera pang'onopang'ono, kuyambira kumapeto kwa sabata loyamba la mankhwalawa, ndikukhazikika pakatha milungu iwiri ya chithandizo. Mankhwalawa ndi othandizanso kupezekanso kwamkati ndi ma neurotic depressions omwe amalimbana ndi amitriptyline. Imatha kusinthanso kubwereza nkhawa.

Cholinga cha mankhwala a osteoarthritis amachepetsa kupweteka, kumawonjezera kaphatikizidwe ka proteinoglycans ndipo kumatsogolera ku kusinthika kwina kwa minofu yama cartilage.

Pharmacokinetics

Mapiritsiwa amakhala ndi zokutira ndi filimu zomwe zimasungunuka m'matumbo okha, chifukwa ademethionine imatulutsidwa mu duodenum.

The bioavailability wa mankhwalawa akamamwa ndi 5%, amawonjezeka pamimba yopanda kanthu. C_max Ademethionine mu plasma amadalira mlingo ndipo amafikira 0.5-1 ml / l 3-5 mawola limodzi pakamwa limodzi mpaka 400 mpaka 1000 mg. C_max ademetionina mu plasma amachepetsedwa kukhala gawo loyamba mkati mwa maola 24

Momwe mapuloteni am'madzi a Plasma sangakwaniritsidwe, ≤ 5%. Imalowa mu BBB. Kuwonjezeka kwakukulu kwa kuchuluka kwa ademetionine mu madzi amchere kumadziwika.

Biotransformed mu chiwindi. Njira yopangira, kugwiritsira ntchito ndalama, komanso kupanga mapangidwe a ademetionine amatchedwa mzunguko wa ademethionine. Pa gawo loyamba la kuzungulira uku, ademethionine omwe amadalira ma methylases amagwiritsa ntchito ademethionine ngati gawo lapansi popanga S-adenosylhomocysteine, pomwe pamakhala hydrolyzed to homocysteine ​​ndi adenosine wokhala ndi S-adenosylhomocysteine ​​hydralase. Homocysteine, nayenso, amasintha kukhala methionine posamutsa gulu la methyl kuchokera ku 5-methyltetrahydrofolate. Zotsatira zake, methionine imatha kusinthidwa kukhala ademethionine, kutsiriza kuzungulira.

T_1/2 - Maola 1.5. Imapukusidwa ndi impso. Mu maphunziro a odzipereka athanzi labwino, kumeza kwa cholembedwa (methyl 14 C) S-adenosyl-L-methionine mu mkodzo kuwulula 15.5 ± 1.5% ya radioactivity atatha maola 48, komanso ndowe - 23,5 ± 3.5% ya radioactivity atatha maola 72. Chifukwa chake, pafupifupi 60% adasungidwa.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mapiritsi okutira a Enteric, ophatikizidwa ndi filimu, yoyera kuti chikasu chikasu, chowulungika, biconvex.

Omwe amathandizira: colloidal silicon dioxide - 4,4 mg, cellcrystalline cellulose - 93,6 mg, sodium carboxymethyl starch (mtundu A) - 17.6 mg, magnesium stearate - 4,4 mg.

Mapangidwe a Shell: kopolymer wa methaconic acid ndi ethyl acrylate (1: 1) - 27,6 mg, macrogol. 07 mg, polysorbate. 44 mg, simethicone (emulsion 30%) - 0,13 mg, sodium hydroxide - 0,36 mg, talc - 18.4 mg, madzi - QS

Ma PC 10 - matuza (1) - mapaketi a makatoni.

Ma PC 10 - matuza (2) - mapaketi a makatoni.

Mlingo

Mankhwala ndi mankhwala pakamwa. Mapiritsi ayenera kumezedwa lonse, osafuna kutafuna, ndikofunika kumwa nawo m'mawa pakati pa chakudya.

Mapiritsi a Heptral ® akuyenera kuchotsedwa pamchimake panalibe pakamwa. Ngati mapiritsiwo ali ndi mtundu wina kupatula woyera mpaka utoto wokhala ndi chikasu (chifukwa chodontha ndi zitsulo zotayidwa), mankhwalawa ndi Heptral ®.

Mlingo woyenera ndi mg / kg / tsiku.

Mlingowu umachokera ku 800 mg / tsiku mpaka 1600 mg / tsiku.

Mlingowu umachokera ku 800 mg / tsiku mpaka 1600 mg / tsiku.

Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

Odwala okalamba

Zochitika zamankhwala ndi kugwiritsa ntchito mankhwalawa Heptral ® sizinawonetse kusiyana kulikonse pakukwanira kwake mwa odwala okalamba komanso odwala aang'ono. Komabe, potengera kuthekera kwakukulu kwa chiwindi chobowola, impso kapena mtima, zina zokhudzana ndi zamankhwala kapena munthawi yomweyo ndi mankhwala ena, muyeso wa Heptral ® uyenera kusankhidwa mosamala kwa okalamba, kuyambira pamunsi pamiyeso ya mlingo.

Odwala omwe ali ndi vuto la impso

Kafukufuku wa odwala omwe ali ndi vuto la aimpso sanachitike, pankhaniyi, kusamala kumalangizidwa mukamagwiritsa ntchito mankhwala a Heptral ® mwa odwala.

Odwala omwe ali ndi vuto la chiwindi

Ma pharmacokinetics a ademetionine ndi ofanana mwa odzipereka athanzi komanso odwala omwe ali ndi matenda osachiritsika a chiwindi.

Kugwiritsa ntchito kwa mankhwala a Heptral ® mwa ana ndiwotsutsana (mphamvu ndi chitetezo sizinakhazikitsidwe).

Kuyanjana kwa mankhwala osokoneza bongo

Zochita zodziwika bwino za mankhwala Heptral ® ndi mankhwala ena sizinawoneke.

Pali lipoti la kwambiri serotonin syndrome mu wodwala akutenga ademetionine ndi clomipramine. Amakhulupirira kuti kulumikizanaku kungatheke ndipo kusamala kuyenera kuperekedwa kwa ademetionine limodzi ndi kusankha ma serotonin reuptake inhibitors, anticepressants a tricyclic (monga clomipramine), komanso mankhwala azitsamba ndi mankhwala okhala ndi tryptophan.

Zotsatira zoyipa

Mwa zina mwazovuta zomwe zimachitika ndi izi: nseru, kupweteka kwam'mimba komanso kutsegula m'mimba. Pansipa pali chidziwitso chofupikitsidwa pazochitika zoyipa zomwe zadziwika panthawi yoyesedwa komanso pakugwiritsa ntchito malonda a ademetionine m'mapiritsi ndi mitundu ya jekeseni ya jekeseni.

Pa mbali ya chitetezo chathupi: hypersensitivity reaction, anaphylactoid kapena anaphylactic zochita (kuphatikizapo matenda a khungu, kufupika, bronchospasm, kupweteka kumbuyo, kusapeza bwino mchifuwa, kuchepa kuthamanga kwa magazi, kuthamanga kwa magazi, tachycardia, bradycardia).

Kuchokera pakupuma dongosolo: laryngeal edema.

Kuchokera pakhungu: kusintha kwa jakisoni malo (osowa kwambiri ndi khungu necrosis), edema ya Quincke, thukuta kwambiri, kusintha kwa pakhungu, kusintha kwa khungu (kuphatikizapo zotupa, kuyabwa, urticaria, erythema).

Zofooka ndi matenda: kwamikodzo thirakiti.

Kuchokera kwamanjenje: chizungulire, kupweteka mutu, paresthesia, nkhawa, chisokonezo, kusowa tulo.

Kuchokera pamtima: "kutentha kwacha", phlebitis yamitsempha yopepuka, matenda amtima.

Kuchokera pamiyambo ya m'mimba: kutulutsa, kupweteka kwam'mimba, kutsegula m'mimba, mkamwa wowuma, dyspepsia, esophagitis, flatulence, m'mimba kukhumudwa, kutaya magazi m'mimba, mseru, kusanza, hepatic colic, cirrhosis.

Kuchokera kwamankhwala am'mimba: arthralgia, minofu kukokana.

Zina: asthenia, kuzizira, matenda ngati chimfine, malaise, zotumphukira edema, malungo.

Intrahepatic cholestasis mu nyengo ya prirrotic komanso cirrhotic, yomwe imatha kuwonedwa ndi matenda otsatirawa:

- kuchepa kwamafuta kwa chiwindi,

- kuwonongeka kwa chiwindi kwa mitundu yambiri, kuphatikizapo zakumwa zoledzeretsa, ma virus, mankhwala (maantibayotiki, antitumor, antituberculosis ndi ma antiviral, antidepressants, tractclic antidepressants, njira zakulera pakamwa),

- Matenda oopsa a cholecystitis,

- encephalopathy, kuphatikizapo zogwirizana ndi kulephera kwa chiwindi (kuphatikizapo mowa).

Intrahepatic cholestasis mwa amayi apakati.

Contraindication

- zovuta zamtundu zomwe zimakhudza kayendedwe ka methionine komanso / kapena kuyambitsa Homocystinuria ndi / kapena hyperhomocysteinemia (kuchepa kwa cystathionine beta-synthase, kusokonezeka kwa vitamini B metabolism₁₂),

- wazaka zochepera 18 (zambiri zachipatala mwa ana ndizochepa),

- Hypersensitivity ku zigawo zikuluzikulu za mankhwala.

Mochenjera, mankhwalawa ayenera kuikidwa pa vuto la kupuma, pakapita nthawi yayitali komanso pakamayamwa (kugwiritsa ntchito kungatheke pokhapokha ngati phindu lomwe lingakhalepo kwa mayi limaposa chiwopsezo cha mwana wosabadwayo ndi mwana), komanso kusankha mankhwala osokoneza bongo a serotonin reuptake inhibitors (SSRIs). (monga clomipramine), mankhwala azitsamba, ndi mankhwala okhala ndi tryptophan mwa odwala okalamba omwe ali ndi vuto la impso.

Kodi matenda ashuga amakhudza bwanji chiwindi?

Malinga ndi ziwerengero zamankhwala, mu shuga mellitus pamakhala kusowa kwa insulini pafupipafupi, kuchuluka kwa glucagon, chifukwa chomwe kufalikira kwa glucose m'thupi kumacheperachepera ndipo kuchuluka kwa mafuta kumawonjezeka.

Pakupanga mafuta a chiwindi hepatosis, kudzazidwa pang'onopang'ono kwa chiwalo ndi mafuta a metabolism zinthu kumachitika. Matendawa akamakula, chiwindi chimalephera kutulutsa zinthu zapoizoni kulowa m'thupi. Chimodzi mwazinthu zoyipa ndizakuti ndi hepatosis kwa nthawi yayitali zizindikiro za matendawa sizimawoneka. Chifukwa chake, nthawi zambiri zimakhala zovuta kuzindikira matenda oyambira m'magawo oyambira.

Mukukula, matendawa amatha kudziwoneka ngati zizindikiro zotsatirazi:

• pamakhala kumverera kowopsa m'derali lomwe lili pansi pa nthiti kumanja,
• Kupanga kwa gasi kumachuluka, limodzi ndi kutulutsa,
• pafupipafupi ndi nseru,
• mgwirizano ndi kuwonongeka kwa ntchito,
• Popita nthawi, kulekerera zakudya zamafuta ambiri,
• Pali mavuto pakhungu lanu ngati zotupa kapena matupi awo sagwirizana,
• masomphenya ayamba kugwa, lakuthwa kwake latayika.

Pofuna kuchiza hepatosis yamafuta, dokotala yemwe amakupatsani mankhwala amakupatsani mankhwala apadera.

Ndi hepatitis ndi cirrhosis, zizindikiro zotsatirazi zingachitike:

1. Jaundice
2. Pali kusinthana kwathunthu ndi chakudya.
3. Kufooka kwathunthu kwa thupi.
4. Kuphatikiza kumawonongeka ndikusintha.
5. Ascites amakula.
6. Kulankhula kumakhala kosasangalatsa.

Dziwani zoyambirira zamatenda akulu a chiwindi, katswiri wazachipatala amatha, kutengera madandaulo a wodwala, kuwonetsa zizindikiro ndi anamnesis. Kuzindikira kumatsimikiziridwa pambuyo panjira zapadera zodziwira matenda - ultrasound, kulingalira kwa maginito ndi michere.

Kuphatikiza apo, chinthu chofanana ndi matenda a chiwindi ndi kukwezedwa kwa mafuta m'thupi.

Kodi amathandizira bwanji?

Chithandizo cha chiwindi chikuyenera kutumizidwa ndi dokotala potengera zotsatira za diagnostics.

Njira ya achire iyenera kutsagana ndi kukana zizolowezi zoipa, kutsatira zakudya zomwe zidakhazikitsidwa, moyo wokangalika.

Kwa mankhwala, monga lamulo, mankhwala apadera amagwiritsidwa ntchito.

Kukonzekera kwapadera kumaphatikizapo:

• Hepatoprotectors,
• antioxidants, komanso mavitamini A ndi E,
• mankhwala omwe amaphatikizapo chinthu monga lipoic acid,
• mankhwala omwe amasintha mamasukidwe akayendedwe amwazi,
• ngati palibe contraindication (kuphatikiza miyala mu hepatic ducts), mankhwala a choleretic angagwiritsidwe ntchito.

Tiyenera kukumbukira kuti mu shuga mellitus, ndikofunikira kusankha mosamala mankhwala ochepetsa shuga kapena jakisoni wa insulin, chifukwa mankhwalawa amakono ambiri amawononga mphamvu ya chiwindi ndipo amatsutsana nawo pakakhala mavuto nawo.

Mankhwala ophatikizika amatha kuthandizidwa ndi njira zina zamakono:

1. Ultrasound ndi laser chithandizo.
2. Mankhwala azitsamba.
3. Hirudotherapy.

Kuphatikiza apo, wodwalayo ayenera kutsatira zakudya zapadera. Pali zinthu zomwe kumwa ndizoletsedwa. Izi zikuphatikiza:

• mkaka wamafuta ambiri ndi mkaka wowawasa,
• Zinthu zonse zokazinga,
• margarine, batala ndi mayonesi,
• nyama yamafuta kapena nkhuku,
• chakudya pompopompo ndi mankhwala osungirako,
• zophika mkate ndi zofikira (kuphatikizapo pasitala),
• mbale zonunkhira.

Chakudya chizikhala chovunda kapena kuwiritsa.

Odwala amalangizidwa kuti azidya nsomba zophika kapena nkhuku, mafuta a mkaka ochepa komanso mkaka wowawasa, masamba atsopano ndi zitsamba.

Zojambula ndi zotsatira za mankhwala Hepa Merz pa thupi

LMankhwala Hepa Merz a matenda a shuga amagwiritsidwa ntchito pakakhala mavuto ndi chiwindi chokwanira.

Chidachi ndi detoxifier-hepatoprotector.

Kuphatikizidwa kwa mankhwalawa kumaphatikiza zigawo ziwiri zazikulu - amino acid ornithine ndi katswiri wa aspartate. Amateteza chiwalo, amathandizira kuti achepetse katundu woopsa pachiwindi, komanso amathandizira kusintha kwa maselo.

Kuphatikiza apo, kugwiritsa ntchito Hepamerz kumathandizira kuchepetsa mawonekedwe a insulin, omwe nthawi zambiri amawonetsedwa mwa odwala omwe ali ndi matenda a shuga 2.

Mankhwala amagwiritsidwa ntchito pamaso pa matenda otsatirawa:

1. Chithandizo cha matenda a shuga 1.
2. Chithandizo cha matenda a shuga 2.
3. Pazoyambitsa matenda osokoneza bongo pamaso pa poyizoni wa zoyambira zosiyanasiyana - chakudya, mankhwala osokoneza bongo kapena mowa.
4. Kuchita ntchito yoteteza pa matenda a chiwindi mu mitundu yovuta kapena yosakhazikika.
5. Ndi chitukuko cha chiwindi.

Kupititsa patsogolo zotsatira za mankhwala achire, mankhwalawa amaphatikizidwa ndi silymarin. Maphunziro athunthu kotero amatha kusintha kagayidwe ka oxidative lipid ndi kusungidwa kwa ziwalo zamaselo a chiwindi motsutsana ndi maziko azovuta za antitoxic. Kuphatikiza apo, kuchira kwazomwe zimakhala ndi ziwalo zomwe zakhudzidwa kumapangidwira.

Mankhwalawa amapangidwa ndi kampani yopanga mankhwala ku Germany ndipo imawonetsedwa pamsika m'njira ziwiri zazikulu:

• ma granule okhala ndi zipatso za zipatso zingapo.
• yang'anani pakukonzekera kulowetsedwa.

Dokotala wokhazokha ndi amene ayenera kukupatsirani mankhwalawo, chifukwa lingaliro lake lodziyimira pakumagwiritsa ntchito lingayambitse zovuta komanso kukulitsa chiopsezo cha mavuto. Nthawi zina, mankhwalawa amatha kugwiritsidwa ntchito ngati njira yothandizira kuti muchepetse zovuta poizoni.

Kuchuluka kwakukulu kumatheka pokhapokha ngati mukudya.

Malangizo ogwiritsira ntchito mankhwalawa

Musanagwiritse ntchito mankhwalawa, muyenera kudziwa zambiri zomwe zimafotokozedwazi.

Kutengera mtundu wa mankhwalawa amasulidwe, komanso chithunzi cha wodwalayo, adotolo amafotokozera kuchuluka kwa mankhwalawa komanso kuchuluka kwa mankhwalawa.

Monga lamulo, granles amatengedwa mogwirizana ndi malingaliro omwe afotokozedwa mu malangizo ogwiritsira ntchito.

Malangizowa ndi awa:

1. Mankhwalawa ayenera kusungunuka mu kapu yamadzi oyera.
2. Mankhwalawa amagwiritsidwa ntchito katatu patsiku, pomwe mlingo waukulu patsiku sayenera kupitirira ma sache awiri.
3. Mankhwalawa amatengedwa pambuyo pa chakudya chachikulu, ndipo osapitirira mphindi makumi awiri ayenera kuchokera ku nthawi ya chakudya.
4. Njira ya mankhwala sayenera upambana masiku makumi awiri. Ngati ndi kotheka, dokotalayo atha kukulemberani mankhwala achiwiri pambuyo pa miyezi iwiri kapena itatu.

Hepamerz mu ampoules imagwiritsidwa ntchito jekeseni ngati mitundu yotsikira. Njira yothetsera vutoli iyenera kuchepetsedwa mu saline ndi kuwonjezera kwa shuga, yankho la Ringer. Pankhaniyi, tsiku lililonse mankhwalawa a mankhwalawa sayenera kupitirira okwanira asanu ndi atatu. Kutalika kwa njira ya mankhwalawa ndi chimodzimodzi ngati mukumwa mankhwalawa mu mawonekedwe a granules.

Pa mimba ndi mkaka wa m`mawere, kumwa mankhwala ali osavomerezeka. Ngati mayi woyembekezera yemwe ali ndi matenda ashuga atenga Hepamerz, mwayi wokhala ndi matenda a shuga wa fetal ukhoza kuchuluka.

Nthawi zina, dokotalayo amatha kukhazikitsa chithandizo cha mankhwalawa panthawi yakubala, ngati pali choopseza ku moyo wa mayi, omwe umawonjezera zovuta za kukula kwakhanda kwa mwana wosabadwayo. Komanso mankhwalawa sagwiritsidwa ntchito pochiza ana osakwana zaka 16.

Milandu ikuluikulu yomwe mankhwalawa akaletsa kugwiritsa ntchito mankhwalawa ndi monga:

• kulephera kwambiri kwa aimpso,
• pamaso pa tsankho limodzi kapena zingapo za mankhwalawa.
• molumikizana ndi magulu ena a mankhwala.

Kulephera kutsatira Mlingo womwe wakonzedwa kumatha kubweretsa mavuto, monga kutsegula m'mimba komanso kupweteka kwam'mimba, kuphwanya mseru, nseru ndi kusanza, mayankho amkati, komanso kupweteka m'malo.

Zambiri pa ubale pakati pa chiwindi ndi matenda a shuga zafotokozedwa muvidiyoyi.

Wotsutsa nkhani yasayansi pankhani zamankhwala ndi zaumoyo, wolemba pepala lasayansi ndi Zharinova V.Yu., Igrunova K.N., Bodretskaya L.A., Chizhova V.P., Samots I.A., Butaletsky A .Yu., Benkovskaya N.N., Tabakovich-Waceba V.A.

Nkhaniyi imagwiritsidwa ntchito pochiza matenda osokoneza bongo a mafuta osokoneza bongo monga chovuta kwa odwala omwe ali ndi matenda amtima komanso a 2 matenda a shuga. Zotsatira zakufufuza za momwe Hepa-Merz® imakonzera magwiridwe antchito a chiwindi, endothelium, magazi, magazi, kapangidwe ka magazi, kapangidwe ka endotoxemia ndi matenda omwe ali mgululi. Zotsatira zake zimatsimikizira kuthekera kwa kukonzekera kwa Hepa-Merz ® pakukonzekera kwa chiwindi kwa odwala omwe ali ndi vuto la mtima komanso mtundu wa 2 matenda a shuga.

Kugwiritsa ntchito koyamba kwa L-Ornithine-L-Aspartate mu Odwala omwe ali ndi Matenda Ovuta Kuthana ndi Matenda a shuga ndi Mtundu Wachiwiri wa Matendawa

Nkhaniyi imakamba za kuchiza kwa matenda osokoneza bongo a nonalcoholic monga chiwopsezo kwa odwala omwe ali ndi vuto la mtima komanso matenda a 2 a mellitus. Zambiri kuchokera ku kafukufuku wokhudzana ndi Hepa-Merz® pa chiwindi, endothelium, magazi, magazi, momwe magazi amayendera, ma endotoxemia ammawu komanso zaumoyo mwa odwala zimaperekedwa. Zomwe apezazi zikutsimikizira kuthekera kwa chiwopsezo cha Hepa-Merz® pazovuta za chiwindi mwa odwala omwe ali ndi vuto la mtima komanso matenda a 2 a mellitus.

Zolemba za ntchito yasayansi pamutu wakuti "Kugwiritsa ntchito koyambirira kwa L-ornithine-L-aspartate kwa odwala omwe ali ndi matenda amtima komanso mtundu 2 matenda a shuga"

ZHARINOVA V.YU., IGRUNOVA K.N., BODRETSKAYAL.A., CHIZHOVA V.P., SAMOTS I.A., BUTINETSZH.S., GALETSKY A.YU., BENKOVSKAYA N.N., TABAKOVICH-VACECA IN .A. State Institution “Institute of Gerontology dzina lake D.F. Chebotareva NAMS aku Ukraine ", Kiev

KUGWIRITSA NTCHITO KWA LORI L-ORNITINAC PAKATI PA ZITSITSO ZA CARDIOVASCULAR PATHOLOGY NDI TYPE 2

Chidule Nkhaniyi imagwiritsidwa ntchito pochiza matenda osokoneza bongo a mafuta osokoneza bongo monga chovuta kwa odwala omwe ali ndi matenda amtima komanso a 2 matenda a shuga. Zotsatira zakufufuza zamomwe kukonzekera kwa Hepa-Merz ® zimathandizira pakhungu, endothelium, magazi, magazi, kapangidwe ka magazi, kapangidwe ka matenda a endotoxicosis, komanso momwe matenda alili m'gulu lino la odwala amaperekedwa. Zotsatira zake zimatsimikizira kuthekera kwa kukonzekera kwa Hepa-Merz ® pakukonzekera kwa chiwindi kwa odwala omwe ali ndi vuto la mtima komanso mtundu wa 2 matenda a shuga.

Mawu ofunikira: matenda a shuga, matenda a mtima, hepatoprotectors, matenda osokoneza bongo a mafuta a chiwindi.

About Fi ® Kafukufuku Wakale

Nyuzipepala yapadziko lonse ya endocrinology

Kwa zaka zambiri, matenda amtima wamagetsi akhala akutsogolera kwambiri pazomwe zimayambitsa kufa kwa chiwerengero cha mayiko otukuka. Malinga ndi akatswiri, chimodzi mwazifukwa zofunika kwambiri pakusiyana pakati pa njira zamakono zogwiritsira ntchito pochiritsira ndi zotsatira zenizeni ndizosagwirizana ndi mfundo zamankhwala abwino posankha mitundu yachipatala.

Chithandizo choyenera cha mankhwalawa chimaphatikizapo kusankha kwa kuphatikiza kwa mankhwalawa komwe kumakupatsani mwayi wokwanira wabwino wokhala ndi chiwopsezo chochepa cha zovuta komanso zovuta. Tsoka ilo, nthawi zambiri chikhumbo chofuna kukwaniritsa izi chimakhazikitsidwa ndikukhazikitsidwa kwa mitundu yonse ya mankhwala osaganizira zomwe munthu akuchita, metabolism, bioavailability, kuthamanga komanso kukwanira kwa kusaloledwa komanso kuthetsa mankhwala. Nthawi yomweyo, ndizinthu izi, makamaka pamalingaliro a comorbid pathology, omwe amathandizire pakuchita bwino komanso chitetezo cha mankhwala omwe adalandira.

Thupi lalikulu lomwe limayang'anira dziko la pharmacokinetics ndi pharmacodynamics ya mankhwala ndikuwunika mtundu wa zomwe zimachitika pakati pa mankhwala ndi chiwindi. Mu chiwindi, kuphatikiza kagayidwe wa pafupifupi magulu onse akulu azachipatala omwe ali m'gulu la machitidwe a mankhwala

matenda a mtima: antiplatelet drug and anticoagulants, beta-adrenergic blocking agents, chiwerengero chachikulu cha ACE zoletsa ndi angiotensin II receptor blockers, calcium channel antagonists.

Nawonso, tizilombo toyambitsa matenda akuluakulu a mtima timagwirizana ndi kusintha kwa chiwindi - 60 mpaka 95% cha odwala omwe ali ndi dyslipidemia, kunenepa kwambiri, atherosclerosis, mtundu 2 matenda a shuga amakhala ndi steatohepatosis kapena steatohepatitis tsiku ngati vuto losagwiritsa ntchito mafuta a chiwindi osagwirizana ndi mowa (NAFLD) 5, 16. Zotsatira za kupenda kwakutali kwawonetsa kuti NAFLD sikungoyenda ndi zamatenda amtima: kuchuluka kwambiri kwamafuta m'chiwindi, kutsegula Ine ufulu kwakukulu makutidwe ndi okosijeni, kutupa kumam'phunzitsa kusintha owononga hepatocytes, zina ndi kugwira ntchito yachibadwa ya thupi. Izi zimakulitsa zovuta za metabolic ndipo zimathandizira kukula kwa matenda oyambitsidwa. Chikhalidwe chowoneka bwino cha kupendekera kwa NAFLD m'matenda amtima ndi

fibrosis ndi cirrhosis ya chiwindi ndizovuta kwambiri pang'onopang'ono zomwe zimayipa kwambiri thanzi ndikuchepetsa chiyembekezo chokhala ndi moyo cha odwala. Chiwopsezo chachikulu kwambiri chotenga chiwindi cha chiwindi chimakhala mwa akazi azaka zopitilira 45 ndi metabolic syndrome, matenda a shuga a 2, matenda oopsa (AH) ndi zizindikiro za cytolysis syndrome m'maphunziro a labotale.

Pokhudzana ndi zomwe tafotokozazi, zikuwonekeratu kuti gawo lofunikira la njira zochizira matenda othandizira matenda a mtima, matenda a shuga a 2, makamaka ovuta chifukwa cha matenda oopsa, ndiko kukonza kwa magwiridwe antchito a chiwindi.

Njira zamakono zothandizira kupewa komanso kuchiza NAFLD zimaphatikizapo: kuchepa thupi, kubwezeretsa chidwi cha insulin (metformin), kukonza lipid metabolism (statins) ndi kugwiritsa ntchito hepatoprotectors. Ngati mfundo zitatu zoyambirira ndizovuta zambiri zomwe zimakhudzidwa ndi akatswiri a mtima ndi ma endocrinologists, ndiye ndi kusankha kwa hepatoprotector, monga lamulo, zovuta zimadza chifukwa chosowa malangizo omveka bwino pakusankhidwa kwa mankhwalawo komanso nthumwi za oimira gulu lino la mankhwalawo.

Tiyenera kudziwa kuti masiku ano palibe gulu lililonse la anthu lotchedwa hepatoprotectors. Kutengera ndi kapangidwe ka mankhwala ndi komwe adapangidwira, magulu angapo a hepatoprotectors amadziwika:

- kukonzekera zitsamba,

- Kukonzekera nyama,

- makonzedwe okhala ndi phospholipids (EFL),

- amino acid kapena zotumphukira zawo,

- mavitamini a antioxidant ndi mankhwala okhala ngati vitamini,

- mankhwala a magulu osiyanasiyana.

Nthawi zambiri, pazachipatala, mankhwala azitsamba amagwiritsidwa ntchito (mpaka 54%), pomwe mankhwala opangira phospholipid amakhala 16%, ndi mankhwala ena, kuphatikizapo omwe amapangidwa, organopharmaceuticals, ndi amino acid akukonzekera 30% yonse ya hepatoprotectors "owona" .

Amakhulupirira kuti mankhwala aliwonse omwe amaperekedwa ngati hepatoprotector ndi othandizira komanso otetezeka ku matenda aliwonse. Nthawi yomweyo, machitidwe akuwonetsa kuti kutali ndi mankhwala onse a kalasi iyi pali umboni wotsimikizira wa kusintha kwa mbiri ya chiwindi. Kuphatikiza apo, popereka hepatoprotector kwa odwala omwe ali ndi matenda osiyanasiyana amtundu, kupezeka kwa zotsatira zosangalatsa kuyenera kukumbukiridwa, zomwe zingathandize kuthandizira kwambiri matenda oyambitsidwa.

Poganizira zomwe tafotokozazi, posankha hepatoprotector kwa odwala omwe ali ndi mtima wam'matumbo, kukonzekera kwa Hepa-Merz® (Merz Pharma GmbH & Co, KGaA) kuyenera kuyang'aniridwa, komwe, limodzi ndi zotsatira za hepatoprotective (zolimbikitsira odwala osagwira kapena okhudzidwa)

maselo a chiwindi, zomwe zimathandizira kusintha kobwereza komanso mphamvu ya kagayidwe kazakudya m'maselo a chiwindi) mwakuwongolera njira zamagetsi ndi ziwalo, kuphatikiza mu myocardium, ndikuchepetsa kupita patsogolo kwa mtima wamitsempha yamagazi chifukwa kukhalapo kwa katundu wotsimikiziridwa wa endothelioprotective.

Kuwona kopambana kotereku kumachitika ndi mankhwalawa, ma amino acid L-Ornithine ndi L-Aspartate, omwe ali zigawo zake. Kukhazikitsidwa kwa ma amino acid m'thupi ndi kuphatikizika kwawo kuzungulira kwa Krebs, gwero lalikulu lamphamvu kupanga mphamvu mwa anthu, kumabweretsa kutsegulira kwa kapangidwe ka mamolekyulu apamwamba, kuchuluka kwa kagayidwe kazinthu komanso kuwonjezeka kwa mphamvu yamagetsi yopanga mphamvu ya myocardium, ndi kuchepa kwa kudalira kwa maselo pakupanga mphamvu ndi anaerobic glycolysis. Zomwe zimasonyezedwa kagayidwe kachakudya ndizofunikira kwambiri kwa odwala omwe ali ndi mtima wam'matumbo, popeza kuwonongeka kwa mphamvu ndi njira ya pathogenetic yamatenda amtima dongosolo ndipo imawonjezera matendawa.

Mtsutso wina m'malo mwa kufunikira kwa kusankha koyambirira kwa L-ornithine-L-aspartate m'gululi la odwala ndi kukhalapo kwa playropic (yowonjezereka) endothelioprotective katundu wophatikizidwa ndi kuwonjezeka kwa L-arginine, gawo laling'ono la kaphatikizidwe ka NO, yomwe ili chizindikiro chachikulu pakugwira ntchito kwa endothelium . Mpaka pano, zatsimikiziridwa kuti kuwonjezeka kwa L-arginine mu plasma ya magazi kumawongolera maphunziro a matenda a mtima (CHD), matenda oopsa (AH), kulephera kwa mtima, matenda ashuga, komanso kumawonjezera mphamvu ya endothelioprotential ya ACE inhibitors, statins, calcium antagonists, etc. .. Chifukwa chake, kukhazikitsidwa kwa kukonzekera kwa Hepa-Merz® kwa odwala omwe ali ndi matenda amtima kumathandizira kwambiri.

Kuphatikiza apo, mankhwalawa adanenanso kutulutsa katundu, komwe ndikofunikira kwambiri kwa odwala omwe ali ndi vuto la mtima. Amadziwika kuti kuchepa kwa nthawi yayitali pakukokoloka kwa mtima kapena kuchepa kwa ntchito kwa mtima ndi kukomoka kwa diastolic kumapangitsa kuti magazi azikondana kwambiri. Pansi pa izi, hypoxic hepatocyte degeneration, hydrostatic cytolysis, biliary thirakiti matenda oopsa, kuchepa kwa katulutsidwe ndi chimbudzi cha bile, thrombosis mu sinusoids, zomwe zimatsogolera kulowa kwa endotoxins kuchokera m'matumbo kudzera mu portal mtsempha, mapangidwe a portocaval anastomoses, ndi ammonia endotoosis.

Kukula kwa kuledzera kwa ammonia kwa odwala omwe ali ndi vuto la mtima kwambiri lomwe silikuwoneka ndi mtima kulephera sikuwonetsanso kulephera kwa chiwindi, komanso chizindikiro cha systemic endotoxemia, popeza nthawi yayitali yokhala ndi ziwalo zingapo.

aakulu mtima kulephera (CHF), kumabweretsa kutsegula kwa nayonso mphamvu njira komanso kuphatikiza kwambiri ammonia m'matumbo, kuphwanya gutamate mapangidwe mu ubongo, ndi kuchepa kwa detoxization ntchito impso 15, 17.

Matenda obwera kuledzera amakhala akuwoneka bwino ndi hepatic encephalopathy (MPE), yomwe imawonetsedwa pang'onopang'ono mu psychomotor zochitika, kuchepa kwa chidwi, kusowa bwino kwa luso la magalimoto, komanso kuwonongeka kwa mawonekedwe. Chithunzi chosinthidwa cha MPE sichimakopa chidwi cha madokotala, komabe, chithandizo chosagwiritsidwa ntchito mosavomerezeka kwa MPE kwa zaka zitatu mu 60% ya odwala kumabweretsa kudwala kwambiri kwa hepatic encephalopathy.

Kuchepetsa kuwonetseredwa kwa kuledzera kwa ammonia, kupatsidwa mawonekedwe ake mwatsatanetsatane, kumatheka pogwiritsa ntchito mitundu ingapo ya mankhwala: maantibayotiki - kuchepetsa kuipitsidwa kwa microflora ya m'matumbo, probiotics (lactulose) - kuchepetsa mapangidwe a ammonia mu colon ndi L-ornithine-L-katswesa ( Hepa-Merz ® - ndi cholinga chowongolera kagayidwe ka ammonia 4, 9, 16.

Iliyonse ya mankhwalawa imakwanira kuthetsa vuto la kuledzera ndi kuledzera kwamkati, komabe, pamaso pa zovuta zamtima zomwe zimapangidwa ndi kulephera kwa mtima kwa odwala omwe ali ndi matenda amtundu wa 2, zomwe amakonda, ziyenera kuperekedwa kwa choyambirira cha L-ornithine-L-aspartate, chomwe, kuphatikiza kwambiri. detoxification ntchito, ili ndi malo okondweretsa omwe aperekedwa pamwambapa.

Katundu wa kukonzanso kwa kukonzekera koyambirira kwa L-arnitine-L-aspartate (Hepa-Merz ®) kumalumikizidwa ndi kuyambitsa kwa urea kaphatikizidwe ka urea (Krebs-Henseleit), kamene kamapezeka mu zotumphukira za hepatocytes, chifukwa cha zomwe mankhwala okhala ndi poizoni okhala ndi kuwonongeka kwa nitrogen, makamaka ammonia, amasinthidwa. mu urea wopanda mankhwalawa osungunulira madzi - chinthu chomaliza chomanga thupi, chomwe chimapangidwa ndi impso.

Ornithine akuphatikizidwa mu kuzungulira kwa urea ngati gawo (pa gawo la citrulline synthesis), imakulitsa ntchito ndikupanga carbamoylphosphate synthetase enzyme (puloteni yoyamba ya kuzungulira kwa urea), mothandizidwa ndi yomwe ammonia imasinthidwa kukhala phosphate ya carbamoyl pamaso pa acetylglutamic acid, yomwe imakhala ndi acetylglutamic acid. Kusintha kotsatizana, ma mamolekyulu a urea amapangidwa omwe amatha kupukusidwa mokwanira ndi thupi.

Arginine imaphatikizidwanso mu kayendedwe ka Krebs - Hensezeit pa gawo la arginineced synthesis ndipo imakwaniritsa mphamvu yotsitsimutsa ya ornithine pa urea synthesis mkombero, imagwira nawo pakumanga kwa ammonia m'mitsempha yamagazi, hepatocytes, ubongo, ndi zina.

Malinga ndi zomwe zaperekedwa, kukonzekera kwa Hepa-Merz® kumakhala ndi njira zingapo zokuthandizira

nism: ili ndi hepatoprotective, detoxification, antioxidant, metabolic zotsatira, komanso imakhala ndi endothelioprotective katundu, yomwe imawonetsa kukhudzika kwa mankhwalawa kwa odwala omwe ali ndi vuto la mtima, mtundu wachiwiri wa matenda a shuga komanso matenda a mtima osalephera.

Cholinga cha phunziroli chinali kuphunzira momwe kukonzekera kwa Hepa-Merz® kumagwirira ntchito kwa chiwindi, endothelium, magazi, magazi, kapangidwe ka magazi, kapangidwe ka matenda a endotooticosis, komanso momwe matenda aliri odwala omwe ali ndi vuto la mtima, mtundu wachiwiri wa matenda ashuga komanso matenda a mtima.

Zida ndi njira

Kapangidwe ka phunzirolo kunali kuphunzira mphamvu za momwe chiwindi chikugwirira ntchito, endothelium, magazi m'magazi, boma la capillary magazi, zikwangwani za endotoxemia usanayambike kukonzekera kwa Hepa-Merz ®, atatha tsiku limodzi (loyamba la mankhwala) komanso lachisanu (tsiku lachisanu la mankhwala) kulowetsedwa kamodzi kwa mankhwalawa Mlingo wa 10 ml (1 ampoule).

Odwala a 45 azaka zapakati pa 60-74 zaka (amatanthauza zaka 68.4 ± zaka 4,2) adawunika ndi matenda a mtima ofunika: angina pectoris P - III FC, CHF 11A - PB st. ndi systolic dysfunction yamanzere yamitsempha yamagulu (gulu lalikulu), omwe adagonekedwa kuchipatala mu dipatimenti yamtima wa State Institution "Gerontology Institute adatchedwa D.F. Chebotareva NAMS yaku Ukraine ".

Mwa kuyesa mwachisawawa, odwalawa adagawika m'magulu awiri: gulu loyamba (odwala 15) adalandira chithandizo chovomerezeka motsatira malingaliro a Ukraine Association of Cardiology ochizira matenda amtundu, gulu lachiwiri (odwala 30), malinga ndi kapangidwe ka kafukufuku, chithandizo chokwanira cha kulephera kwa mtima chinathandiziridwa poika mankhwala oyamba a L- ar-nitin-aspartate mu mawonekedwe a infusions muyezo wa 10 ml 1 nthawi patsiku. Kuyesedwa kunachitika tsiku litayamba kulowetsedwa komanso kumapeto kwa maphunzirowo - asanu infusions.

Kusankhidwa m'maguluwo kunachitika potsatira kusakanikirana mosamala kwa ma anamnesis, komanso chidziwitso kuchokera ku mayeso azachipatala, othandizira ndi ma labotale (ECG, echocardiography, magazi ndi mkodzo mayeso). Kuyesedwa kwamankhwala kwa odwala kunachitika molingana ndi njira zovomerezeka zowunika za matenda a mtima ndi kulephera kwa mtima (Malangizo a Chiyukireniya cha Cardiology cha matenda a mtima ndi matenda a mtima, Kiev, 2013).

Ntchito yogwira ntchito ya endothelium (FSE) idayesedwa ndi laser Doppler flowmetry (LDF) pamagetsi awiri a laser Doppler flowmeter LAKK-2 (Russia) pamtunda wapakati wachitatu wamkati wamanja.

Ntchito yophatikizira mafupa am'magazi a venous idawerengedwa pogwiritsa ntchito njira yophatikizira yopitilira katatu ya 2003LA (Biola, Moscow)

njira zodzikongoletsera. Mlingo wazodzikongoletsa komanso wosakanikirana wophatikizana ndi mapuloteni unawunikiridwa.

Katundu wa magazi wamagazi amaphunziridwa pogwiritsa ntchito AKR-2 rotational viscometer (Russia) pamisiti ya 10 s-1, 20 s-1, 50 s-1, 100 s-1, 200 s-1 ndi kuwerengera kwa erythrocyte deformability index (IDE) ndi erythrocyte aggregation index (IAE). Mndandanda wa erythrocyte aggregation unawerengedwa ngati mtengo wamkati wamitsempha wamafuta a 20 s-1 ndi mamasukidwe amwazi pamsiti wa 100 s-1. Mlozera wopunduka ndi kuchuluka kwa kukwera kwa magazi pamakwerero a ubweya wa 100 s-1 ndi kugunda kwa ubweya wa 200 s-1.

Ma microcirculation mkhalidwe wa bulbar conjunctiva adaphunziridwa pogwiritsa ntchito nyali ya Zeiss TV slit (Germany). Zithunzi zinajambulidwa pogwiritsa ntchito mapulogalamu apakompyuta ndipo kenako anafufuza pogwiritsa ntchito pulogalamu ya pakompyuta yopangidwa ndi ogwira ntchito a bungweli (Pisaruk A.V., Chebotarev N.D., 2002).

Magawo a microcirculation system omwe adalandiridwa ndi kusanthula kwa morphometric nawonso adawunikiridwa, omwe adakonzedwa pamlingo woloza (Malaya L.T., Volkov V.S., 1977), zomwe zimapangitsa kuti pakhale kusintha kwamphamvu pamaubizinesi ochepa. Kusintha kwa ma cellvascular, komanso kusintha kwakaposachedwa komanso kwamkati, kudawerengedwa. Padera, index ya mtima wam'mimba, index yolumikizira yowonjezera, ndi index ya intravastival, komanso index yonse ya conjunctival, yomwe ili wofanana ndi chiwerengero cha kuchuluka kwa ma indices onse, adawerengedwa padera.

Mulingo wa ma molekyulu ochepera kulemera anatsimikiza kugwiritsa ntchito trichloroacetic acid (TCA). 0,3 ml ya 10% TCA adawonjezeredwa ndi 0,6 ml ya seramu, yosakanizidwa, yoyatsidwa kwa mphindi 5 pa -20 ° C. Kenako centrifuged kwa 20 min at

1700 g. 4.5 ml ya madzi osungunuka adawonjezeredwa ndi 0,5 ml ya supernatant. Miyesoyo inkachitika pazoyambira 280 ndi 254 nm. Kenako, chisonyezo chogawa chinawerengeredwa pogawa zotsatira za kuwala kwa 280 nm ndi cholembera kachulukidwe ka 254 nm. Mtengo wabwinobwino wa IR ndi 1.4 cu

Mkhalidwe wama cell a thupi adawunikidwa ndi zizindikiro za apoptosis induction index. Kuti muwone mulingo wa apoptosis ndi njira ya annexin, maselo amitsempha yamagazi a odwala adayikidwa pambali yolimba ya ficol-urographin (d = 1,077). Maselo a mononuclear a 105 adasankhidwa kuti adziwe index ya apoptosis induction. Anopoposis inducer adawonjezeredwa kumodzi wa timachubu ndipo adadziunjikira pa sing'anga yamafuta pa 37 ° C kwa maola 18.

Apneti wa apneti wa a Axxin adaphunzira pa PAS flow cytometer (Parteo, Germany) pogwiritsa ntchito chizindikiritso cha Annexin V-FITC Apoptosis Kit I cha zida zopangira apoptosis (BD Bioscience Pharmingen, USA).

Zomwe zapezedwa zidakonzedwa pogwiritsa ntchito pulogalamu ya Statistica 6.0 StatSoft USA. Kuwerengeredwa kwamawonekedwe azizindikiro ndi zolakwika zawo (M ± m). Kufunika kwa kusiyana pakati pa magulu kunayesedwa ndi mayeso a Student t-samples odziimira pawokha. Zosiyanazo pa p zidawonedwa kuti ndizofunika. Simukupeza zomwe mukufuna? Yeserani ntchito yosankha mabuku.

Malinga ndi zotsatira zomwe zapezeka, kulowetsedwa koyamba kwa kukonzekera kwa Hepa-Merz® kunapangitsa kuchepa kwakukulu pamlingo wa hepatic enzymes (Gome 1).Ndipo ngakhale kutchulidwa kuti cytolysis syndrome sikumadziwika ndi matenda amtima ndipo mulingo wazizindikiro mu gulu loyeserera anali wokwera pang'ono poyerekeza ndizowonetsa, zomwe zimafotokozedwazo zitha kuonedwa ngati zabwino

Gome 1. Mlingo wa chikhazikitso chomwe chikuwonetsa kugwira ntchito kwa chiwindi m'gulu loyeserera panthawi ya mankhwala

Gulu Lotsogolera (n = 30) Gulu lofananiza (n = 15)

Pamaso mankhwala Pa tsiku loyamba la mankhwala patsiku lachisanu la mankhwala Asanalandire chithandizo patsiku lachisanu la mankhwala

ALT 48.6 ± 2.3 38.4 ± 1.7 * 27.6 ± 1.6 * 60.55 ± 3.40 53.55 ± 4.60

AST 41.6 ± 1.6 34.6 ± 2.5 * 27.2 ± 1.1 * 49.55 ± 4.40 45.4 ± 3.7

GGT 72.5 ± 2.3 57.3 ± 2.6 * 46.8 ± 1.7 * 72.9 ± 10.5 63.3 ± 8.3

AL 101.8 ± 9.4 92.3 ± 3.3 71.3 ± 2.1 * 111.8 ± 9.4 95.8 ± 9.9

CRP 6.6 ± 1.4 3.6 ± 0.4 2.8 ± 0.3 * 5.9 ± 0.8 4.6 ± 0.7

Mapuloteni onse 72.6 ± 1.4 67.4 ± 2.4 69.4 ± 3.8 71.8 ± 2.4 66.6 ± 3.5

FG 5.1 ± 0.7 4.5 ± 0.3 3.5 ± 0.2 * 4.5 ± 0.3 4.0 ± 0.3

INR 1.6 ± 0.5 1.8 ± 0.3 1.8 ± 0.2 1.4 ± 0.2 1.6 ± 0.2

Ch. 4.8 ± 0.3 4.46 ± 0.30 3.92 ± 0.20 * 4.66 ± 0.30 4.44 ± 0.40

TG 3.2 ± 0.1 2.7 ± 0.2 2.2 ± 0.2 * 3.21 ± 0.30 3.2 ± 0.2

Zokuthandizani: * - tanthauzo la kusiyana p sindingapeze zomwe mukufuna? Yeserani ntchito yosankha mabuku.

mphamvu ya mankhwala pa magwiridwe antchito a hepatocytes, kuchepa kwa kugwirira kwake munthawi ya biliary.

Komanso, motsutsana ndi maziko a mankhwalawa ndi Hepa-Merz ®, kuchuluka kwa fibrinogen, CRP, cholesterol yathunthu ndi triglycerides yafupika kwambiri (Table 1), yomwe imatsimikizira kuchuluka kwa hepatoprotective komanso anti-yotupa.

Kuwonjezeka kwa kuchuluka kwa magazi a pakhungu pakukhathamira kwa minyewa yotakasika, yomwe imadziwonetsera kuchokera ku kulowetsedwa koyamba ndikufika pamankhwala ofunikira kwambiri panthawi yopereka mankhwalawa, kukuwonetsa kusintha kwa ntchito ya vasomotor ya endothelium ndikutsimikizira kukhalapo kwa endothelioprotective zotsatira za kukonzekera kwa Hepa-Merz® (Table 2).

Imodzi ndi kusintha kwa magwiridwe antchito a endothelium, chithandizo cha Hepa-Merz ® chimathandizira kuchepa kwamphamvu kwamitsempha yamagazi, zochita za maselo ofiira am'magazi komanso kusinthika kwa kukula kwa ziwalo zawo (Table 3).

Zosinthidwa zomwe zikuwonetsedwa mu mawonekedwe a hemovascular homeostasis yolumikizidwa ndi kubwezeretsanso kwa kuchuluka kwa ma cell a plasma, madzi amadzimadzi a membrane wama cell am'magazi komanso zoteteza za endothelium, adakhala chinthu chofunikira pakuwonjezeka kwa kufalikira kwa magazi a ziwalo ndi minofu. Mlingo wa ma microcirculation musanalandire chithandizo anali 2.6 perf.ed., pambuyo poyambitsa koyamba kumawonjezeka mpaka 3.2 perf.ed. pambuyo maphunziro

Gome 2. Yogwira ntchito ya endothelium munthawi ya mankhwala mwa odwala omwe ayesedwa (laser Doppler flowmetry data)

Chizindikiro chachikulu Gulu Lofanizira

Pamaso mankhwala Pa tsiku loyamba la mankhwala patsiku lachisanu la mankhwala Asanalandire chithandizo patsiku lachisanu la mankhwala

PMIS 2.6 ± 0.1 3.2 ± 0.1 * 3.5 ± 0.1 * 2.8 ± 0.2 3.2 ± 0.2 *

PMmax 6.7 ± 0.5 8.3 ± 0.4 * 10.8 ± 0.4 * 7.33 ± 1.50 8.6 ± 1.5

Zokuthandizani: * - tanthauzo la kusiyana p sindingapeze zomwe mukufuna? Yeserani ntchito yosankha mabuku.

100 s-1 3.6 ± 0.2 3.5 ± 01.14 ± 0.10 * 3.6 ± 0.2 3.5 ± 0,2

50 s-1 3.8 ± 0.1 3.75 ± 0.10 3.35 ± 0.20 * 3.8 ± 0.2 3.7 ± 0.1

20 s-1 4.11 ± 0.20 4.0 ± 0.2 3.59 ± 0.20 4.07 ± 0.20 3.97 ± 0.10

10 s-1 5.6 ± 0.2 4.16 ± 0.20 3.75 ± 0.10 * 4.13 ± 0.10 4.13 ± 0.20

IDE 1.03 ± 0.01 1.04 ± 0.01 1.05 ± 0.02 * 1.03 ± 0.10 1.04 ± 0.10

IAE 1.16 ± 0.02 1.13 ± 0.10 1.11 ± 0.03 * 1.16 ± 0.10 1.13 ± 0.10

Zokuthandizani: * - tanthauzo la kusiyana p sindingapeze zomwe mukufuna? Yeserani ntchito yosankha mabuku.

Poona kuti kusakhazikika kwa systemic capillary erythmic ndi komwe kumayambitsa kufa kwa odwala omwe ali ndi vuto lalikulu la mtima, kuwonjezeka kwa kuchuluka kwamankhwala omwe amawonedwa panthawi ya mankhwala a Hepa-Merz® kukuwonetsa kuwonjezeka kwa maselo ofiira a magazi omwe akudutsa gawo lililonse pachinthu chimodzi minofu, imatsimikizira kuthekera kokulimbikitsa kagayidwe kachakudya mu minofu, osati chifukwa chakugawana kwa ziwiya za mankhwala m'zinthu za metabolic, komanso chifukwa chakuwonjezeka kwa kutulutsa kwa okosijeni kwa chemisised ziwalo ndi minofu.

Kutsika kwa kuchuluka kwa minofu hypoxia ndikusintha kwa magwiridwe antchito a hepatocytes munthawi yamankhwala othandizira ndi L-ornithine-L-aspartate yoyambirira kunathandizira kuchepetsa kuopsa kwa kuledzera kwamkati, monga zikuwonekera ndi mphamvu ya ma molekyulu apakati (MSM): isanachitike chithandizo, mulingo wa MSM280 anali 0,346. e., ndipo atadutsa maphunzirowo - 0,3004 pa. e.

Kafukufuku wa mulingo wa MSM254 adawonetsa kusintha kofananako kwa MSM280, komabe, zosinthazo zidatchulidwa kwambiri ndipo atatha chithandizo mulingo wa MSM254 udatsika mpaka kuwongolera. Chifukwa chake, mulingo wa MSM254 musanalandire chithandizo anali wofanana ndi 0.522 cu, ndipo atatha kulandira chithandizo - 0.417 cu .

Monga mukudziwa, gawo lalikulu la kufa kwa cell mu hypoxia aakulu ndi kuledzera ndi apoptosis. Ndizachidziwikire kuti kuwongolera magazi ndikamachepetsa kuchuluka kwa kuledzera kwakutali komanso kuwonongeka kwa zotsalira zaulere zimapangitsa kuti zinthu zisinthe mthupi lathu lomwe limadziwoneka lokha

0,45 0,4 0,35 0,3 0,25 0,2 0,15 0,1 0,05

Pamaso pa chithandizo, 280 nm

Chithunzi 2. Mlingo wa MCM280 wokhala ndi ma amino acid onunkhira m'magazi a odwala omwe amathandizidwa pogwiritsa ntchito choyambirira cha L-ornithine-L-aspartate

Pamaso mankhwala 254nm

Chithunzi 3. Mlingo wa MSM wopanda mafungo amino acid mumitsempha yamagazi ya okalamba odwala matenda amitsempha yama cell omwe amathandizidwa pogwiritsa ntchito choyambirira cha L-ornithine-L-aspartate

Gawo 4. Zowonetsa za capillaroscopy ya bulbar conjunctiva mwa odwala omwe adayesedwa pamankhwala, kuphatikizapo choyambirira cha L-ornithine-L-aspartate

Chizindikiro chachikulu Gulu Lofanizira

Pamaso mankhwala Pa tsiku lachisanu la mankhwala Asanalandire chithandizo Pa tsiku lachisanu la mankhwala

Vaspi conjunctival index 10.53 ± 0.20 9.03 ± 0.20 * 11.03 ± 0.30 10.78 ± 0.20

Zowonjezera zowonjezera zamkati 1.00 ± 0.01 1.10 ± 0.01 * 1.10 ± 0.01 1.10 ± 0.01

Intravascular conjunctival index 3.71 ± 0.10 1.71 ± 0.20 * 3.82 ± 0.10 3.79 ± 0.10

General conjunctival index 15.43 ± 0.50 12.27 ± 0.22 * 15.11 ± 0.50 15.21 ± 0.40

Dongosolo la arterioles, μm 10.04 ± 0.20 11.57 ± 0.10 * 9.7 ± 0.3 10.5 ± 0.5

Dongosolo lolemekeza, μm 29.3 ± 0.4 27.6 ± 0.5 * 29.3 ± 0.4 28.9 ± 0,2

Arterio-venular coefflication 0.41 ± 0.01 0.44 ± 0.01 * 0.42 ± 0.01 0.42 ± 0.01

Chiwerengero cha ma capillaries omwe amagwira ntchito mu 1 mm2 8.0 ± 0.1 8.0 ± 0, 2 8.0 ± 0.1 8.0 ± 0.1

Chidziwitso: * - tanthauzo la kusiyana p sindingapeze zomwe mukufuna? Yeserani ntchito yosankha mabuku.

Ndizotheka kuti izi ndi umboni wazotheka kuchita zabwino

Pamaso mankhwala Pambuyo mankhwala

Mu Apoptosis Papoptosis ind.

Chithunzi 4. Mlingo wama cell am'magazi a odwala omwe amathandizidwa pogwiritsa ntchito L-ornithine-L-aspartate yoyambirira

Pamaso mankhwala Pambuyo mankhwala

Chithunzi 5. Mlingo wa IIA wama cell am'magazi omwe adathandizidwa pogwiritsa ntchito L-ornithine-L-aspartate yoyambirira

momwe mankhwalawa amakhudzira kuchuluka kwa moyo wa anthu amtunduwu.

Kutsiriza kumeneku kumathandizidwa ndi kusintha kwaumoyo wa odwala omwe awunika. Izi zikuwonetsedwa ndikuwonjezereka kwa zotsatira zoyeserera ndikuyenda kwamphindi 6, kuchepa kwa nthawi ya ischemia ndi kuchuluka kwa extrasystoles malinga ndi kuwunika tsiku ndi tsiku kwa ECG, komanso kuchepa kwa chiwerengero cha mafunso a Minnesota omwe ali ndi moyo wabwino wa odwala (Table 5).

Zotsatira za phunziroli zikuwonetsa kufunikira kwa kuphatikiza mankhwala a Hepa-Merz ® mankhwalawa odwala omwe ali ndi vuto la mtima ndi mtundu wa 2 matenda a shuga.

Zotsatira zake zimatsimikizira kuthekera kwa kukonzekera kwa Hepa-Merz ® pakukonzekera kwamatenda a chiwindi kwa odwala omwe ali ndi matenda amtima komanso matenda a 2 a shuga.

Kwambiri, izi zikuwonetsedwa ndi kusintha kwa odwala omwe ayesedwa: kuchuluka kwa zotsatira zoyeserera ndikuyenda kwamphindi 6 ndi 10%, kuchepa kwa nthawi ya ischemia ndi 68% ndi kuchuluka kwa extrasystoles malinga ndi kuwunika tsiku lililonse kwa ECG ndioposa 100%, komanso kuchepa kwa chiwerengero cha mafunso a Minnesota omwe ali ndi moyo wabwino odwala.

Kugwiritsa ntchito kwa labotale pokonzekera kwa Hepa-Merz® kumatsimikiziridwa ndi kusintha pazomwe zikuwonetsa ntchito ya chiwindi (poyerekeza ndi ziwerengero zoyambirira) ndi maphunziro a masiku asanu a 10 ml (1 ampoule patsiku): kuchepa kwa ALT ndi 44%, AST - mwa 35%, GGT - wolemba 37 %, Alkaline phosphatase - pofika 30%, CRP - ndi 230%, FG - ndi 32%, kuchuluka kwa INR ndi 12%, kutsika kwa cholesterol yonse ndi 19%, ndi triglycerides ndi 32%.

Kuthekera kwa endothelial zoteteza pakukonzekera kwa Hepa-Merz ®, kuthana ndi kuchuluka kwa magazi ndi ziwalo zowonjezera zamafuta zimatsimikiziridwa ndikuwonjezereka kwa kuchuluka kwa magazi othamanga kwamitsempha yamagetsi ndi pafupifupi 20-25%, kuchepa kwa magazi m'mitsempha yamagazi, ntchito zowonjezera.

Tebulo 5. Mphamvu zakuwonetsa za moyo wabwino mothandizidwa ndi mankhwala

Chizindikiro chachikulu Gulu Lofanizira

Pamaso mankhwala Pa tsiku lachisanu la mankhwala Asanalandire chithandizo Pa tsiku lachisanu la mankhwala

MO QL, landirani 227.4 ± 12.2 246.3 ± 7.2 * 211.03 ± 6.39 219.78 ± 3.20

Zitsanzo ndi 6 min. kuyenda, m 74.3 ± 2.2 79.4 ± 1.2 * 74.8 ± 3.5 75.3 ± 4.2

Kutalika kwa ischemia tsiku ndi tsiku, mphindi 22.3 ± 0.7 15.3 ± 1.2 * 25.3 ± 2.3 21.3 ± 1.9

Chiwerengero cha ventricular extra-systoles / tsiku 1348.4 ± 12.7 648.4 ± 3.4 * 1521.4 ± 8.7 1422.4 ± 6.7

Chiwerengero cha supraventricular extrasystoles / tsiku 2648.4 ± 14.3 748.4 ± 12.7 * 3248.8 ± 9.3 1355.4 ± 25.1

Zokuthandizani: * - tanthauzo la kusiyana p sindingapeze zomwe mukufuna? Yeserani ntchito yosankha mabuku.

erythrocyte ndi kusintha kwa elasticity awo nembanemba pafupifupi 20-30%. Izi zidapangitsa kuti magazi awonjezeke ndi ziwalo komanso minofu yowonjezera, poganiziridwa ndi indexcirculation index ndi data ya capillaroscopy. Kuwonjezeka kwa microcirculation kuchulukitsa pambuyo poyambitsidwa koyamba ndi 19% komanso patsiku lachisanu la mankhwala - ndi 26%.

Mlingo wa kuledzeretsa kwakanthawi kogwiritsa ntchito mankhwala ochepa a Hepa-Merz®, 10 ml patsiku kudzera mu magazi, kutsika ndi 12%, zomwe zikuwonetsa kuchepa kwa minofu hypoxia komanso kusintha kwa magwiridwe antchito a hepatocytes. Imatsimikiziranso kuthekera kwa kuyambitsa kagayidwe kachakudya ka minofu mu minofu, osati chifukwa chokhala nawo gawo la kukonzekera kwa Hepa-Merz® mumayendedwe a metabolic, komanso chifukwa chakuwonjezeka kwa kuperekera kwa oksijeni ku ziwalo ndi ischemic minofu.

Munthawi ya mankhwala a Hepa-Merz ®, kuchepa kwakanthawi kochepa kochititsa chidwi kwa ma cell a mononuclear cell, komanso index ya apoptosis yodziwitsa kuthekera kwa cell, mpaka 30% inawonedwa.

Poona kuti matenda a kukonzekera kwa Hepa-Merz ® akuyamba kuwonekera kuyambira kulowetsedwa koyamba, odwala omwe ali ndi mtima matenda atha kutumikiridwa nthawi yochepa ya 10 ml 1 nthawi patsiku kwa masiku asanu a mankhwalawa ndikupititsanso njira ya granular yoyambirira ya L -ornithine-L-aspartate.

1. tayari kulowetsedwa koyamba kwa kukonzekera kwa Hepa-Merz® kumabweretsa kuchepa kwakukulu pamlingo wa michere ya chiwindi.

2. Poyerekeza ndi momwe mankhwalawo amathandizira ndi Hepa-Merz ®, kuchuluka kwa fibrinogen, CRP, cholesterol yathunthu ndi triglycerides imatsika kwambiri, zomwe zimatsimikizira kuchuluka kwa hepatoprotective komanso anti-yotupa.

3. Mlingo wa kuledzera kwa amkati pogwiritsa ntchito mankhwala ochepa a Hepa-Merz ® kukonzekera kumachepetsedwa ndi 12%, zomwe zikuwonetsa kuchepa kwa minofu hypoxia ndikusintha kwa magwiridwe antchito a hepatocytes.

4. Poyerekeza ndi zamankhwala omwe amathandizidwa ndi Hepa-Merz ®, pali kuchepa kwakukulu kochitika mosazungulira ndi kupangika kwa apoptosis yama cell a mononuclear, komanso index ya apoptosis yodziwitsa kuthekera kwa maselo, mpaka 30%.

1. Mubarakshina O.A. Hepatoprotectors: mawonekedwe ofananirako ndi mbali zina zogwiritsidwa ntchito pakuchipatala // Medical Herald. - 2008. - Na. 34.

2. Wosankhidwa S.V. Clacical pharmacology ya hepatoprotectors // Wothandizira. - 2002. - Na. 3.

3. Perederii V.G., Chernyavsky V.V., Shipulin V.P. Kuyerekeza bwino kwa hepatoprotectors

Matenda owopsa a chiwindi // Ateroasna gastroenterology. - 2008. - Ayi. 3. - S. 81-83.

4.Arab J.P., Candia R., Zapata R. et al. Kuwongolera matenda a chiwindi osakhudzana ndi zakumwa: chiwonetsero chazachipatala chaumboni wokhudzana ndi zamankhwala // World J. Gastroenterol. - 2014 .-- 20 (34). - 12182201. doi: 10.3748 / wjg.v20.i34.12182.

5. Bass N. M., Mullen K. D., Sanyal A. et al. Chithandizo cha Rifaximin mu hepatic encephalopathy // New England Journal of Medicine. - 2010 .-- 362 (12). - 1071-1081.

6. Clark J.M. Mliri wamatenda amafuta osagwiritsa ntchito mafuta a chiwindi mwa akulu // J. Clin. Gastroenterol. - 2006 Mar. - 40, Suppl. 1.- S5-10.

8. Farrell G.C., Larter C.Z. Nonalcoholic fatty chiwindi matenda: kuchokera ku steatosis mpaka ku cirrhosis // Hepatology. - 2006 Feb. - 43 (2, Suppl. 1). - S99-S11.

9. Jalan R., Wright G., Davies N.A., Hodges S.J. L-Ornithine phenylacetate (OP): chithandizo chamankhwala cha hyperammonemia ndi hepatic encephalopathy // Med. Hypotheses. - 2007. - 69. - 1064-69.

10. Leise M, Poterucha J., Kamath P. Management ya Hepatic Encephalopathy mu Chipatala // Clin. Proc. - 2014 .-- 89 (2). - 241-253.

11. Malaguarnera M., Gargante M.P., Cristaldi E. et al. Chithandizo cha Ace-tyl-L-carnitine mu ochepa hepatic encephalopathy // Matenda a Magazi ndi Sayansi. - 2008 .-- 53 (11). - 30183025.

12. McPhail M., Leech R., Grover V. et al. Kusintha kwa neural activation kutsatira chithandizo cha hepatic encephalopathy // Neurology. - 2013 .-- 80 (11). - P. 1041-1047.

13. Miyake M., Kirisako T. Zoyesedwa zopanda mayesero pazotsatira za L-ornithine pazizindikiro zolemetsa komanso kugona mokwanira mwa ogwira ntchito athanzi // Nutr. J. - 2014 .-- 13 .-- P. 53-55.

14. Neuschwander-Tetri B.A., Caldwell S.H. Nonalcoholic steatohepatitis: Chidule cha Msonkhano Wapadera wa AASLD // Hepatology. - 2003 .-- 37 (5). - 1202-1219.

15. Ong J.P., Elariny H., Collantes R. et al. Okulosera zamankhwala osapatsa mowa a steatohepatitis apamwamba ndi fibrosis apamwamba mwa odwala omwe ali ndi vuto la kunenepa kwambiri. Surg. - 2005 Mar. - 15 (3). - 310-5.

16. Rinella M.E. Nonalcoholic fatty chiwindi matenda: kuwunikira mwadongosolo // JAMA. - 2015 Juni 9 - 313 (22). - 2263-73. doi: 10.1001 / jama.2015.5370.

17. Sharma P., SharmaC., Puri V., Sarin S.K. Cholembera chotseguka mosasamala choyeserera cha lactulose ndi ma phenootic mankhwalawa ochepa hepatic encephalopathy // European Journal ya Gastroenterology ndi Hepatology. - 2008 .-- 20 (6). - 506511.

18. Skowronska M., Albrecht J. Kusintha kwa zotchinga magazi mu ubongo mu hyperammonemia // Neurotox. res. - 2012 .-- 21 (2). - P. 236-244.

19. Thompson J.R. Malangizo a mankhwalawa a hepatic encephalopathy // Pharmacotherapy. - 2010 .-- 30 (5). - 4S-9S.

20. Zhang Y., Janssen P., WinglerK. et al. Modulating endothelial nitric oxide synthase: njira yatsopano yamankhwala othandizira mtima // Am. J. Physiol. Kuzungulira kwa mtima. Physiol. - 2011. - 301. - H634-H646.

Zalandiridwa 11/20/15 U

Zharnova V.Yu., 1grunova K.N., Bodretsky L.A., Chizhova V.P., Samots I.A., Butinets J.S., Galetsky A.Yu., Benkovska M.M., Tabakovch-Vaceba V.A. DU “Nstitutgerontologi''m. D.F. Chebotaryova NAMS aku Ukraine ", metro Kiv

KUSINTHA KWA DZIKO LAPANSI L-ORSTINCH ASHPARTOU KU ITS BURI i3 KUSANTHA KWA CARDUVASCULAR

PATHALOPEUS I CHURCH DIABETES TYPE 2

Chidule Nkhaniyi idaperekedwa ku zakumwa zopanda mowa! mafuta! masamba a ma cookie ngati ana opitilira muyeso mu odwala i3 omwe ali ndi zovuta za mtima ndi mtundu wa 2 matenda a shuga. Bweretsani kukonzekera kwa Gepa-Merz® kumphamvu yachitofu, stotelium, kubwezeretsanso magazi, magazi ena a capillary, marceri endotoxemia ndi msasa wabwino kwambiri! Gulu 'Paschentav. Kanizani zotsatirazi ndikuwatsimikizira kuti mutha kuyambitsa kukonzekera kwa Hepa-Merz® pa robot yoyesedwa bwino pa paschatna i3 yokhala ndi matenda amtima wamatenda komanso mtundu wa matenda a shuga 2.

Mawu a Kro40Bi: matenda a shuga, matenda am'mimba, hepatoprotector, mafuta osaneneka a chidole.

Zharynova V.Yu., IhrunovaK.N., Bodretska L.A., Chyzhova V.P., Samots I.A., ButynetsZh.S., HaletskyiA.Yu, Benkovska N.N., Tabakovych-Vatseba V.O. State Institution "Institute of Gerontology yotchedwa D.F. Chebotariov wa National Academy of Medical Science of Ukraine ”, Kyiv, Ukraine KUGWIRA NTCHITO KWA OTSOGOLA L-ORNITHINE-L-POPHUNZITSIRA Odwala omwe ali Ndi ZOCHITITSA CARDIOVASCULAR CHEMA NDI MISITU 2

Chidule Nkhaniyi imakamba za kuchiza kwa matenda osokoneza bongo a nonalcoholic monga chiwopsezo kwa odwala omwe ali ndi vuto la mtima komanso matenda a 2 a mellitus. Zambiri kuchokera ku kafukufuku wokhudzana ndi Hepa-Merz® pa chiwindi, endothelium, magazi, magazi, momwe magazi amayendera, ma endotoxemia ammawu komanso zaumoyo mwa odwala zimaperekedwa. Zomwe apezazi zikutsimikizira kuthekera kwa chiwopsezo cha Hepa-Merz® pazovuta za chiwindi mwa odwala omwe ali ndi vuto la mtima komanso matenda a 2 a mellitus.

Mawu ofunika: matenda a shuga, matenda am'mimba, hepatoprotectors, matenda osokoneza bongo a mafuta a chiwindi.

Hepa Merz wa matenda a shuga: mankhwalawa a matenda a shuga a chiwindi

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Matenda a diabetes a hepatopathy amatha kuchitika mwa munthu wodwala matenda a shuga a mtundu woyamba kapena wachiwiri. Zochizira hepatopathy, mankhwala Hepa Merz amagwiritsidwa ntchito.

Poona ndemanga za mankhwalawa, imathandiza kwambiri pochiritsa matenda. Mtengo wamba wa mankhwalawo ndi pafupifupi ma ruble 3,000.

Zofanana muzoyimira zamankhwala ndi Ornicketil ndi Ornithine.

Mimba komanso kuyamwa

Kugwiritsidwa ntchito kwa ademetionine mu Mlingo wambiri mu IV trimester ya mimba sikunachititse zotsatira zoyipa.

Kugwiritsa ntchito mankhwala Heptral ® munthawi yoyamba kubereka komanso panthawi yoyamwitsa kumatheka pokhapokha ngati phindu lomwe lingachitike kwa mayi lipitilira chiwopsezo cha mwana wosabadwayo kapena mwana.

Malangizo apadera

Popeza mphamvu ya mankhwalawa, simalimbikitsidwa kuti muzigwiritsa ntchito musanayambe kugona.

Mukamagwiritsa ntchito mankhwala Heptral ® odwala omwe ali ndi vuto la chiwindi motsutsana ndi hyperazotemia, kuyang'anira nitrogen yomwe ili m'magazi ndikofunikira. Pa nthawi yayitali ya mankhwala, ndikofunikira kudziwa zomwe zili urea ndi creatinine m'mitsempha yamagazi.

Ademethionine osavomerezeka mu odwala omwe ali ndi vuto la kupuma. Pali malipoti a kusintha kwa kukhumudwa kwa hypomania kapena mania mwa odwala omwe akutenga ademetionin.

Odwala omwe ali ndi nkhawa amakhala ndi chiopsezo chodzipha komanso zochitika zina zovuta, chifukwa chake, pakalandira chithandizo ndi ademethionine, odwala oterowo amayenera kuyang'aniridwa ndi achipatala pafupipafupi kuti athe kuwunika komanso kuchiza zizindikiro za kukhumudwa. Odwala ayenera kudziwitsa dokotala ngati zizindikiro za kukhumudwa zomwe adaziwona sizikuchepa kapena kukulira ndi ademetionine mankhwala.

Palinso malipoti a kusintha kwadzidzidzi kapena kuwonjezeka kwa nkhawa kwa odwala omwe amatenga ademetionine. Nthawi zambiri, kusiya kwa mankhwalawa sikofunikira; nthawi zambiri, mkhalidwe wa nkhawa umatha pambuyo pakuchepetsa kapena kusiya mankhwala.

Popeza kuchepa kwa cyanocobalamin ndi folic acid kumatha kuchepetsa zomwe zili mu ademetionine mwa odwala omwe ali pachiwopsezo (ndi kuchepa kwa magazi, matenda a chiwindi, kutenga pakati kapena kuthekera kwa kuchepa kwa vitamini, chifukwa cha matenda ena kapena zakudya, mwachitsanzo, masamba), zomwe mavitamini amapezeka m'magazi amayenera kuyang'aniridwa. Ngati kuperewera kwapezeka, tikulimbikitsidwa kuti mutenge cyanocobalamin ndi folic acid musanayambe mankhwala ndi ademetionine kapena kudya kwa ademetionine wa tsiku limodzi.

Mu kusanthula kwa immunological, kugwiritsa ntchito ademetionine kumatha kuthandizira pakutsimikiza kwabodza kwa chizindikiro cha homocysteine ​​yapamwamba m'magazi. Kwa odwala omwe akutenga ademetionine, tikulimbikitsidwa kugwiritsa ntchito njira zosasinthira kuti tidziwe zomwe zili mu homocysteine.

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu

Odwala ena amatha kumva chizungulire akamamwa Heptral ®. Sitikulimbikitsidwa kuyendetsa galimoto ndikugwira ntchito mosamala pomwa mankhwala mpaka wodwala akutsimikiza kuti chithandizo sichikhudza kuthekera kochita zinthu zamtunduwu.

Kodi hepatoprotectors ndi chiyani?

Pakadali pano, pali magawo awa:

• phospholipids,
• Amino acid zotumphukira
• mankhwala a nyama
• bile acid
• mankhwala azitsamba
• mankhwala apanyumba
• Zakudya zowonjezera zakudya.

Koma ziribe kanthu kuti ndi odwala angati omwe amafunsa, ndi mankhwala ati omwe amagwiritsidwa ntchito bwino pakukonzanso magwiridwe antchito, kukonza ndi kuchiza chiwindi, mankhwala abwino omwe angabwezeretse minyewa ya chiwindi mwachangu komanso moyenera, komabe.

Monga lamulo, kudya mankhwalawa kumachitika nthawi yonseyi kufikira zotsatira zoyipa za chiwindi cha munthu zizindikiridwa ndipo pakakhala kuwonongeka koteroko.

Mitundu ingapo ya mankhwala a hepatoprotective

Nthawi yomweyo, odwala omwe amafunikira kutetezedwa kwa chiwindi akamamwa maantibayotiki, kapena omwe akufuna kudziwa momwe angathandizire chiwindi akamwa mowa, ayenera kumvetsetsa kuti kumwa kamodzi kwa mankhwalawa munthu atamwa mowa, mankhwala osokoneza bongo, kudya kwambiri, sikuthandiza konse . Chifukwa chake, ndibwino kusachitira chiwindi pawokha, chifukwa wothandizirana ndi hepatoprotective ndi mankhwala othandizira panjira yovuta, ndipo ndi katswiri yekha yemwe ayenera kudziwa mtundu wa mankhwalawa omwe ali bwino komanso momwe angachitire.

Kodi hepatoprotectors iyenera kutengedwa ndipo ndi chiyani?

Pharmacology yamakono imapereka mndandanda waukulu wa mankhwala a chiwindi, omwe ndi hepatoprotectors.

Palinso ma hepatoprotectors am'badwo watsopano, mndandanda womwe nawonso ndi waukulu kwambiri. Tiyenera kukumbukira kuti mankhwalawa amalembedwa pafupipafupi mdziko lathu, chithandizo cha chiwindi ndi mankhwala ndiokwera mtengo kwambiri, koma sikuti zotsatira zake zimachitika pambuyo pa maphunziro.

Kusamvana pazabwino kwa chiwindi, komanso ngati kumveka m'mankhwala otere, kwachitika pakati pa madokotala kwa nthawi yayitali. Koma pakadali pano, mankhwalawa amalamulidwa ndi madokotala chifukwa cha matenda ndi mikhalidwe yotere:

• Virtual hepatitis - yoikidwa ngati ma antiviral chithandizo sichikugwira ntchito, kapena pali zifukwa zomwe sizimalola chithandizo cha antiviral. Nthawi zina zotchulidwa kupewa cirrhosis wa zovuta mankhwala. Amalembedwa mosasamala kanthu kuti chiwindi chimapweteka ndi hepatitis C.
• Mowa hepatitis, momwe mumakhala chiwopsezo cha matenda a chiwindi - kubwezeretsanso chiwindi ndikotheka kokha ngati munthu achotsa kudalira mowa ndipo osamwa mowa. Ngati mutenga hepatoprotectors ofanana ndi mowa, palibe zotsatira. Ndi zakumwa zoledzeretsa, kuwonongeka kwa chiwindi cha poizoni sikungathe kuchiritsa mankhwala abwino kwambiri.
• Matenda a chiwindi chamafuta (osagwirizana ndi uchidakwa) - amayamba kunenepa kwambiri, mtundu 2 shuga. Ndi matendawa, maselo amafuta amapanga m'chiwindi, chifukwa chomwe chimayamba pang'onopang'ono. Pankhaniyi, ndikofunikira kumwa hepatoprotectors kokha ndi chithandizo chovuta kwambiri - muyenera kutsatira zakudya, kuchepetsa thupi pang'onopang'ono, kuchita masewera olimbitsa thupi, kumwa mankhwala osokoneza bongo komanso kuchepetsa cholesterol.
• Hepatitis officinalis, chachikulu biliary cirrhosis - mankhwala oterewa amagwiritsidwa ntchito povuta. Kudya kwa matenda oopsa a chiwindi ndikofunikira.

Chifukwa chake, ziyenera kumvetsetsa kuti mankhwalawa amathandizira kuti mankhwalawa akhale opanda mphamvu ngati simumachepetsa kumwa mowa, osatsata zakudya. Ndikofunikanso kupereka chithandizo chokwanira ku matenda onse, chifukwa ndimatenda a chiwindi, ntchito ya chikhodzodzo ndi kapamba nthawi zambiri imalephera.

Ndi maiko ati omwe hepatoprotectors amathandizidwa?

Iyenera kukumbukiridwa, pogwiritsira ntchito wothandizira aliyense wa hepatoprotective, kuti gulu ili la mankhwala likupezeka ku Russia kokha, komanso m'maiko ena a CIS. Mndandanda wa gulu ili la mankhwalawa likusowa ku Europe ndi America.

Samaphatikizidwa m'ndandanda wazomwe zimagwiritsidwa ntchito pa matenda a chiwindi, chifukwa sizikutsimikiziridwa kuti mankhwalawa ndi othandiza.

Osati kawirikawiri, m'maiko ena, mankhwalawa amagwiritsidwa ntchito ngati zowonjezera zakudya. Ndizosangalatsa kuti kampani yochokera ku France, Sanofi, yomwe ndi imodzi mwa omwe akupanga mankhwala a Essentiale, amatumiza zochuluka za mankhwalawa ku mayiko a CIS, chifukwa palibe chifukwa chilichonse chofunira izi kulikonse padziko lapansi.

Mwambiri, ndikofunikira kumvetsetsa kuti makampani amakono azamankhwala ndi ntchito yopindulitsa kwambiri, chifukwa chake, pali mpikisano komanso maphunziro azikhalidwe pazakuchita bwino kwa mankhwala. Chifukwa chake, ndizovuta kudziwa kuti mankhwalawa ndi othandiza motani, komanso kuchuluka kwake. Kufotokozedwa kwa gulu lirilonse la mankhwalawa kumawonetsa malingaliro abwino ndi oyipa okhudza iwo kuchokera kosiyanasiyana.

Kusankha mankhwala abwino kwambiri pochizira chiwindi, ndikofunikira kuganizira malingaliro a dokotala. Ndiye amene pamapeto pake ayenera kudziwa dzina la mapiritsi a chithandizo. Nthawi yomweyo, mtengo wa mankhwalawa kwa chiwindi sichimagwira nthawi yayitali.

Phospholipids ofunikira

Asanatenge ma phospholipids ofunikira, ndi chiyani, dokotala ayenera kufotokozera wodwalayo. Ndikofunikira kudziwa kuti mtengo wa ma phospholipids ofunikira ndiwokwera kwambiri.

Ngati mukukhulupirira malangizo ndi malonda omwe amafotokoza momwe angathandizire chiwindi ndi hepatitis C, ndiye kuti ma phospholipids amagwiritsidwa ntchito pochiza hepatitis - poizoni ndi chidakwa, komanso radiation. Koma, pali zosiyana pamalingaliro amomwe ma hypoprotectors amachitira.

Chifukwa chake, malangizo a mankhwalawa amawonetsa kuti ma phospholipids ofunikira omwe amapezeka kuchokera soya ndi zigawo za khoma la hepatocytes.

Njira yawo yochitira izi ndi motere: ma phospholipids amalowa m'matumba a lipid a khoma la maselo omwe adawonongeka ndikuwongolera ntchito zawo.

Odwala ena amakhulupirira kuti ma phospholipids ofunikira amabwezeretsa maselo a chiwindi, koma kwenikweni amatha kukonza mkhalidwe wamakhoma a maselo.

Ngati munthu atenga phospholipids, ndiye kuti kuchepa kwa mphamvu ya chiwindi, ntchito za enzyme zimawonjezeka, ndipo zimatha bile. Kuti mupeze izi, muyenera kumwa mapiritsi kwa nthawi yayitali - osachepera miyezi isanu ndi umodzi.Zotsatira zazikulu zimawonedwa ngati jakisoni wa Essential Forte amalandiridwa kudzera m'mitsempha.

Mukamamwa phospholipids, kuthekera kwa mayankho ku α-interferon kumawonjezereka (ngati mankhwala a hepatitis C amachitika).

Komabe, pali malingaliro oyipa okhudza mankhwalawa. Makamaka, mu 2003, kafukufuku adachitika ku United States omwe sanazindikire zotsatira zabwino za mankhwalawa pakugwira ntchito kwa chiwindi. Asayansi adadziwikanso kuti mankhwalawa a hepatitis - pachimake komanso osachiritsika, kutupa kumakulirakulira, popeza mankhwalawa ali mgululi alibe choleretic katundu, komanso bile stagnates.

Kutengera maphunziro awa, kusankha kwa mankhwala amtunduwu pochizira matenda a chiwindi ndi chisankho cholakwika.

Palinso umboni kuti mavitamini osiyanasiyana a B omwe alipo, mwachitsanzo, ku Essliver Forte, saloledwa kuti angatenge nthawi yomweyo.

Olemba ena akuti mapiritsi monga Essentiale mothandizidwa samalowa m'chiwindi, amagawidwa thupi lonse. Ndikofunika kuti mutenge mavitamini a B osiyana ndi mapiritsi, mayina a mankhwalawa atha kupezeka kuchokera kwa dokotala.

Chifukwa chake, mankhwalawa a matenda a chiwindi omwe ali ndi mankhwalawa amatha kukhala osathandiza. Nthawi yomweyo, mtengo wa mankhwala a hepatoprotective ndiwokwera kwambiri: ngati mutatenga makapisozi kwa mwezi umodzi, mtengo wa chithandizo ukakhala pafupifupi ma ruble 3000.

Chifukwa chake, pogwiritsira ntchito njira zamakono zamtunduwu, wodwalayo amalandira bwino. Ndipo anthu omwe ali ndi matenda otupa chiwindi (mawonekedwe a matendawa) ayenera kuwatenga mosamala kwambiri.

Zambiri

Mankhwala omwe amathandizira pakugwira ntchito kwa chiwindi ndikuthandizira kubwezeretsa kwake ndi hepatoprotectors.

Mankhwalawa, omwe mndandanda wawo umaperekedwa pansipa, amateteza thupi ku:

• mankhwala andewu
• kukhudzana ndi ziphe
• mowa.

Kugwiritsa ntchito kumakuthandizani kusintha kagayidwe. Amatsimikizira kutha kwa maselo a chiwindi. Chifukwa chake, ntchito yayikulu ya mankhwala ndikuteteza thupi ku zinthu zoipa zomwe zimawonongeka.

Akatswiri azamankhwala amakono apanga ma hepatoprotectors osiyanasiyana. Mndandanda wamankhwala uyenera kugawidwa malinga ndi momwe angachitire komanso mawonekedwe ake. Komabe, mankhwala onsewa amapindulitsa chiwindi. Koma ayenera kumwedwa pokhapokha atakambirana ndi katswiri.

Kuphatikiza apo, ndikofunikira kumvetsetsa: hepatoprotectors sangathe kuteteza kwathunthu thupi ku zovuta zomwe mowa umayambitsa. Njira yokhayo yopeweretsera zowonongeka ndikuteteza thupi ku zakumwa zoledzeretsa.

Osati chithandizo chokha, komanso chifukwa cha prophylactic, hepatoprotectors (mankhwala) ndi omwe amapatsidwa.

Mndandanda wamankhwala omwe aphatikizidwa m'gululi ali ndi zidziwitso zazikulu zozama:

1. Ndikofunika kuti muzigwiritsa ntchito kwa anthu omwe amakhala akulumikizana pafupipafupi ndi mankhwala, ma radioactive, komanso mankhwala oopsa.
2. Mankhwalawa ndi othandiza kwa anthu okalamba, chifukwa chiwindi chawo nthawi zambiri chimafunikira thandizo la kuchipatala.
3. Kuphatikiza apo, ndalamazi ndizothandiza polimbana ndi matenda am'mimba, biliary thirakiti.

Koma koposa zonse - tiyenera kukumbukira kuti hepatoprotectors angagwiritsidwe ntchito pokhapokha poikidwa ndi dokotala.

Katundu woyambira

Tiyenera kukumbukira kuti pali mitundu yambiri ya hepatoprotectors. Kukonzekera, mndandanda womwe umasankhidwa kutengera momwe umagwirira ntchito komanso chinthu chachikulu, umagwira ntchito zosiyanasiyana. Mankhwala ena amachira maselo owonongeka mwachangu. Ena ndibwino kuti ayeretse chiwindi.

Ngakhale izi zimasiyana, mankhwala onse ali ndi zofanana:

1. Hepatoprotectors amatengera zinthu zachilengedwe, magawo a chilengedwe zachilengedwe.
2. Zochita zawo zakonzedwa kuti abwezeretse vuto la chiwindi ndi matenda a metabolism.
3. Mankhwalawa amaletsa zinthu zapoizoni zomwe zimalowa m'thupi kuchokera kunja kapena zimapangidwa mkati, chifukwa cha kusokonezeka kwa metabolic kapena matenda.
4. Mankhwala amathandizira kukonzanso maselo ndikuonetsetsa kuti akukana zotsatira zovulaza.

Kugwiritsa ntchito mankhwala

Chifukwa chake, hepatoprotectors ndi mankhwala omwe amathandizanso pakugwira ntchito kwa chiwindi. Komabe, onsewa amasiyana machitidwe amachitidwe. Othandizira oterewa amatha kupereka zinthu izi mthupi: anti-kutupa, antifibrotic, metabolic.

Mankhwalawa amagwiritsidwa ntchito kwambiri:

• matenda a chiwindi (uchidakwa komanso osamwetsa mowa),
• hepatitis (mankhwala, mavairasi, poizoni),
• matenda amatsenga
• psoriasis
• zotupa za cholestatic,
• toxicosis pa mimba.

Gulu la mankhwala

Tsoka ilo, mpaka pano palibe dongosolo limodzi lomwe limakupatsani mwayi wogawa m'magulu a hepatoprotectors (mankhwala).

Gulu laopezeka m'mankhwala ili motere:

1. Phospholipids ofunikira. Mankhwala m'gululi amachokera kwa soya. Awa ndi ma hepatoprotectors abwino kwambiri ochokera kumera. Mndandanda wamankhwala omwe ali mgululi: Ofunika Forte, Phosphogliv, Rezalyut Pro, Essliver forte. Zomera za phospholipids zimafanana ndi zomwe zimapezeka m'maselo a chiwindi aanthu. Ichi ndichifukwa chake amalumikizana mwachilengedwe m'maselo omwe akhudzidwa ndi matendawa ndikuthandizira kuti ayambe kuchira. Mankhwala alibe zotsatira zoyipa. Ndizachilendo kwambiri kuti zimatha kuyambitsa mavuto ngati munthu akukumana ndi mankhwalawo, kapena kupumula kwa chopondapo.
2. Chomera flavonoids. Mankhwala oterewa ndi mankhwala achilengedwe - antioxidants achilengedwe. Zochita zamankhwala zimapangidwira kusokoneza ma free radicals. Mankhwala amatengedwa kuchokera ku mankhwala azomera: celandine, haze mankhwala, turistam ya mkaka, turmeric. Awa ndi otchuka kwambiri a hepatoprotectors. Mndandanda wa mankhwala omwe amapanga gululi: Karsil, Hepabene, Silimar, Legalon, Hepatofalk Plant. Mankhwalawa ali ndi mndandanda wochepa wazotsatira zoyipa. Nthawi zina, amatha kupangitsa kuti ziwonekere kapena kuti zikhale zotayirira. Mankhwalawa samangokhala ndi hepatoprotective effect. Amathandizanso kupindika kwa ndulu, kuthandizira kukonza kutuluka kwa bile ndi kupanga. Ndi chifukwa chake mankhwalawa amalembera chiwindi, limodzi ndi biliary dyskinesia, cholecystitis.
3. Zopatula zama amino acid. Mankhwalawa amachokera pazinthu zomanga thupi ndi zinthu zina zofunika kwa thupi. Izi zimathandizira kutenga nawo mwachindunji kwa mankhwalawa mu metabolism. Amakwaniritsa komanso kusintha kagayidwe kachakudya, amakhala ndi zotsitsika ndipo amathandizira kuchirikiza thupi. Mwa mitundu yayikulu ya kuledzera, kulephera kwa chiwindi, hepatoprotectors zotchulidwa. Mndandanda wamankhwala omwe ali m'gulu la zomwe zimachokera ku amino acid ndi awa: Heptral, Heptor, Hepa-Merz, Hepasol A, Hepasol Neo, Remaxol, Hepasteril. Mankhwalawa nthawi zambiri amabweretsa zotsatira zoyipa. Zina mwazo ndi: kusapeza bwino m'mimba, nseru, m'mimba.
4. Mankhwala a ursodeoxycholic acid. Mankhwalawa amachokera pazinthu zachilengedwe - bile ya Himalayan chimbalangondo. Thupi lotere limatchedwa ursodeoxycholic acid. Gawolo limathandizira kukonza solubility ndikuchotsa bile kuchokera mthupi la munthu. Thupi limayambitsa kuchepa kuwonongeka ndi kufa kwa maselo a chiwindi omwe ali ndi zovuta zosiyanasiyana. Ursodeoxycholic acid ali ndi immunomodulatory effect.Pankhani ya matenda a ndulu, hepatosis yamafuta, biliary cirrhosis, matenda oledzera, ndiye ma hepatoprotectors a chiwindi omwe angapindule. Mndandanda wa mankhwala othandiza kwambiri: Ursodex, Ursodez, Ursosan, Ursofalk, PMS-ursodiol, Urdox, Urzofalk, Urso 100, Ursodeoxycholic Acid, Ursoliv, Ursoliv Ursolizin ”," Ursorom S "," Ursokhol "," Holudexan ". Mankhwalawa ali contraindicated mu kwambiri hepatic ndi aimpso kulephera, decompensated cirrhosis, kapamba, zilonda zam'mimba, calcium miyala mu ndulu, kutupa pachimake kwa chikhodzodzo.

Kuphatikiza pa mankhwala omwe atchulidwa pamwambapa, palinso mankhwala ena omwe ali ndi katundu wa hepatoprotective.

Izi zikuphatikiza zowonjezera zakudya:

Mankhwala ena ofanana ndi homeopathic ali ndi mphamvu yotupa:

Komabe, kuphatikiza zinthu zofunika m'mankhwala awa sikokwanira. Chifukwa chake, saloledwa kugwiritsa ntchito matenda.

Ganizirani za hepatoprotectors othandiza kwambiri - mndandanda wa mankhwala abwino kwambiri, malinga ndi madokotala.

Mankhwala "Heptral"

Chipangizochi chimakhazikitsidwa ndi ademetionin - amino acid yemwe amatenga mbali pazinthu zambiri zamthupi zomwe zimachitika mthupi. Izi zimapangitsa kuti thupi lipangidwe bwino, limachepetsa kawopsedwe ndikuthandizira kuchoka kwake.

Mankhwalawa amalembera:

• cholestasis
• kuchepa kwamafuta,
• matenda a chiwindi
• aakulu a chiwindi.

Mankhwala ali ndi mavuto. Zimatha kupsinjitsa kukanika kwa m'mimba thirakiti, kusokonezeka kwa tulo, psyche. Nthawi zina zimayambitsa thupi sayanjana. Izi sapangira anthu osakwana zaka 18, amayi apakati ndi oyamwitsa.

Mankhwala abwino kwambiri aana

Zonsezi pamwambapa zimatilola kuganiza kuti ndi ati omwe hepatoprotectors amagwiritsidwa ntchito makanda.

Mndandanda wa ana uli ndi mankhwala otsatirawa:

1. Kuyambira nthawi yatsopano. Mankhwala omwe agwiritsidwa ntchito ndi awa: Galstena, Hepel.
2. Ana kuyambira zaka 3. Amaloledwa kugwiritsa ntchito mankhwala a Essentiale.
3. Ana kuyambira zaka 4. Tumizani Antral.
4. Ana azaka zisanu. Mankhwalawa atha kuphatikiza mankhwala: Karsil, Legalon, Gepabene, Ursosan.
5. Kuyambira wazaka 12. Fotokozani mankhwala "Cholenzym".
6. Anthu azaka 18. Heptral ikhoza kutengedwa.

Komabe, musaiwale kuti mankhwalawa ayenera kumwa pokhapokha atauzidwa ndi dokotala.

Mapiritsi a chiwindi. Mndandanda wa hepatoprotectors ogwira pochiritsa chiwindi. Zoona ndi Zonama

Chiwalo chachikulu kwambiri m'thupi la munthu, chiwindi chimagwira ntchito zofunikira zingapo, kuphatikizapo kuonetsetsa kuti ziwalo zina ndi machitidwe ena zilipo. Ndi chikhalidwe cha chiwindi chomwe chimasankha momwe tikumvera, chifukwa chake palibe chodabwitsa mu chikhumbo chonse chothandizira othandizira, kuti azithandizira pakugwira ntchito molimbika. Kuti achite izi, ogula amatengera njira zosiyanasiyana ndi njira: kuchokera pazokayikitsa kwambiri komanso zosagwirizana ndi njira zamankhwala zoyeretsa "chiwindi mothandizidwa ndi mapiritsi okayikira kumagulu ovomerezeka ndi ogwiritsidwa ntchito kwambiri a gulu la hepatoprotector.

Zowona, chakuti chiwindi chimagonjetsedwa ndimatenda angapo. Ali pachiwopsezo chotenga kachilomboka, ali ndi vuto la kuchuluka kwa zinthu zamafuta m'magazi, amawonongeka ndimankhwala ena owopsa. Chifukwa chake, sizosadabwitsa kuti hepatoprotectors, mankhwala opangidwa kuti ateteze maselo a chiwindi, amagwiritsidwa ntchito kwambiri. Komabe, ziyenera kudziwidwa nthawi yomweyo kuti mankhwala a gulu lachipatalachi samadziwika m'maiko onse apadziko lapansi. Komanso, gulu la hepatoprotectors kumadzulo kulibe. Koma m'maiko a CIS, "oteteza chiwindi" ambiri ndi omwe akugulitsa kwambiri.

Ndiye kodi katundu wa hepatoprotectors ndi chiyani? Ndi ma mankhwala ati omwe madokotala ambiri sazindikira kuti ndi mankhwala? Kodi amagwira ntchito bwanji, ndipo amagwira ntchito bwanji? Kwa mafunso awa ndi ena ambiri onena za hepatoprotectors pamapiritsi ndi ma ampoules, tiyesa kupeza mafunso m'nkhani yathu. Ndipo timayamba ndi kufotokoza kwa momwe zinthu za m'magazi zimapangidwira kuti mankhwala azichiza chiwindi.

Chiwindi chili pachiwopsezo

"China chake chomwe chiwindi changa chikusokosera ..." Mawu odabwitsawa amamveka pafupipafupi. Pafupifupi aliyense wamkulu nthawi ndi nthawi, makamaka pambuyo chakudya chamadzulo kapena phwando lalikulu, amawoneka wolemetsa mu hypochondrium yoyenera ndi mseru. Ndizizindikiro izi zomwe zingawonetse kukula kwa imodzi mwazofooka kwambiri matenda a chiwindi, mafuta a hepatosis, kapena steatosis. Ndiye chiwindi steatosis ndi chiyani? Awa ndi matenda osatupa omwe maselo a chiwindi, hepatocytes amasintha, amasintha kukhala minofu ya adipose.

Monga lamulo, steatosis imayamba chifukwa cha kudya mopitirira muyeso, kunenepa kwambiri, kuperewera kwa zakudya m'thupi ndi kuchuluka kwambiri kwa zakudya zamafuta. Chochititsa china chofala cha hepatosis yamafuta ndim kumwa mowa kwambiri, ndipo mwayi wokhala ndi matendawa siwofanana kwenikweni ndi kuchuluka kwa mowa. Zimachitika kuti ngakhale kumwa pang'ono kwakumwa kumayambitsa chiwindi steatosis. Kuphatikiza apo, matendawa amathanso kukhala mukumwa mankhwala omwe amakhudza chiwindi.

Cholestatic hepatosis imakhala yocheperako, momwe mapangidwe ndi kutuluka kwa bile amasauka, chifukwa chomwe bile pigment imasonkhana mu hepatocytes. Zomwe zimayambitsa zimatha kukhala zovuta za poizoni kapena kupsinjika kwa chiwindi, mwachitsanzo, panthawi yoyembekezera. Ndi cholestasis, kuyabwa kwambiri pakhungu, kudetsa khungu la mkodzo ndi kusungunuka kwa ndowe, komanso magawo amwazi amwazi.

Polankhula za matenda ofala a chiwindi, munthu sangangotchulapo zotupa za chiwindi, hepatitis. Itha kuyamba chifukwa chomwa mowa, mankhwala osokoneza bongo kapena ziphe, komanso chifukwa cha kachilombo ka HIV. Ambiri omwe ali ndi matenda a hepatitis B (pafupifupi anthu mamiliyoni 350 pachaka), hepatitis A (oposa mamiliyoni 100) ndi hepatitis C (odwala miliyoni miliyoni chaka chilichonse). Njira yopweteka kwambiri ndi hepatitis C, yomwe pakanapanda chithandizo imakhala yovuta kwambiri chifukwa cha matenda a khansa komanso chiwindi. Ma virus a Hepatitis D ndi E amadziwikanso .. Zatsimikiziridwa kuti matenda a hepatitis B ndi C ndi omwe amayambitsa khansa ya chiwindi.

Mfundo zochizira matenda a chiwindi

Njira zamachiritso zamatenda a chiwindi zimakhazikitsidwa pazanjira ziwiri zazikulu:

1. Mankhwala otchedwa etiotropic therapy, omwe cholinga chake ndi omwe amayambitsa matendawa. Chitsanzo chabwino cha chithandizo choterechi ndikulimbana ndi kachilomboka mu matenda a hepatitis. Komabe, ziyenera kudziwidwa kuti siwonse chiwindi cha hepatitis chomwe chimafunikira mankhwala ochizira. Chifukwa chake, ndi hepatitis A, siyofunikira - kachilombo kamafa payokha. Koma ndi hepatitis, yomwe imafalikira kudzera m'magazi komanso pogonana, chithandizo chothandizira kupatsirana ndichofunikira kwenikweni.
2. Mankhwala a pathogenetic, zomwe zikutanthauza kuti zimakhudza magawo osiyanasiyana a matenda.

Kuteteza chiwindi, mankhwala a magulu osiyanasiyana a mankhwala atha kuperekedwa, kuphatikiza:

• Mavitamini, ma amino acid ndi zinthu zina zama metabolic,
• mankhwala omwe amalimbikitsa chiwopsezo cha chiwindi (mwachitsanzo, adsorbents),
• othandizira othandizira mapangidwe a bile (choleretic),
• mankhwala oletsa kubereka
• amatanthauza kulimbikitsa kuyankha kwamthupi (ma immunomodulators). Amachita mbali yofunika kwambiri pa mankhwalawa a hepatitis C,
• painkiller ndi anti-yotupa mankhwala (NSAIDs),
• Ma antioxidants omwe amamanga ma radicals aulere motero amateteza kuwonongeka kwa ziwalo,
• hepatoprotectors, omwe amasiyana pakapangidwe kake, komanso komwe adachokera, komanso momwe amagwirira ntchito.

Gulu la hepatoprotectors

Kugawanika kwa hepatoprotectors konsekonse kulibe lero - pali kusamvana kwakukulu pakati pa akatswiri, ngakhale ena apakhomo, omwe mankhwalawa amafunika kuwalemba. Komabe, zitha kugawidwa m'magulu asanu a mankhwala:

1. Kukonzekera zitsamba zomwe zimakhala ndi mkaka nthula flavonoids. Izi zikuphatikiza Gepabene, Carsil, Silibor ndi ena.
2. Mankhwala ena azitsamba, omwe akuphatikizapo Hofitol, Liv-52.
3. Hepatoprotectors a nyama zoyambira, makamaka, Sirepar.
4. Njira zomwe zimakhala ndi ma phospholipids ofunikira. Mankhwala odziwika kwambiri a gululi ndi Essentiale.
5. Mankhwala okhala m'magulu osiyanasiyana a mankhwala.

Tiyenera kudziwa kuti ngakhale mtundu wa hepatoprotectors padziko lapansi ulibe masiku ano, asayansi adafikanso pa chipangano chimodzi chodziwika kuti ndi mankhwala ati abwino, abwino omwe amabwezeretsanso ntchito ya chiwindi. Zofunikira zake:

• mkulu bioavailability
• kutha kumanga poizoni, ma free radicals,
• odana ndi yotupa
• kukondoweza kwa kudzichiritsa kwa chiwindi,
• chitetezo chachikulu.

Tsoka ilo, ngakhale pali mndandanda wosangalatsa wa hepatoprotectors amakono, omwe ali ndi mashelufu mumafamu aku Russia, palibe amene amakwaniritsa zomwe zili pamwambazi.

Pazachipatala zamakono zamakono, amakhulupirira kuti mankhwala omwe "angayambitse" kusintha kwa chiwindi samakhalako. Ndipo bwanji kuyiyambitsa, ngati chiwindi chokha chikonzanso bwino, ndikwanira kuti pazikhala mokwanira, kuchepetsa kuchuluka kwa zakudya zamafuta ndi poizoni pang'ono.

Kukonzekera kwazitsamba kwina

Kuthekera kwa mankhwala azitsamba poteteza chiwindi ndi mkaka nthula, mwachidziwikire, sikumatha, ndipo pamsika wamakampani mumakhala kukonzekera kwazitsamba kosiyanasiyana mwakufuna kwina kwachilengedwe.

Izi zikuphatikiza:

1. Kukonzekera kochokera ku artichoke Tingafinye - Hofitol, Cholebil, Artichoke Tingafinye
2. Kukonzekera kwazitsamba kosakanikirana - Hepabene, Sibektan, Hepaphor, Dipana, Liv-52.

Dziwani bwino.

Kuphatikiza azitsamba azitsamba matenda a chiwindi

Gulu la mankhwala osokoneza bongo omwe, mogwirizana ndi malangizo, nawonso ali ndi hepatoprotective, amagwera m'gululi.

Hepabene ndi m'modzi mwa atsogoleri pakati pa mankhwala a choleretic ndi hepatoprotective. Muli zigawo ziwiri zogwira ntchito:

• nthenga zamkaka,
• Tingafinye watsi.

Chochita choyamba, monga tanena kale, chikuwonetsa kukhathamiritsa kwa hepatoprotective mu zovuta komanso zakumwa zoledzeretsa. Gawo lachiwiri, fume Tingafinye, limagwira ntchito chifukwa cha fumarin alkaloid mmenemo, lomwe limakhala ndi choleretic kwambiri ndipo limachepetsa kuphipha kwa ma ducts a bile, omwe amathandizira kutuluka kwa bile kuchokera ku chiwindi kulowa m'matumbo.

Zisonyezero za Hepabene ndizovuta kuwonongeka kwa chiwindi kosachokera kumayendedwe ena ndi dyskinesia wa mayendedwe a thirakiti. Mankhwalawa sayenera kugwiritsidwa ntchito pa matenda owopsa a chiwindi ndi biliary system (pachimake cholecystitis, hepatitis), komanso kwa ana ochepera zaka 18 chifukwa cha kusowa kwa mayeso m'gulu ili la odwala.

Sibektan ndi ntchito yophatikiza zitsamba pamodzi ndi chitukuko cha mabanja. Muli akupanga tansy, mkaka nthula, hypericum, birch. Imateteza maselo a chiwindi, maselo a ma hepatocytes, amawonetsa antioxidant ndi choleretic kwenikweni.Contraindication pakugwiritsa ntchito mapiritsi awa ndi gallstone matenda, ndipo zikuwonetsa zosiyanasiyana zotupa za chiwindi ndi biliary thirakiti.

Kapangidwe ka mankhwala ena aku Russia, Hepaphor, pamodzi ndi mkaka nthula amaphatikizira bifidobacteria ndi lactobacilli, omwe adapangidwa kuti abwezeretse matumbo ndipo potero amatulutsa matumbo.

Dipana, Liv-52 - njira yopanga makampani opanga mankhwala ku India, omwe amakhala ndi mankhwala azitsamba ambiri omwe amagwiritsidwa ntchito mu mankhwala a Ayurvedic. Mankhwala onse awiriwa, mogwirizana ndi malangizo ogwiritsira ntchito, ali ndi hepatoprotective kwambiri, kubwezeretsa ntchito kwa chiwindi, kusinthanso kukonzanso maselo ake, kuwonetsa choleretic, kuteteza thupi ku poizoni.

Kugwiritsa Ntchito Umboni

Maziko ena aumboni adapeza chifukwa cha mankhwala ena azitsamba a hepatoprotective, makamaka, Gepabene ndi Liv-52. Yoyamba idaphunziridwa kwambiri mu maphunziro aku Russia, yachiwiri - kuphatikiza azungu. Umboni wazotsatira zabwino za hepatoprotector izi pa ntchito ya chiwindi wapezeka, koma akatswiri ambiri aku Western samaziona ngati zotopetsa. Lingaliro limatsimikiziridwa ndi kuchuluka kwa kafukufuku wina kuwonetsa kuperewera kwa Liv-52 mu hepatitis yoledzera.

NB! Kafukufuku woyipa okhudza odwala omwe ali ndi chiwindi cha mowa adagwirizanitsidwa ndi Liv-52. Zinawonetsa kuti kupulumuka mgulu la odwala omwe amalandila Liv-52 anali otsika 12% kuposa m'gululi omwe amatenga mapiritsi a dummy (74% poyerekeza ndi 86%). 22 mwa anthu 23 omwe anamwalira mu gulu la Liv-52 adalumikizidwa ndi vuto la chiwindi. Zotsatira za ntchitoyi zidakhala chifukwa chabwino chochotsa ndalama msika waku America kokha.

Chifukwa chake, kuphatikiza kwa mankhwala azitsamba a hepatoprotectors palokha malinga ndi umboni wopangira mankhwala amakhalabe wokayikira. Komabe, pochita zapakhomo, mankhwala a gululi amagwiritsidwa ntchito kwambiri ndipo ndi otchuka kwambiri.

Olemera komanso otchuka: phospholipids ofunikira

Ma phospholipids ndi gawo lofunikira la membrane aliyense wa khungu, kuonetsetsa umphumphu wake ndikugwira ntchito. Kufunika kwa thupilo kwa iwo kumawonjezeka kwambiri ndi katundu wowonjezereka komanso kuwonongeka kwa ziwalo zina, makamaka chiwindi. Nthawi yomweyo, chilema chimapangidwa khoma la hepatocytes, maselo a chiwindi, omwe amatha m'malo mwake ndi kukonzekera komwe kumakhala ndi phospholipids ofunikira.

Ma hepatoprotector angapo omwe ali ndi chinthu ichi amalembedwa pamsika wamakono:

• Essentiale Forte N,
• Rezalyut Pro,
• Essliver
• Phosphoncial,
• Phosphogliv,
• Brenziale forte
• Livolife forte,
• Antraliv
• Livenziale ndi ena.

Onsewa ndi ochokera ku chilengedwe: ma phospholipids ofunikira amapezeka kuchokera ku soya mwa kukonza mafuta awo.

Njira yamachitidwe

Zomwe zimapangitsa phospholipids yofunika chifukwa cha kufanana kwawo ndi phospholipids m'thupi la munthu. Amaphatikizidwa mosavuta mu nembanemba ya selo, kupereka chithandizo chokwanira. Hepatoprotectors a gululi amalimbikitsa kubwezeretsanso maselo a chiwindi ndikuwateteza ku zochita za poizoni, kuphatikizapo mowa, mankhwala osokoneza bongo, mankhwala osokoneza bongo, ndi zina zambiri. Malinga ndi malipoti ena, ma phospholipids ofunikiranso amathandizanso kuchepetsa kuchuluka kwa cholesterol "yoyipa" ndipo, chifukwa chake, amachepetsa chiopsezo chotenga atherosclerosis. Kuphatikiza apo, kugwiritsa ntchito kwawo kumalepheretsa mapangidwe a miyala ya cholesterol mu ndulu.

Ndingamwe chiyani ndi kapamba wa kapamba

Ndi kutupa kwa kapamba, ndikofunikira kusankha mankhwalawa kwa ana ndi akulu omwe.

Sayenera kungochotsa ululu ndi zizindikiro zina, komanso kukonza magwiridwe antchito, mankhwalawa amayenera kuchitira chiwalo ndi kapamba.

Mitundu ya mankhwala a kapamba

Tikuwona nthawi yomweyo kuti chithandizo cha pancreatitis chikuwonetsa kuti mutha kumwa mankhwala otsatirawa:

1. analgesics
2. Kukonzekera kwa enzyme
3. mankhwala anticholinergic
4. kukonzekera kwa antienzyme
5. mafuta
6. maantacid
7. H2 - blockers.

Munthawi yoyamba kugwiritsa ntchito mankhwalawa, chithandizo chothandiza kwambiri cha matendawa chimatheka. Kuchuluka kwa pancreatitis kumapangidwira kukonzekera kwa antienzyme, komwe chinthu chogwira ntchito ndi aprotinin polypeptide. Katunduyo amachokera m'mapapu a ng'ombe.

Kukonzekera kwa antienzyme kwa pancreatitis yovuta komanso yosatha kumayenera kuphatikizidwa ndi kuyeretsedwa kuchokera ku michere ya pancreatic ndi zinthu zawo zowola. Ndikofunikanso kuchitapo kanthu kuti muyeretse matumbo.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mankhwala omwe amalembera zotupa za kapamba amatha kugawidwa m'mitundu ingapo:

Mankhwala a Antispasmodic amatha kuledzera kuti muchepetse kupweteka kwapachangu ndi kutupa kwa pancreatic ndikuthandizira vutoli. Mankhwala atha kuphatikizira analgin kapena paracetamol.

Kuvomerezedwa kuyenera kuvomerezedwa ndi adokotala, popeza kuti mwina pali zovuta zomwe zingachitike.

Mankhwala enzyme omwe adapangidwa kuti:

• kuchepetsa nseru
• kusintha chimbudzi
• kuchepetsa kuchuluka kwa kupweteka kwa ana ndi akulu.

Kuphatikizikako kumakhala ndi ma enzymes omwe amathandiza kugaya chakudya. Kugwiritsa ntchito michere mopitilira muyeso kumatha kubweretsa vuto m'tsogolo, kenako vuto limodzi liyenera kuthandizidwa. Musanagule, muyenera kudziwa zonse kuchokera kwa dokotala.

Zokonzekera zonse za enzyme zimagawidwa m'mitundu iwiri:

1. Mankhwala okhala ndi bile omwe ali ndi mphamvu. Zabwino zimathandizanso kwa mankhwala a choleretic, omwe amatha kukhala ndi bile kapena yopanda bile. Koma kwa mitundu yonse iwiri ya mankhwala pali contraindication kwa ana ndi akulu.
2. Maantacidids omwe amachepetsa acidity ya madzi am'mimba komanso kuchuluka kwa michere yomwe imawonongeka m'mimba. Mutha kumwa iwo kuti muwonjezere mphamvu ya kukonzekera kwa enzyme.
3. Kukonzekera kwazitsamba ndi choleretic kanthu, mwachitsanzo, mankhwala azitsamba.

Pafupifupi mitundu yonse yamankhwala omwe adalembedwapo amagwirizana ndi othandizira kapena oyambira. Dziwani kuti mankhwalawa a choleretic ochokera ku mankhwala azikhalidwe, omwe nthawi zambiri amatha kuledzera, amatsimikizira kugwira ntchito kwawo pothana ndi vuto la kapamba, ndipo amatha kuchiza.

Cholinergic ndi antispasmodic mankhwala

Chithandizo cha pancreatitis chimachokera pa kugwiritsa ntchito mankhwala a antispasmodic ndi anticholinergic. Amabayidwa jekeseni pang'ono pakatikati, ndiye kuti amwe mankhwalawa sangagwire ntchito.

Chithandizo chotere chimachitika pokhapokha chifukwa cha kutupa kwa kapamba wokhala ndi ululu waukulu.

Tikulemba mndandanda wa mankhwala omwe amagwiritsidwa ntchito panthawiyi:

Maantacid okhala amalimbikitsa kukonzekera kwa enzyme. Mwa zomwe zikulimbikitsidwa kumwa chifukwa cha zovuta ndi kapamba, mayankho awiri akhoza kuyankhidwa:

Kuphatikiza apo, pali zosakaniza zamchere zamchere.

Ma blockers a H-2 akulimbikitsidwa kumwa pamaso pa kupweteka kwakutchulidwa mu kapamba. Pakati pawo pali othandiza kwambiri:

Mankhwala enzyme

Ndi pancreatitis, michere ya pancreatic iyenera kudyedwa mutangotha ​​kudya, kapena nthawi, kuchuluka kwa makapisozi atatu. Mankhwalawa amagwiritsidwa ntchito atatha kuthetseratu, wokhala ndi ululu waukulu.

Mlingo wofanana wa ana ndi akulu umakhazikitsidwa mwa aliyense payekha. Izi zimatengera kusowa kwa lipase.

Ndi kapamba, adotolo atha kukulembera kukonzekera kwa enzyme:

• Chiboni.Ndi chinsinsi cha kuchepa kwazinsinsi.
• Pancurmen
• Panzinorm. Ndi biliary pancreatic insuffuffence

Mwa mitundu yayikulu ya steatorrhea, madotolo amakupatsani mankhwala owonjezera: mavitamini K, D, E, A ndi gulu B, omwe mudzamwa pa ndandanda.

Maantibayotiki

Pakakhala mtundu wina wa kapamba ndipo pakakhala chiwonetsero cha cholangitis ndi peripancreatitis, mankhwala amaikidwa. Njira yothandizira mankhwalawa sikudalira zaka za wodwalayo, ndipo chithandizo cha matenda a kapamba sikuti amangokhala mankhwala.

Kuphatikiza pa maantibayotiki, cefuroxime ndi mankhwala, omwe amaperekedwa 1 g kudzera m'mitsempha kapena intramuscularly.

Munthawi yomweyo, intramuscularly pa mankhwala kutumikiridwa:

Therapy Antenzyme

Mankhwala a Antenzyme akuwonetsedwa kwa anthu omwe ali ndi vuto lotere:

• kapamba edema
• hypermilasemia
• yapakati mawonekedwe a pancreatic aakulu kutupa.

Ndikofunikira kudziwa kuti ndi ati mwazoyipa zomwe zalembedwera mwachidwi kwambiri ndipo ndi zofala.

Mankhwala a Antenzyme amawonetsedwa kukapanda kuleka. Mwachitsanzo, aprotinin amalembedwa kangapo patsiku, ndi mlingo wa mayunitsi 100,000, contracal of 20,000 units.

Nthawi zambiri njira yochizira imachokera masiku 7 mpaka 10. Mwa akulu ndi ana, kutalika kwa mankhwalawa kumatha kusiyanasiyana, mwachidziwikire, kuchuluka kwa mankhwalawa.

Kugwiritsa ntchito mankhwala a antienzyme kumatengera kulekerera kwa wodwalayo!

Kupumula

Ululu wamankhwala ndiwowona pafupifupi gawo limodzi mwa magawo atatu a odwala omwe ali ndi pancreatitis yayitali. Nthawi zambiri, dokotala yemwe amakupatsiranipo mankhwala amakupatsani mankhwala otsatirawa kwa akulu ndi ana oti amwe:

Nthawi zina amasankha kupereka mankhwala: tramadol kapena buprenorphine. Nthawi zina, melipramine imawonjezeredwa kwa analgesics (pali chiopsezo kwambiri cha mankhwala osokoneza bongo) ndi stelazine, onsewa amatha kuledzera moyenera molamulidwa.

Chithandizo cha zotupa za kapamba zimaphatikizapo mndandanda wa mankhwala omwe amasankhidwa payekhapayekha. Mwachilengedwe, mndandanda wa mankhwalawa umaphatikizapo odana ndi kutupa, mwachitsanzo, palibe-spa.

Musanagwiritse ntchito mankhwala aliwonse, muyenera kufunsa dokotala. Izi zikugwiranso ntchito pakugwiritsa ntchito mankhwala a choleretic kuchokera ku zida zamankhwala azikhalidwe.

Kodi imalembedwa liti?

Hepatoprotectors okhala ndi phospholipids ofunikira amagwiritsidwa ntchito matenda osiyanasiyana a chiwindi mu nthawi yovuta komanso kukhululuka. Zina mwazomwe zimawonetsa kuti amagwiritsidwa ntchito ndi hepatitis yovuta komanso yopanda mafuta, kuchepa kwa mafuta a chiwindi, mosasamala kanthu komwe adachokera, zotupa za zakumwa zoledzeretsa, kupha poyizoni, kuphatikiza mankhwala osokoneza bongo, kuwonongeka kwa chiwindi pantchito zina.

Tiyenera kukumbukira kuti kugwiritsa ntchito mankhwalawa pogwiritsa ntchito ma phospholipids ofunika kwambiri kumatengera nthawi yomwe maphunzirowo atchulidwa: Malinga ndi malangizo ogwiritsira ntchito, awa hepatoprotectors amawayikira muyezo waukulu (600 mg mpaka katatu patsiku) kwa miyezi itatu. Ngati ndi kotheka, njira ya mankhwalawa imabwerezedwa ndikuwonjezeredwa mpaka zaka zingapo yogwiritsa ntchito mosalekeza.

NB! Madokotala amakhulupirira kuti chithandizo cha makolo ndi phospholipids chofunikira chimawonetsa zotsatira zabwino. Chifukwa chake, Essentiale forte N ndi ma envelopu ake amathandizira kudzera m'mitsempha, yomwe imasungunulidwa kale ndi magazi a wodwalayo pazowerengera 1: 1.

Gepa Merz

Hepa-Merz ndi kapangidwe koyambirira kamene kali ndi tata L-ornithine-L-aspartate. Mu thupi, limasinthira kukhala zinthu ziwiri zodziyimira pawokha - ornithine ndi aspartate. Hepatoprotectors a gululi amapangidwa mu mawonekedwe a granules pakukonzekera njira yothetsera kukonzekera kwamlomo, komanso ma ampoules a jekeseni wa intramuscular and intravenous. Pamodzi ndi Hepa-Merz, ma analogi ake Orneticetil, Larnamin ndi Ornilatex adalembetsa ku Russian Federation.

UDCA - khwangwala oyera pamtundu wa hepatoprotectors

Ndipo pamapeto pake, nthawi inayamba kukambirana za mankhwalawo, omwe amakhala m'malo apadera a hepatoprotectors. Timasungitsa nthawi yomweyo kuti tisazunze owerenga - apadera kuchokera kumbali yabwino.

Ursodeoxycholic acid ndi bile acid yomwe imapangidwa yaying'ono mthupi la munthu. Mankhwalawa adayamba kupezeka ku bile bile, koma lero amapangidwa.

M'mafakitala apakhomo, hepatoprotector iyi imayimiriridwa ndi gulu la mayina amalonda, omwe mwa awa:

• Ursofalk, mankhwala odula kwambiri, oyamba
• Urososan
• Ursodez
• Livodex
• Urdox
• Ursoliv
• Greenterol
• Holudekasan
• Ursodex ndi ena.

Kodi imakhazikitsidwa liti?

Hepatoprotectors okhala ndi ursodeoxycholic acid amagwiritsidwa ntchito ngati matenda a gallstone (pokhapokha ngati miyala yotsimikizika ya cholesterol, yomwe imawonedwa mu 80-90% ya milandu), komanso chiwindi chachikulu komanso chopanda chiwindi, kuwonongeka kwa chiwindi chowopsa, mosasamala mtundu wa poizoni yemwe adadzetsa matendawa, matenda oledzera chiwindi, dyskinesia wa biliary. Kuphatikiza apo, ursodeoxycholic acid imagwiritsidwa ntchito ngati gawo la mankhwala osakanikirana a cystic fibrosis.

Mankhwala a Hepatoprotective UDCA amagwiritsidwanso ntchito ngati cholestasis, kuphatikiza azimayi oyembekezera - mbiri yawo yachitetezo imakupatsani mwayi wogawa magawo omwe ali pachiwopsezo kwambiri cha ogula, kuphatikiza ana aang'ono.

Kafukufuku wamankhwala: sikuti gliff onse ndi golide

Kutsitsa zokambirana zathu za hepatoprotectors amakono, tidzalemba mu funso lomwe limasokoneza makasitomala ambiri (ndipo, mwatsoka, ngakhale madotolo) ndikuwapatsa malingaliro abodza pakugwira bwino ntchito kwa mankhwalawa.

Chowonadi ndi chakuti zotsatira za kafukufuku wosiyanasiyana wa mankhwala sizodalirika nthawi zonse. Kupatula kuthekera kopeza chidziwitso chabodza, ntchitoyi iyenera kuchitika molingana ndi zofunikira zina zomwe zimapangidwa mu mfundo zoyambirira zamankhwala zokhala ndi umboni. Chifukwa chake, maphunziro omwe ophunzira adagawika m'magulu angapo omwe amamwa mankhwalawa ndi ma dummies kapena njira zina kuyerekezera (kafukufuku wosasankhidwa) amawona kuti ndi odalirika kwambiri. Palibe wodwala amene ayenera kudziwa zomwe akulandira - mankhwala kapena placebo (kafukufuku wakhungu), ndibwinonso ngati ngakhale dokotala samadziwa za izi (kafukufuku wakhungu kawiri). Mkhalidwe wofunikira wodalirika - kuphatikizidwa kwa ambiri mwa otenga nawo gawo - mu ntchito zazikulu zomwe tikulankhula za zikwi za odzipereka. Ndipo sizinthu zonse zofunikira pakufufuza kwamakono.

Kuyesa kotereku kumafuna nthawi komanso kulipira zazinthu zambiri. Kuphatikiza apo, palibe kampani yopanga mankhwala omwe angayendetse ngati pakukayikira kwambiri zotsatira zake, chifukwa cholinga cha ntchitoyi ndikutsimikiza, kulembetsa ntchitoyo pamisika yayitali, kuwonjezera malonda ndikukula phindu.

Kuti atuluke ndikuwonetsa "umboni wa kugwiranso ntchito", makampani opanga mankhwala amagwiritsa ntchito zododometsa kuti agwiritse ntchito zanzeru: amayambitsa kafukufuku ndi zotsatira zabwino. Kuyesaku kumachitika bwino ndi odwala angapo, ndipo zofunikira za mankhwala zozikika umboni zimapangidwanso mwanjira zawo. Zambiri zomwe zidapeza zomwe zimakwaniritsa zokonda za wopanga zimagwiritsidwa ntchito popititsa patsogolo mankhwalawa - zimamveka kutsatsa, kukongoletsa timabuku komanso kusokoneza ogula.

Kalanga, zomwe zikuchitikanso m'maiko a CIS ndi lamulo kuposa momwe zimakhalira. Chifukwa chake, pankhani yakusankha mankhwala opitilira apo, lamulo la msika wankhanza liyenera kugwira ntchito: sikuti onse omwe ali obisika ndi golide. Makamaka pankhani ya hepatoprotectors.

Nkhani yomwe ili pamwambapa ndi ndemanga zomwe olembedwa ndi owerenga ali ndi zolinga zokhazokha ndipo samayitanitsa kuti mudzidzipatsa nokha mankhwala. Funsani katswiri pofotokoza za matenda anu komanso matenda anu. Mukamalandira mankhwala aliwonse, monga chofunikira, nthawi zonse muzigwiritsa ntchito malangizo omwe ali phukusi komanso, komanso malangizo a dokotala.

Popewa kuphonya zofalitsa zatsopano pamalowo, ndizotheka kuzilandira ndi imelo. Amvera.

Mukufuna kuchotsa matenda anu amphuno, pakhosi, m'mapapu ndi kuzizira? Kenako onetsetsani kuti mwayang'ana apa.

Ndikofunika kulabadira zolemba zina zosangalatsa: