Mitsempha yam'mimba, khunyu, mitsempha, ubongo

Mwachitsanzo: Strokov I.A., Akhmedzhanova L.T. Chithandizo cha kupweteka kwa neuropathic mu diabetesic polyneuropathy // khansa ya m'mawere. 2008. Ayi. 28. S. 1892

Mu 2007, akatswiri opweteka adapanga tanthauzo latsopano la kupweteka kwa neuropathic, malinga ndi zomwe zimachitika chifukwa cha kuwonongeka koyambirira kapena matenda a dongosolo la somatosensory. Maziko a ululu wa neuropathic ndimayendedwe a pathological a painways, omwe amatha kuphatikizidwa ndi kuwonongeka kwa dongosolo lamanjenje pamlingo wamitsempha yamapapo, ma plexus ndi mizere yakumbuyo (kupweteka kwa neuropathic) kapena chingwe cha msana ndi ubongo (kupweteka kwapakati pa neuropathic). Kafukufuku yemwe adachitika m'maiko osiyanasiyana adawonetsa kuti ululu wa neuropathic umawonedwa mu 6-8% ya anthu ndipo amagwirizanitsidwa ndi ma syndromes opweteka kwambiri, kugonana kwa akazi, odwala okalamba komanso malo ochepetsetsa, omwe angatengedwe ngati owopsa. Kupweteka kwa Neuropathic, komwe kumayambitsa kuvulala ndi matenda osiyanasiyana, kumalumikizidwa ndi kukula kwakukulu kwa matenda opweteka komanso kufunafuna chithandizo chamankhwala pafupipafupi. Pamaso pa ululu wa neuropathic, moyo wa odwala, kusintha kwawo magwiridwe antchito ndikutha kugwira ntchito, ndipo, nthawi zambiri, ululu wa neuropathic, ndizovuta kuchiza. Izi zikuwonetsa kukhudzika kwakukulu kwazachipatala komanso zachuma komanso kuzindikira kwa matenda komanso kupweteka kwa mitsempha ya neuropathic.

Odwala omwe ali ndi matenda a shuga, kupangika kwa mitundu yosiyanasiyana ya matenda am'mimba opatsirana am'mimba ndikotheka, komwe kumasiyana pakumva kupweteka, kutha kwa chibadwidwe komanso chikhalidwe cha ululu, ngakhale muzochitika zonsezo ululu ndi neuropathic (Gome 1). Kuphatikizika kwapadera kwa kupweteka kwapadera kwa neuropathic ndikumva kupweteka kwa matenda ashuga a distal symmetric sensory-motor polyneuropathy. Kafukufuku wa Epidemiological omwe adachitika ku USA awonetsa kuti kupweteka kwa neuropathic kumachitika nthawi zambiri ndi matenda ashuga a polyneuropathy kuposa ma polyneuropathies amtundu wina wophatikizidwa. Malinga ndi kafukufuku wa ku Russia EPIC, kupweteka kwa ma neuropathic mu matenda ashuga a polyneuropathy ndi wachiwiri pakumva ululu wammbuyo.
Diabetesic polyneuropathy (DPN) imawonedwa pafupifupi 50% ya odwala matenda a shuga, pomwe ululu wa neuropathic umawonedwa mu 11-24% ya odwala omwe ali ndi polyneuropathy, zomwe zimatengera nthawi yayitali ya shuga ndi polyneuropathy, komanso mtundu wa matenda ashuga. Pofotokozera koyamba kwa wodwala yemwe ali ndi DPN mu 1798, dotolo Wachingelezi J. Rollo adazindikira ululu ndi kupweteka kwa m'mimba monga chizindikiro chachikulu. Mawonekedwe amankhwala, pafupipafupi, kuuma komanso kutalika kwa ululu wamankhwala okhala ndi DPN ndizosiyanasiyana, mawonekedwe akeofala - mawonekedwe amtundu wa kupweteka kwa neuropathic. Mwa odwala omwe ali ndi matenda ashuga, kupweteka kosatha kumachitika mu 25% ya milandu, pomwe chiwerengero cha anthu opweteka kwambiri chimakhala pafupifupi 15%, ndipo kusiyana kumapangidwa makamaka chifukwa cha ululu wa neuropathic.
Ululu wa Neuropathic mu DPN umayimilidwa ndi zigawo ziwiri zazikulu: kudzipereka (kosadalira-kuzimiririka) komanso kupweteka. Ululu wongobwera umatha kusunthika pafupipafupi (kupweteka koyaka) kapena kuchitika paroxysmally ndi kutalika kwa ululu kuyambira masekondi mpaka maora (kuwombera ululu). Kupweteka kwapang'onopang'ono kumachitika chifukwa cha ntchito ya ectopic ya ma noncicept C-fibre chifukwa cha kuwonekera kwa njira zambiri za sodium pa iwo pansi pamikhalidwe yovuta komanso kusintha kwa kusefukira kwa zolandilira zowawa, zomwe zimapangitsa kuti adziwike pansi pazovuta zapansi, zomwe sizimayang'aniridwa pansi pazovuta zina.Ndizothekanso kuwoneka kwa kusintha kwa kukoka kuchokera ku mtundu wina kupita kwina - chodabwitsa cha kufufutidwa kwa efaptic. Chifukwa chake, kuphatikizika kwa ululu kumakulitsidwa, zomwe zimatsogolera pambuyo pake pakusintha kwa chisangalalo cha mitsempha yopanda chidwi ya ganglion ya mizu yakumbuyo ndi nyanga yotsalira. Njira zododometsera kwa magwiridwe antchito a neurons a lipenga la nyanga yomwe imagwirizanitsidwa ndi njira zamagetsi ozungulira a pre-and postynaptic inhibition, chidwi, komanso magwiridwe antchito apakati pakuwonongeka kwa mitsempha yofalikira akufotokozedwa mwatsatanetsatane pakuwunikira kwa olemba akunja ndi apanyumba. Zizindikiro zolumikizana ndi Noci kuchokera ku ma neurons a nyanga ya lipenga amalowa mu optic tubercle kenako kulowa somatosensory cortex, komwe kumapangitsa kumva kwa kupweteka kumachitika. Zimawonetsedwa kuti, mosiyana ndi odwala omwe ali ndi matenda osokoneza bongo opanda ululu, odwala omwe ali ndi DPN yopweteka amasintha kagayidwe ka thalamus. Neurons of the central sensory patterns amathanso kusintha kusangalala kwawo ndikupanga chodabwitsa cha chidwi. Magawo onse apakati a ululu wopweteketsa ndi kuzindikira ali ndi mgwirizano wapafupipafupi wokhala ndi njira zotsikira. Zotsatira zazikulu zoletsa (antinocicpent) zimalumikizidwa ndi njira zotsika kuchokera kuzinthu zakumaso zapafupi ndi magawo a rostro-ventral a medulla oblongata kupita kunyanga. Zotsatira zotsikira zotsalazo zimazindikira kudzera mwa mitsempha ya noradrenaline ndi serotonin neurotransmitter.
Muzochita zamankhwala, kuzindikira mawonekedwe a neuropathic a ululu nthawi zambiri kumakhala kovuta. Kumva kupweteka kumakhala kogwirizana nthawi zonse, sikungayesedwe molondola, ndipo palibe njira zenizeni zothandizira kusiyanitsa kupweteka kwa neuropathic. Njira zopangira pathophysiological zomwe zimayambitsa matenda opweteka zimatha kuweruzidwa kokha, pokhapokha potsatira kupweteka, deta kuchokera pakuwunika kwa mitsempha ndi zotsatira za kafukufuku wamitsempha. Komanso, kuzindikirika kwa mawonetseredwe azachipatala ndi kusintha kwa zidziwitso zamagetsi owonetsa kusintha kwa chikhalidwe cha machitidwe a nocicept sikutsimikizira molondola kupezeka kwa ululu wa neuropathic. Ululu wa Neopopathic umatha kuchitika msanga ukawonongeka mu nocicept system (mwachitsanzo, ndi ululu wamankhwala owonda kwambiri m'mitsempha ya shuga), ndipo umatha kukhala zaka kapena zaka makumi atawonongeka (mwachitsanzo, ndi DPN). Mkhalidwe wosapweteka wa neuropathic ululu ukhoza kupezeka ngati pali kuphwanya kwa ntchito ya machitidwe a nocicept pamaso pa: 1) zodziwikiratu zomverera zam'maganizo, 2) zotsatira zoyesedwa kuchipatala ndi zizindikiro zamanjenje: zabwino za neuropathic (kupweteka kwakudalirana) kuperewera), 3) data kuchokera ku maphunziro a neurophysiological (EMG, kuyesa konkitsa kwa malingaliro, komwe kumayambitsa mphamvu ya somatosensory). Kusankha kwa njira zakufufuzira kumatsimikiziridwa ndi zotsatira za kuyesa kwa mitsempha. Zizindikiro zamitsempha zimatha kudziwa kukhalapo, digirii ndi kufalikira kwa kuwonongeka kwa mitsempha. Kuti muwone chodabwitsa cha kupweteka kwa neuropathic, adokotala amakhala ndi chidwi ndi mkhalidwe wamalingaliro. Zikuwonekeratu kuti, kutengera ndi zotumphukira kapena njira yodziwika bwino ya kayendedwe ka matenda, kufufuza kwa mawonekedwe a mitsempha, kuphatikiza magalimoto ndi ma autonomic system, ndikofunikira kwambiri pakuwonetsetsa. Pankhaniyi, zizindikiro zosafunikira zidzaphatikizira, mwachitsanzo, kuchepa kwa mphamvu, minofu yolimba, kuchepa kwa minofu, kuwuma ndi kusintha khungu. Mukazindikira zotupa zamagetsi zamatsenga kuti muzindikire ululu wamitsempha, zimawongoleredwa ndi mkhalidwe wamalingaliro omwe amalumikizidwa ndi kutseguka kwa maonda ofooka a myelinated A- (ozizira komanso owoneka ngati wosakanika) komanso maonda ocheperako a non-myelinated C-fibers (kupweteka ndi kukondoweza kwa mafuta).Tiyenera kukumbukira kuti ululu wa neuropathic nthawi zambiri umapezeka mu gawo la kuchepa kapena kusowa kwa chidwi, ndiye kuti, gawo la ululu ndi zovuta m'malingaliro amtunduwu zimagwirizana. M'zaka zaposachedwa, kuchititsa maphunziro apadera kuti aphunzire kuchuluka kwa zowawa zimakhazikitsidwa ndikugwiritsa ntchito mafunso apadera, omwe amachititsa kudziwa mtundu wa ululu molondola kwambiri.
Chithandizo cha kupweteka kwa neuropathic ndizokhazikika pamalingaliro amakono pazinthu zamatenda a kukula kwake. Zotsatira zamankhwala zimagwiritsidwa ntchito pochepetsa kuyanjana, kutsata kusintha kwa chisangalalo cha mitsempha ya msana ndi ubongo, mankhwala omwe amachepetsa kusangalala kwa mitsempha ya nocicept, komanso mankhwala omwe amathandizira supraspinal kutsika inhibitory antinocicepts. Woopsa, kukhazikitsidwa kwa mankhwala a pharmacological kumagwiritsidwa ntchito pafupi ndi chapakati receptors (intradological). Ndikotheka kugwiritsa ntchito zamagetsi kukondoweza kwa mitsempha, makamaka makina olimbikira, kuti mulimbikitse zovuta zomwe zimapangitsa kuti chisangalalo cha mitsempha ya nocicept ya msana, komanso kupweteka. Mankhwala othandizira opaleshoni yotsutsana ndi pharmacotherapy atha kuphatikizira kugwiritsa ntchito ma electrodes obisika muubongo kapena chingwe cha msana, kumasulidwa kwa mitsempha chifukwa cha kukakamira kapena kuwonongeka kwake, kuwonongeka kwa mankhwala kapena kupindika mtima. Gome 2 imapereka malingaliro aku Russia omwe afotokozedwa posachedwa pokhudzana ndi matenda komanso kupweteka kwa mitsempha ya neuropathic, yokonzedwa ndi gulu la akatswiri otsogolera pantchito zamankhwala opweteka komanso kufalitsa motsogozedwa ndi katswiri wazamaphunziro a Russian Academy of Medical Sayansi, pulofesa N.N. Yah.
Monga momwe tikuwonera patebulo lachiwiri, kuchokera pakuwoneka mankhwala omwe ali ndi umboni, kugwiritsa ntchito magulu anayi a mankhwalawa pochizira NB ndikofunikira kwambiri: anticonvulsants, antidepressants, opioid analgesics and anesthetics wamba.
Kugwiritsidwa ntchito kwa mankhwala opatsirana kwakanthawi kumayambitsa kuchepa kwa ululu wa neuropathic, makamaka muzochitika momwe kukula kwake kumachitika makamaka chifukwa cha kusintha kwa zam'mitsempha m'mitsempha yapafupipafupi. Komabe, mankhwala oletsa ululu m'dongosolo la zomata, samalimbikitsidwa kuti azigwiritsidwa ntchito kwa nthawi yayitali komanso ngati dera la lesion ndilokwanira.
Ma antidepressants amagwiritsidwa ntchito kwambiri pochiza ululu wa neuropathic wamitundu yosiyanasiyana. Tricyclic antidepressants (TCAs), yomwe idayamba kugwiritsidwa ntchito mu 50s ya XX century, makamaka amitriptyline, imathandiza kwambiri kupweteka kwa neuropathic. Mukumva kupweteka kwa matenda ashuga polyneuropathy m'malo opitilira 80%, kuikidwa kwawo kumachepetsa ululu kapena kumapangitsa kutsika kwake. Njira yayikulu yogwirira ntchito ya TCA ndikuletsa kubwezeretsanso kwa norepinephrine ndi serotonin mu termynaptic terminal chifukwa cha zomwe zimachitika pamayendedwe a sodium ndi calcium, zomwe zimapangitsa kuti ntchito yowonjezereka yapakati pakhale.
Kusankha serotonin reuptake blockers (paroxetine, fluoxetine) sikumakhudza ma postynaptic receptors, chifukwa chake amakhala ndi zovuta zochepa, koma kuthekera kwawo kuchepetsa ululu wa neuropathic kumakhala kotsika kwambiri ku TCA. Amitriptyline adawerengeredwa m'mayesero angapo owongoleredwa a shuga a polyneuropathy opweteka. Mlingo wofanana wa amitriptyline womwe 25 mg umayambika, mankhwalawa amtundu wa mankhwala ndi 75-150 mg. TCA satha kugwiritsidwa ntchito kupweteka kwa neuropathic ululu, makamaka odwala okalamba, chifukwa cha zovuta zambiri komanso nthawi zina. Orthostatic hypotension, kwamikodzo posungira, kudzimbidwa, tachycardia, "youma matenda" amatha kuchitika mwa anthu achikulire okha. Kupezeka kwa glaucoma ndi adenoma ya Prostate ndikutsutsana ndi TCA. Kuphatikiza apo, zikuwonetsedwa kuti kugwiritsa ntchito nthawi yayitali ma TCAs kumawonjezera chiopsezo chokhala ndi myocardial infaration ndi 2.2.Zowonjezera zina za amitriptyline zimaphatikizapo kusakhala kwa mzere wama pharmacokinetics, ndiko kuti, mutatenga Mlingo wocheperako, kugwiritsidwa ntchito kwa plasma kumatha kukhala kwakukulu kuposa mukamatenga waukulu.
Maanticonvulsants adayamba kugwiritsidwa ntchito pochiza ma syndromes opweteka kuyambira 40s ya XX century, pomwe mphamvu ya phenytoin pochiza neuralgia ya trigeminal inasonyezedwa. Mu 1962, pochiza matenda a trigeminal neuralgia, mankhwala a anticonvulsant carbamazepine adagwiritsidwa ntchito koyamba, omwe ali ofanana ndi TCA, omwe amakhalabe mankhwala oyambira mu mankhwala a trigeminal neuralgia mpaka pano. Mankhwala othandizira othandizira kupweteka kwa mitsempha ya neuropathic osiyanasiyana etiology adatsimikizira kuti ndi gabapentin, anticonvulsant yomwe idawoneka m'zaka za 90s za XX. Gabapentin ali pafupi kwambiri ndi g-aminobutyric acid (GABA). Kuchita bwino kwa gabapentin woyambayo (Neurontin) kwawonetsedwa m'maphunziro a khungu lamaso owonera kawiri, omwe ali ndi vuto la neuropathic odwala omwe ali ndi matenda ashuga a polyneuropathy. Komabe, muyenera kukumbukiridwa kuti mulingo woyenera kwambiri wa mankhwalawa a gabapentin wochizira NB ndi 1800-2400 mg, mankhwalawa amayenera kuperekedwa kwa masabata awiri, zomwe zimapangitsa kuti ikhale yovuta kwambiri kugwiritsa ntchito.
Mwa anticonvulsants a m'badwo wotsiriza omwe afufuzidwa zaka zaposachedwa pochiza matenda amitsempha ya m'mimba matenda a DPN. Pregabalin (Nyimbo), malinga ndi malingaliro aku Russia pazithandizo za NB, ndi mankhwala a mzere woyamba wochizira NB ndi DPN. Mayeso 10 osasinthika amaso awiri, omwe amayendetsedwa ndi placebo adachitika, makamaka odwala omwe ali ndi vuto la matenda ashuga polyneuropathy ndi postherpetic neuralgia, pomwe odwala pafupifupi 10,000 adatenga nawo gawo. Pregabalin adawonetsedwa kuti ndiwothandiza kwambiri kupweteka kwamtundu uliwonse wa neuropathic. Zokwanira kunena kuti pregabalin amalembedwa ku USA ndi Russia ngati mankhwala ochizira mitundu yonse ya ululu wa neuropathic. Pregabalin ali ndi makina enaake amachitidwe - amasintha ntchito ya neurons. Pregabalin amamangiriza mapuloteni a calcium a2-delta volt-amadalira calcium ndipo amachepetsa kulowa kwa calcium mu cytoplasm. Izi zimabweretsa kuchepa kwa kumasulidwa kwa ma neurotransmitters, makamaka osangalatsa a glutamate mkhalapakati, omwe amachititsa kuchepa kwa chisangalalo cha ma neurons a lipenga lakumbuyo. Kuphatikiza apo, pregabalin imagwiritsa ntchito makamaka ma neurons osangalatsa.
Ubwino wofunika wa pregabalin ndi ma pharmacokinetics. Amatengeka mwachangu kwambiri kuchokera m'matumbo ndikukhazikika m'magazi pambuyo pa ola limodzi ndipo amasungidwa nthawi yayitali m'magazi kwambiri, zomwe zimapangitsa kuti mankhwalawa alembe kawiri tsiku lililonse mu Mlingo wofanana. Munthawi yonse ya Mlingo wothandizira (kuchokera pa 150 mpaka 600 mg), pregabalin amakhala ndi mankhwala opatsirana a cellarokinetics, omwe samayang'aniridwa mu mankhwala ena, kuphatikizapo gabapentin. Pregabalin ali ndi bioavailability yapamwamba kwambiri (90%), yopitilira gabapentin pankhaniyi (60%). Kudya sikukhudza bioavailability wa mankhwalawa. Chithandizo chimayamba ndi 75 mg kawiri pa tsiku, kenako pakatha masiku atatu, mlingo uyenera kuchuluka mpaka 300 mg patsiku. Kafukufuku wasonyeza kuti pregabalin imachepetsa kwambiri kupweteka kwa neuropathic m'masiku atatu oyambirira a kumwa mankhwalawa. Kugwiritsa ntchito kwambiri kwa pregabalin poyimitsa NB kumasiyanitsa bwino ndi mbadwo wapitala wa anticonvulsants, mwachitsanzo gabapentin. Kafukufuku wa nthawi yayitali (miyezi 15) yogwiritsidwa ntchito kwa pregabalin kupweteka kwa neuropathic awonetsa kuti imasunga zotsatira zake za analgesic kwa nthawi yonse yoyendetsera popanda kukulitsa kulolera kwa mankhwalawa. Kuphatikiza kwamphamvu kwa analgesic kwa pregabalin kumatsimikiziridwa ndi kusintha kwa kugona kwa wodwala, momwe amadzikonzera komanso mtundu wa zizindikiro za moyo.Pregabalin imalekeredwa bwino ndi odwala omwe ali ndi ululu wa neuropathic. Zotsatira zoyipa, kuchuluka kwa kugona ndi chizungulire nthawi zambiri kumawonedwa, zomwe nthawi zambiri zimatha msanga (masabata 2-4), ngakhale wodwalayo akapitiliza kumwa mankhwalawo kapena akuwonjezera mlingo wake. Chifukwa chakuti mankhwalawa samapangidwira m'chiwindi, samagwira ntchito ndi P450 cytochrome ndipo amachotsa impso ngati molekyulu yosasintha, ilibe hepatotoxicity. Mankhwalawa sasokoneza minofu ya impso ndipo samayambitsa matenda a impso, chifukwa chake amatha kugwiritsidwa ntchito mwa odwala omwe ali ndi aimpso, komabe, mlingo wa mankhwalawa ayenera kusankhidwa malinga ndi malangizo. Pregabalin samalumikizana ndi mankhwala ena ndipo amatha kugwiritsidwa ntchito mosiyanasiyana, mwachitsanzo, ndi mankhwala othandizira odwala matenda ashuga. M'maphunziro azachipatala, pregabalin yawonetsedwa kuti imagwira kwambiri kupweteka kwa neuropathic chifukwa cha kuwonongeka kwa mitsempha ya diabetes. Chifukwa chake, pofufuza mosasinthika, akhungu awiri, owongoleredwa ndi placebo mwa odwala 146 omwe ali ndi DPN, kuchepa kwakukulu kwa ululu wa neuropathic kunapezeka mu sabata yoyamba ya kafukufukuyu, yomwe idasungidwa kwa milungu 8 yotsatira ya kumwa mankhwalawo. Monga chofunikira, phunziroli linagwiritsa ntchito sikert ya Likert yomaliza maphunziro. Kusintha kwakukulu mu kugona ndi kuthekera kwa odwala kudadziwikanso. Kafukufuku wina mwa odwala 81, adawonetsedwa kuti ndi kusagwira bwino kwina kwa mankhwala ena okonzekera matenda opha shuga a polyneuropathy, pregabalin muyezo wa 150-600 mg anali wodalirika.
Chifukwa chake, mankhwala amakono a pharmacological, makamaka pregabalin, omwe amagwiritsidwa ntchito pochiza ululu wa neuropathic odwala omwe ali ndi DPN, kuwagwiritsa ntchito ngati monotherapy kapena kuphatikiza, amatha kuchepetsa ululu kwa odwala ambiri ndikuwongolera kwambiri moyo wawo.

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Chofunikira mu matenda a shuga ndikudziwikiratu kwa njira zosachiritsika ndi matenda. Nthawi zina pamakhala matenda a shuga a retinitis komanso atrophy ya mitsempha ya maso.

Matenda a diabetes a amblyopia ali ofanana mu pathogeneis ndi amblyopia ya nikotini. Zikuwoneka kuti Vitamini B wophatikizira amagwira ntchito yofunika kwambiri pathogenesis yake.

Mu madzi a cerebrospinal, shuga amapezeka m'magazi.Acetone mumadzi imatha kupezeka pamaso pa chikomokere, asidi acetoacetic m'madzi amapezeka pokhapokha ngati pali chikomokere. Ndi ketonuria wa nthawi yayitali, matupi a ketone amapita m'madzi.

Vuto lalikulu la matenda ashuga Matenda a hyperglycemic. Chomwe chimayambitsa kuperesa ndi kuchuluka kwa zinthu za metabolic zamafuta acid ndi acetone mthupi. Zosokoneza mu kagayidwe kazakudya zimapangitsa kuti mafuta asatulutse mafuta, komanso mapuloteni, pazinthu zawo zabwinobwino zomaliza. Kuphimba zofunikira zamagetsi, thupi limakakamizidwa kugwiritsa ntchito kuchuluka kwa mapuloteni komanso mafuta. Poterepa, kuthekera kopitiliza kuwotcha matupi a ketone kutayika, komwe kumapangitsa kuti adzikundikire m'thupi komanso kukulitsa acidosis. Beta-hydroxybutyric acid, yomwe imadziunjikira m'thupi, imakhala ndi poizoni m'thupi lamanjenje. Malinga ndi S. S. Genes, B-hydroxybutyric acid imalepheretsa njira za enzymatic mkati wamanjenje ndipo imalepheretsa maselo ake kukhala ndi thanzi labwino. Zovuta zambiri zamankhwala am'mwazi zimatha kupangitsa kuti mapuloteni a cell awonongeke.

Pankhaniyi, potaziyamu ndi phosphate zambiri zimamasulidwa, zomwe zimatuluka mkodzo.

Maonekedwe a chikomokere amatha chifukwa cha kuchepa kwa insulin, cholakwika chakudya, matenda opatsirana, komanso kuvutika m'maganizo. Nthawi zambiri, wodwala matenda ashuga amakula pang'onopang'ono masiku angapo. Poyamba, kusokonezeka m'matumbo kumawoneka ngati kusowa kwa chakudya, kupweteka pamimba, nseru, kusanza, kudzimbidwa kapena kutsegula m'mimba. Posachedwa pamakhala kumva kutopa konsekonse, chidwi, mutu. Kenako kuvuta kupuma kumalumikizana, komwe kumakhala kwakuya komanso kosakwiya (kupumira kwa Kussmaul). Mlengalenga wokhathamira, kununkhira kwa acetone kumamveka. Wodwalayo wagona, kenako kutuluka kwadzidzidzi kumadutsa pansi. Zomwe zimachitika zimachitika pafupipafupi komanso zochepa kwambiri, matenthedwe amakhala abwinobwino kapena otsika, kuthamanga kwa magazi kumatsika. Ana ake amapukusidwa. Tendon Reflexes amachepetsedwa kapena kulibe, kamvekedwe ka minofu kachepetsedwa. Pali kuledzera kwathunthu kwa thupi, komwe gawo lofunikira limakhala poyizoni wamkati wamanjenje, komwe kumayambitsa kupuma, kutsika kwamitsempha, kutsika kwa minofu komanso kuthina kwamphamvu kwamanjenje.

Kusintha kwachidziwitso komwe kumapezeka mu ubongo ali ofanana ndi omwe amawona ndi asphyxiation. Zombozo zimaphika, ma stasis amawoneka mwa iwo. Kuphwanya kwazovomerezeka za capillaries kumayambitsa matenda a edema ndi kufa kwa maselo amitsempha chifukwa cha kusokonezeka kwa metabolic ndi chidwi chawo chachikulu cha kuchepa kwa mpweya.

Mitundu itatu ya zotupa za msana zafotokozedwa:

1. Zosintha mu ma cell a mwendo wam'mimba mwa chingwe cha msana komanso mu tsinde laubongo . Ku chipatalako, nthawi zina, chithunzi cha poliomyelitis chawonedwa. Nthawi zambiri, sizinadziwikebe ngati zosinthazi zinali zoyambirira kapena zachiwiri chifukwa cha kusintha kwa mizu ndi mitsempha yotumphera.

2. Kusintha kwa mizu yakumbuyo ndi zipilala zam'mbuyo, zofanana ndi kusintha kwauma kwa dorsal . Zakhala zikudziwika kale kuti mu shuga, matenda ofanana ndi chingwe cha msana (pseudotabes diabetesica) amatha kuyang'aniridwa. Olemba amakono amakhulupirira kuti kuphatikizika kwa shuga kumachitika chifukwa cha kuwonongeka kwa mitsempha yapamadzi.

3. Zosintha m'makhola am'mbuyo komanso pang'ono pang'onopang'ono, zofanana ndi chithunzi cha myelosis yosangalatsa mu magazi a Burmer's . Grieg ndi Olsen, omwe amafotokoza za mtundu wamtunduwu, akukhulupirira kuti kuchepa kwa mphamvu ya ziwiya ndi makulidwe a makhoma awo kunapangitsa kusowa kwa magazi kwa nthawi yayitali kwa chingwe cha msana, zomwe zinayambitsa kusintha kwazomwezi. Tidawona wodwala wazaka 57 akudwala matenda a shuga kwa zaka 30. Matendawa adachulukirachulukira ndi polyneuritis. Kenako zilonda zam'mapazi zapakati pake, chithunzi chamkati mwa minyewa yamkati ya thoracic yam'mimba imayamba. Tizilombo ta m'mimba tinafotokoza za necrosis ya gawo la thoracic la chingwe cha msana.Pakuwunika kwa histological, kusintha kwa arteriosulinotic kunapezeka popanda chizindikiro cha syphilis.

Zilonda zam'mimba zam'mimba m'matenda a shuga osowa. Waltman ndi Wilder adatola matenda ashuga makumi asanu ndi limodzi m'mabuku momwe kuyezetsa kwa chingwe cha msana kudachitika. Mwa 20 mwa iwo, kusintha kwa msana kunapezeka. Olembawo agogomezera kuti milandu yambiriyi imafotokozedwa asanafike pakuyambitsa kwa Wassermann, koma chithunzi cha anatomical sichimapereka chifukwa chokwanira kupatula syphilis.

Polyneuritis mu shuga imakhudza makamaka miyendo yakumapazi. Olemba ena amakhulupirira kuti polyneuritis imapezeka muoposa theka la milandu yonse ya matenda ashuga, pomwe ena amawapeza m'mavuto osakwana 1%. Kusiyana kwakukulu uku kukufotokozedwa ndi njira yosiyana yaomwe alembi amafotokozera kutsimikiza kwa matenda ashuga a polyneuritis. Ena amakhulupirira kuti polyneuritis iyenera kuphatikizapo milandu yonse yomwe, ngakhale pakalibe cholinga, odwala amadandaula za ululu. Ena amati ndi polyneuritis pokhapokha ngati zizindikiritso zimadziwika. Kutengera kusankhika kokhwima kumeneku, ma rand kuchokera kwa odwala 400 omwe ali ndi matenda ashuga anapeza polyneuritis 4%. Martin adawona zizindikiro za polyneuritis mu 5% ya odwala matenda ashuga, 12% ya odwala amadandaula ndi kupweteka kwa m'mimba ndi ululu, koma sizinapezeke chizindikiro. Nthawi zambiri, kuyambika kwa zizindikiro za polyneuritis kumayambitsidwa ndi matenda omwe amakhala ndi matenda ashuga osagwira bwino, osathandizidwa bwino kapena osathandizidwa konse.

Nthawi zambiri kuposa mawonekedwe opangidwa mokwanira, pali mitundu yovutitsa ya polyneuritis, yomwe nthawi zambiri imakhala yofanana ndi zizindikiro zapadera: kupweteka kwa minofu, paresthesia, kuchepa kwa tendon Reflex, kusokonezeka kwa trophic. Ululu wamiyendo wowoneka ngati chizindikiro chakutali umapezedwa mumitsempha ya ng'ombe, kuyezetsa cholinga nthawi zambiri sikuwulula. Nthawi zambiri pamakhala madandaulo a kutentha, woipa usiku paresthesia m'miyendo ndi kumapazi. Odwala amathandizidwanso pakuziziritsa miyendo yawo ("diabetesic causalgia"). Pomaliza, kufalikira kwakuda kwa bondo ndi mawonekedwe a Achilles ndizofala kwambiri. Malinga ndi Goldflam, zovuta zina zakumanzere zimapezeka 13% ya odwala matenda ashuga.

Matenda a shuga a shuga amayamba pang'onopang'ono, osayamba kugonja. Kupita patsogolo pang'onopang'ono, kumatha kuyamba ndi neuralgia ya mitsempha payokha: mitsempha yachilengedwe, yachikazi, brachial plexus. Ndi chitukuko cha matenda ashuga neuralgia, chidwi chimakopeka kuti chizolowezi cha zilonda zam'mimba, mwachitsanzo, sayansi yapakati pa sayansi ya neuralgia. Neuralgia yachikazi ndizofala kwambiri, kotero mtundu wamtunduwu wosavomerezeka komanso makamaka wa neuralgia uyenera kukweza kukayikira kwa matenda ashuga.

Kumapeto kwa zaka zana zapitazi, Leiden adazindikira mitundu itatu yayikulu ya matenda ashuga polyneuritis: chidwi, motor ndi atactic. Kafukufuku wina wawonetsa kuti mtundu wa matenda ashuga ndiwofatsa, pomwe ululu wosalekeza, kawirikawiri sizitengera mawonekedwe a kupweteka kowombera. Nthawi zambiri, ululu umawonekera m'miyendo, makamaka minofu ya ng'ombe. Nthawi zambiri amakula kwambiri usiku. Ululu umatha kupitilira, koma nthawi zina umachulukirachulukira ndi ma paroxysms.

Oposa theka la odwala, limodzi ndi zowawa, paresthesia amawonedwa ngati mukumeza, kuwotcha, kumva tulo, komanso kupumira. Mokulira, kusokonezeka kwa chidwi kumasonyezedwa makamaka pakusokoneza kwa kugunda kwamphamvu. Zocheperako ndiz kuphwanya mitundu yonse ya zomverera mu zigawo zam'munsi zam'munsi. Mwa zina mwazovuta mawonekedwe a matenda ashuga polyneuritis, kutayika kwa tendon Reflex, makamaka Achilles, kumapezeka. Milandu yophatikizidwa kwa mtundu uwu wa polyneuritis wokhala ndi zizindikiro za retrobulbar optic neuritis akufotokozedwa.

Tsamba 2 - 2 mwa 3

Matendawa monga pelvic neuralgia ndiofala kwambiri komanso ovuta kuchiza.Chimodzi mwazifukwa zovuta zomwe zimakumana ndi mankhwalawa ndikuti matenda amtunduwu mu zisonyezo zake ali ofanana ndi matenda amumuna mwa abambo ndi amayi.

Nthawi zambiri, pelvic neuralgia imadzipweteka yokha m'dera lumbar, komabe, matendawa amakhalanso ndi matenda ena ambiri. Vuto lina lomwe limakhalapo chifukwa chakuti mayesowa sangathandizidwe kuzindikira nthawi zonse, muzochitika izi titha kunena kuti etiology yodziwika bwino siyinafotokozedwe.

Pamene neuralgia ya pelvic imachitika, zizindikiro zazikulu zimakhala zowawa kwambiri, komanso kumva kutentha. Dziwani kuti zizindikiro ngati izi zimangochitika mwadzidzidzi zikangodzidzimutsa, komanso zimakhudza thupi kwakanthawi kochepa, komabe, ululuwu umakhala waukulu kwambiri mpaka anthu amakhulupirira kuti nthawi zonse kumakhala kupweteka. Ululu umathanso kukhala m'chiuno, sangakhale ndi kuthekera konse, nthawi zambiri kumachitika pang'onopang'ono. Chofunikira kwambiri ndikuti ndi matenda otere ululu umatha kukhala wopitilira pang'ono, ndiko kuti, ungathe kupita impso, mtima ndi chiwindi. Ngati ululu umasokonekera, ndiye kuti sizotheka kudziwa vuto linalake.

Makamaka ululu waukulu umadzipangitsa kumayenda momasuka, kuchita masewera olimbitsa thupi, pamene munthu agwada ndi kutsokomola. Mulimonsemo, ndikofunikira kunena kuti ululu uliwonse umasiyana, chilichonse pano chimadalira mwachindunji komwe mitsempha imakhudzidwa. Apa muyenera kufotokozera zonse mwatsatanetsatane:

1. Ngati mitsempha yachikazi yapanikizika, ndiye kuti zizindikiro zake ndi - ululu wowopsa umayamba ngati pali kupanikizika kwa liginal inguinal, bondo palokha limapindika, minofu ya quadriceps imafooka.
2. Ngati minyewa yakunja yolumikizidwa, imangokhala ngati ikuyaka, ngati kuti zikwangwanjambazi zikukwawa. Zovuta, zomwe zimakulitsa kupweteka kwambiri, munthu amatuluka thukuta kwambiri, tsitsi limatha kutuluka.
3. Ngati minyewa yododometsa yapanikizika, zizindikiro zake ndi - ululu umamveka m'dera lamasamba, zimapwetekanso mu perineum, ngati mwendo utuluka pansi, ndikovuta kukhala pamalo oyimilira.
4. Ngati mitsempha ya sciatic yapindidwa - malo a matako amvekeka, ndikovuta kugwada, mawondo amasintha, miyendo imayaka ndikumva kulemera. Ndipo zala ndizovuta kuwerama kapena osawerama nkomwe.
5. Ngati mitsempha yapamwamba imapindika - imapweteka kwambiri matako, ntchafu ndiyovuta kuyibweza, thupi limavuta kuyimirira, ndipo minyewa ya mabatani imakhudzidwa.
6. Ngati misempha yocheperako ya gluteal imadina - m'chiuno molumikizana komanso m'matako zimapweteka, mayendedwe onse ndiovuta, makamaka miyendo.

Munthu akakhala ndi neuralgia, ululu umakhala waukulu. Mavuto makamaka amakumana ndi mwana, chifukwa amatha kulira kuchokera ku zowawa zazikuru kapena monga choncho, ndipo pano ambiri pazizindikirozo amatha kusokoneza katswiri wazodziwa kwambiri.

Zokhudza kupweteka

Ndi matenda otere, ndikofunikira kuti muchepetse kupweteka kwakanthawi, mankhwala oyenera agwiritsidwe ntchito pano. Pankhaniyi, nitroglycerin yadzitsimikizira yokha, komanso njira zina, cholinga chake ndikuletsa kupweteka kwa mtima ndi zizindikiro zina zofanana.

Ngati cholowa m'chiuno chikuyamba kupweteka, ndiye kuti muyenera kuyendera katswiri wa zamitsempha posachedwa, chifukwa chithandizo chamankhwala chofunikira ndichofunikira mwachangu. Pofuna kuchepetsa kukhumudwa, dokotala amatha kukupatsani mankhwala omwe ali ndi vuto la vasoconstrictive, antidepressants adziwonetsanso okha.

About diagnostics

Chilichonse pano sichophweka, chifukwa ululu ulibe malo okhazikika, omwe amathandizira kwambiri kudziwa njira yodziwira matenda. Nthawi zambiri kutulutsa kwawoko kumakhala m'munsi kumbuyo, kumbuyo. Ululu umalimba munthu akamayenda, pomwe mitsempha ya m'chiuno imayamba kugwira ntchito.Chifukwa chake, kusanthula kolondola nthawi zambiri sikungaperekedwe ngakhale maphunziro onse ofunikira atachitika, kuphatikiza ndi a labotale.

Kuzindikira kumatengera madandaulo, mayeso ndi mayeso a labotale, ndipo adotolo amayenera kuwunika wodwalayo mpaka awonetsetse zomwe zidapangitsa ululuwo.

About mitundu ya pelvic neuralgia

Neuralgia yotere imakhudza thupi m'mitundu iwiri:

1. Mitsempha ya mitsempha ya m'chiuno, yomwe ululu umalimbikitsidwa kwambiri pakuyenda, kuthamanga, komanso kuchita masewera olimbitsa thupi. Kuchepetsa koteroko kumachitika motsutsana ndi poyambira kuvulala kwa m'chiuno pakamadwala pakagwa matenda (makamaka pakakhala kutupa), pakakhala chopinga cha hernia kapena kapangidwe kake ka mafupa (amatha chifukwa cha chifuwa chachikulu).
2. Ngati mitsempha yodontha yomwe yakhazikika idakhudzidwa, ululuwo umawonekera pansi pakhungu osati mwakuya, ndipo imayamba kupweteka kwambiri usiku, ndiye kuti thupi likapumula.

Cholinga choyambirira cha mankhwalawa ndikuchotsa kapena kuchepetsa ululu. Pankhaniyi, analgesic imagwiritsidwa ntchito nthawi zambiri. Kenako mutha kugwiritsa ntchito mankhwala omwe amapezeka mu mawonekedwe a gels ndi mafuta. Ngati pali mitsempha yovuta kupininkha, ndiye kuti kugwiritsa ntchito mitundu yosiyanasiyana ya kukonzekera kwa mahomoni kumasonyezedwa, ndiye kuti mankhwalawa atenga nthawi yayitali.

Kuphatikiza pa mankhwalawa pogwiritsa ntchito mankhwala, njira zolimbitsa thupi zimagwiritsidwa ntchito mwachangu, zomwe zatsimikizira okha bwino, chithandizo chotere chikufalikira. Ndipo chithandizo chamankhwala a wowerengeka ndiyotchuka kwambiri, mankhwala oterowo amathandizadi, komabe, musanagwiritse ntchito, muyenera kuonana ndi dokotala, apo ayi mankhwalawo sangathere ndi chabwino chilichonse. Mankhwala oterowo nthawi zambiri amathandiza kwambiri kuchepetsa kusasangalala kwakuti ngakhale kugwiritsa ntchito mankhwala ochepetsa mphamvu ya mankhwala sofunikira. Pali njira zambiri zamankhwala zotere zomwe mungagwiritse ntchito ndi wowerengeka azitsamba, ndikofunikira kukambirana pazofala kwambiri:

• mukungoyenera kupukuta savalo ndikuyika pamalo omwe akukhudzidwawo,
• geranium yachipinda imatengedwa, masamba ake amawayika komwe amapweteka, ndiye kuti chilichonse chimakulungidwa ndi bandeji,
• pukutani khungu lakuda ndikututira m'deralo ndi msuzi wake,
• tengani masamba a lilac, pukuta, pwanya, sakanizani ndi mafuta a nkhumba ndikugwiritsa ntchito monga chopukusira,
• sakanizani chitsamba chowirira ndi mafuta a maolivi kuti mupange slurry ndikuyika pomwe ikupweteka.

About a pelvic neuralgia pamene majini apweteka

Nthawi zambiri matenda oterewa amayamba chifukwa cha matenda amiseche omwe amakhala ndi vuto losakhazikika mwa amayi, ndiko kuti, limayamba kuvulala mu perineum. Matenda opatsirana amathanso kuchitika pano. Njira yakuzindikira ikachitika, ndikofunikira kudziwa zizindikiritso zosonyeza kuti ndi amtunduwu:

• msambo umasweka
• pali zotulutsira zachilengedwe.
• kusabereka kumawonedwa.

Zikatero, oimira agonana angwiro nthawi zambiri amadandaula za kupweteka kumbuyo, m'mimba, nyini imatha kupweteka, ndipo kupweteka kumakulirakulira panthawi yogonana. Ngati kupweteka kumalumikizidwa ndi kuzungulira kwa msambo, ndiye makamaka izi zimachitika chifukwa cha matenda amisala.

Za abambo

Kupweteka kumatha kuchitika mwa abambo, ndipo kuchuluka kwa kuthekera kungakhale kosiyana, kulimba, nawonso, koma maphunziro a chilengedwe cha microbiological sangawonetse chilichonse. M'dera lachitukuko, kupweteka kwa m'chiuno, mumimba, komanso kumaliseche kumamasulidwa. Zomwe zimachitika izi zimakhala zosiyanasiyana: mitundu yosiyanasiyana ya kutupa (imatha kuwunikiridwa ndikuwunikira kwa Microbiology), komanso njira yomwe ilibe mawonekedwe otupa. Kwa kugonana kwamphamvu, otchulidwa ndizizindikiro:

• zilonda m'munsi
• Zimapweteka munthu akamakodza,
• kumaliseche kumakhala mawonekedwe a chinthu chosasangalatsa,
• kusinthasintha kumayambitsa kupweteka.

Komabe, ndi dokotala wokha yemwe amatha kuthana ndi zomwe zimayambitsa, amafotokozanso chithandizo choyenera cha mitsempha ya pelvic.

Zokhudza boma la pakati

Amadziwika kuti thupi la mkazi lili ndi pakati, limasinthidwa mosiyanasiyana, ndipo zambiri mwa zosinthazi zimakhudza malo a m'chiuno. Chifukwa chake, nchiani chomwe chingakhale chifukwa cha pelvic neuralgia mwa amayi oyembekezera? Nawa ena:

• chiberekero chikukula msanga,
• kupsinjika kambiri kumayikidwa m'chiuno,
• mathero a mitsempha akupanikizika kwambiri,
• chitetezo chochepa mphamvu.

Nthawi zambiri, imayamba kupweteka mkati mwa trimester yachitatu, mwana wosabadwayo akamakula, kupanikizika kwa mafupa kumawonjezeka. Kusunthika m'mitsempha kumayamba chifukwa chakuti ndizosatheka kuyenda kwathunthu, kuyenda kwa magazi kumasokonezeka pamene mwana wosabadwayo akuyenda, kupweteka kumakulirakulira ndipo malo a m'chiuno amapanikizika kwambiri.

Kuphatikizika kwa mitsempha kotereku kumadziwika kuti ndikofala kwambiri. Mtundu wina wa neuropathy umawonedwa mu 50% ya odwala matenda ashuga. Zomwe zimayambitsa zimatsutsanabe.

Pali lingaliro la sorbitol. Malinga ndi izi, glucose owonjezereka amasungidwa mkati mwa maselo, zomwe zimatsogolera ku glycosylation wa mapuloteni ndikuwonjezereka kwa fibronectin. Zotsatira zake ndikukula kwa microangiopathy.

Microangiopathy imawononga mitsempha yaying'ono, zomwe zimapangitsa kukula kwa mitsempha yodwala.

Macroangiopathy ndimawonongeka pamitsempha yamagazi yomwe imayamba chifukwa cha hyperglycemia. Chifukwa cha njirazi, kusintha pakhungu ndi minofu yofewa kumawonedwa, komanso kuwonongeka kwa misempha yaying'ono.

Pali chiopsezo chopanga ma neuropathies osiyanasiyana, koma nthawi zambiri odwala matenda ashuga a sensorimotor neuropathies amakula.

Zizindikiro za matenda ashuga:

- Chizindikiro chodziwika bwino ndikumverera kwa dzanzi ndikuwotcha m'miyendo, kenako pali zotupa zamanja,

- mphamvu zam'miyendo zikutayika,

- khungu la miyendo limayamba kusinthika.

- cranial nerve neuropathy ikupezeka,

- ndi autonomic neuropathy, kutsekula m'mimba, kusungika kwamikodzo, kusabala kumawonedwa,

- mitsempha yayikulu ndi miyendo imakhudzidwa chifukwa cha mononeuritis yambiri,

Ndi femur neuropathy, kufooka kumamveka m'mitsempha yoluka, kupweteka m'chiuno, Reflex ya bondo imatayika.

Kodi neuropathy imapezeka bwanji?

Nthawi zambiri, kuti muwadziwitse moyenera, ndikokwanira kutolera anamnesis ndikupeza zotsatira zoyesedwa. Mutha kuzindikira matenda ashuga mwa kuyang'ana glucose wanu wosala ndikuchita mayeso ololera a glucose kwa maola awiri. Kafukufuku wa EMG wa mitsempha yopanga imapangitsa kuti azindikire neuropathy ya ulusi waukulu. Koma pazingwe zazing'ono, kafukufukuyu sioyenera.

Zosiyanasiyana

Neuralgia "imatha" kugunda "mitsempha iliyonse, koma mochulukitsa omwe akatswiri azachipatala amatenga matenda amtunduwu:

• nkhope neuralgia kapena trigeminal neuralgia,
• neuralgia kumbuyo,
• sciatic neuralgia,
• glossopharyngeal neuralgia,
• occipital mitsempha neuralgia.

Zomwe zimayambitsa kupititsa patsogolo matenda zimatha kusiyanasiyana kutengera ndi momwe msempha wamafupa udakhudzidwira.

Zomwe zimayambitsa mitsempha ya occipital:

• chotupa chamchiberekero kapena chovulaza, chosakhazikika khosi lachiberekero,
• kuvulala kwa khomo lachiberekero losiyanasiyana,
• hypothermia wa nape.

Etiology ya nkhope neuralgia:

• aneurysm ya mitsempha yomwe imadyetsa bongo,
• chotupa chamtundu woyipa ndi wowonda, wopezeka muubongo,
• Hypothermia wa nkhope,
• Njira zopatsirana ndi matenda osakhazikika kumaso. Pankhaniyi, tikukambirana, ndi zina zambiri.

Etiology ya sciatic nerve neuralgia:

• chepetsa msana
• kupindika kwa chiwalo kapena chachikazi,
• chotupa cha chosaopsa kapena chovunda, chopezeka pamalo opangira mitsempha,
• Hypothermia ya m'munsi kumbuyo, m'chiuno ndi matako,
• onenepa kwambiri
• mimba
• kukhalapo kwa matenda opatsirana kapena otupa mu ziwalo za m'chiberekero.

Etiology ya glossopharyngeal neuralgia:

• kupezeka kwa matenda opatsirana, monga, ndi zina zotero.
• thupi lawo siligwirizana
• kagayidwe kachakudya
• kuledzera thupi
• kumwa kwambiri mowa,

Kuponderezedwa kwamphamvu

Nuralgia wamkati limachitika nthawi zambiri. Cholinga chake ndichosavuta - mitsempha iyi imasiya chigaza kudzera pakung'onoting'ono kwambiri, chifukwa chake, minofu yoyandikana nayo imatha kufinya. Mitsempha iyi imayambitsa kuteteza nkhope.

Nthawi zambiri matendawa amayamba kukula kwambiri - kumakhala kupweteka kwambiri kumaso. Ndi paroxysmal mwachilengedwe. Odwala amadziwa kuti izi zikufanana ndi gawo lamagetsi. Nthawi zambiri amawuma ndikuyesa kuti asayendenso pakakhala vuto lotere. Kutalika kwake kumasiyanasiyana kwa munthu aliyense - kwa ena ndi mphindi zochepa, komanso kwa ena mphindi zochepa. Ndikofunika kudziwa kuti kukomoka kumatha kubwerezedwa mpaka katatu pa tsiku, zomwe zimatopetsa kwambiri munthu. Ululu nthawi zambiri umakhala kudzanja lamanja la nkhope. Pafupipafupi ndi neuralgia pawiri.

Kugunda kwaminyewa itatu kumatha kuyamba kupita patsogolo ndi zotsatira zakuthupi pazinthu zina zapadera kumaso (mapiko amphuno, ngodya zamaso, ndi zina). Izi zimawonedwa nthawi zonse kutafuna chakudya, kutsuka mano, kugwiritsa ntchito zodzoladzola kapena kumeta.

Kupsyinjika kwa mitsempha ya sayansi

Sayansi neuralgia imawonetsedwa ndi zizindikiro zotsatirazi:

• "Kuwombera" ululu m'mitsempha,
• kumverera koyaka m'munsi, matako,
• makamaka nthambi imodzi yamitsempha imakhudzidwa,
• Wodwalayo akuti mbali yomwe idakhudzidwayo anali ndi vuto la "kukwawa".

Kupsyinjika kwa mitsempha yapa ntchito

• vuto lakupweteka limagwira munthu mwadzidzidzi. Nthawi zina zitha kudutsidwa ndi kukwiya pang'ono, mwachitsanzo, munthu amangokanda mutu kapena kutembenuzira kwambiri,
• kupweteka kwakukulu mu mawonekedwe a "lumbago" kumachitika kumbuyo kwa khosi, khosi kapena kumbuyo kwa makutu,
• ululu wamankhwala ululu umakhazikitsidwa kuchokera hafu imodzi yokha ya mutu ndi khosi, koma chotupa chakumanzere sichimachotsedwa.

• lunda
• kuvutikira kumachitika kamodzi. Koma nthawi zambiri zimayambitsidwa ndi kusintha kwamphamvu pakulimbitsa thupi, kupuma mwamphamvu, kutsokomola mwamphamvu,
• nthawi ya ululu imasiyana - kuchokera maora angapo mpaka masiku angapo,
• pamalo omwe minyewa yamtsempha yakhudzidwa, kuchepa kwa chidwi cha khungu kumatha kuzindikira.

Leion wa glossopharyngeal nerve

Kubwerera m'mbuyo, kudya kapena kutsokomola zimatha kudzutsa chiwonetsero cha zizindikiro za glossopharyngeal neuralgia. Zotsatira zake, wodwalayo amamva kupweteka kwambiri pamizu ya lilime, komwe kuli ma toni, pharynx. Panthawi ya kuukira, pakamwa pouma amadziwika, ndipo atatha kuimitsidwa - kuwonjezeka kwa kupulumuka. Ndizofunikira kudziwa kuti zakudya zonse zomwe munthu adzatenge nthawi ino zizimveka zowawa kwa iye.

Zizindikiro

Ngati zizindikiro zomwe zawoneka pamwambazi zikuwonekera, muyenera kulumikizana ndi a chipatala msanga kuti mudziwe bwino momwe matenda anu akupatsirani. Dokotala atha kukuwuzani za kupezeka kwa matendawa pakuwunika koyambirira ndikuwunika madandaulo a wodwala. Kuti muwonetsetse ngati wodwalayo azindikira kuti ali ndi vutoli, amatumizidwa kukayesedwa.

Njira zochizira

Muyenera kuyamba kuchiza neuralgia mutangozindikira kuti mwazindikira. Ambiri amakhulupirira kuti izi sizowopsa m'thupi la munthu. Izi sizoganiza zolondola kwathunthu. Monga tafotokozera pamwambapa, neuralgia imapita patsogolo kachiwiri, zomwe zikutanthauza kuti lisanawonekere m'thupi njira iliyonse yowopsa ya pathological inapita kale. Chifukwa chake zimabweretsa chiwopsezo ku thanzi la anthu komanso moyo, ndipo choyambirira ndichofunika kuzichiza.Neuralgia imakhala yowopsa kwambiri panthawi yoyembekezera, chifukwa imangokulitsa njira yake komanso ingayambitse vuto lolakwika.

Njira zonse zochizira neuralgia zimagawidwa kuti zikhale zosasangalatsa komanso opareshoni. Madokotala nthawi zambiri amayesetsa kuchitira opereshoni mankhwala osafunikira, ndipo chifukwa cha kusachita bwino kwa njira zopangira opaleshoni.

Chithandizo cha Conservative:

• poika anti-yotupa ndi analgesic mankhwala. Ndikofunikira kuchitira neuralgia ndi mankhwalawa, chifukwa amathandizira kuimitsa ululu wammbuyo ndikuchotsa kutupa mu minyewa yamitsempha yomwe yakhudzidwa. Dongosolo la chithandizo likuphatikiza baclofen, ibuprofen, ndi zina zambiri.
• kumwa mavitamini kuchokera ku gulu B. Nthawi zambiri, amapatsidwa ma jakisoni kuti athandize odwala,
• acupuncture imapereka zotsatira zabwino kwambiri pochiza matenda,
• chithandizo cha physiotherapeutic. Gwiritsani ntchito ma ultraviolet, laser, maginito ndi zina zambiri.

Therapy imatha kuthandizidwa ndi njira zina, kutengera mtundu wa matenda omwe adapezeka:

• ndi intercostal neuralgia, kukulitsa msana, kusambira ndikuvala ma corsets apadera akuwonetsedwa. Mankhwala ochepetsa ululu amaphatikizidwanso m'lingaliro la chithandizo.
• kuponderezana kwamankhwala atatu kumachitika ndi anticonvulsants. Nthawi zina madokotala amatembenukira ku kuwonongeka kwa gawo la minyewa yomwe yakhudzidwa,
• ndi matenda a mitsempha ya sciatic, kupumula kwa kama, mankhwala odana ndi kutupa, kutsitsa kwa mitsempha ndi kukondoweza kwa magetsi kukuwonetsedwa.

Kusamalidwa kwapadera kuyenera kumwedwa pochotsa neuralgia panthawi yapakati. Ndikofunika kuchitira chithandizo amayi apakati osakhazikika kuti madotolo azitha kuyang'anira momwe mayiyo aliri.

Kodi chilichonse ndicholondola m'ndimeyi malinga ndi zamankhwala?

Yankho lokha ngati mwatsimikizira chidziwitso chachipatala.

Neuralgia ndimatenda omwe munthu amakhudzidwa ndi mitsempha yapadera. Pankhaniyi, wodwalayo amamva kupweteka kwakukulu kwa paroxysmal, komwe sikungathetsedwe ndi analgesics yosavuta. Zilonda zimatha kuchitika m'malo osiyanasiyana amanjenje. Pankhani imeneyi, akatswiri amagawana mitundu ingapo yayikulu ya neuralgia. Nthawi zambiri, misempha yamkati, yakuthupi, yachikazi komanso yakunja imakhudzidwa. Malinga ndi kafukufuku wazachipatala, azimayi opitirira zaka 40 nthawi zambiri amadwala matendawa.

Zizindikiro za Neuralgia

Chizindikiro choyamba komanso chachikulu cha matendawa ndi kupweteka. Ndi neuralgia, chizindikiro ichi ndichoperewera kwambiri. Zimachitika mwadzidzidzi ndipo zimatha nthawi yayitali. Komabe, palibe ma analgesics omwe angachepetse kupweteka kwathunthu. Kuphatikiza apo, neuralgia imayambitsa zizindikiro zotsatirazi:

• redness la khungu m'dera la mitsempha yomwe yakhudzidwa,
• kulephera kutenga mapapu athunthu amzimu (ndi matenda amtundu wamtundu),
• kupweteka kwambiri pamene kutsokomola, kuseka, kusefukira,
• nkhope zosokoneza,
• dzanzi la miyendo (ndi kuwonongeka kwa mitsempha yachikazi).

Neuralgia yovuta kwambiri imakhalapo pomwe pterygo-palatine node imawonongeka. Poterepa, munthu amakhala ndi ululu wambiri womwe umaphimba gawo lamaso, thambo, akachisi. Chizindikiro ichi chimatha kufalikira mpaka khosi, kupatsa manja, kufikira manja. Nthawi zambiri, ululu umachitika usiku. Amatha kukhala maola angapo kapena masiku awiri.

Neuralgia ya kuntchito imayambitsa zofanana. Ndi zowawa zamtunduwu, zimawonekeranso m'diso, kufalikira kumakachisi. Kusuntha kwamutu kulikonse kumakulitsa chizindikiro ichi. Nthawi zina ululu umakhala pachimake kwambiri mpaka umatha kupangitsa kuti musanduke nseru komanso kusanza mwa munthu.

Buku: Big Medical Encyclopedia, 1956

Pali zinthu zambiri zomwe zimayambitsa matendawa. Mwachitsanzo, ma neuralgia omwe amapezeka kwambiri mwa anthu amatha kuchitika chifukwa cha:

• kachilombo koyambitsa matenda
• nsapato,
• multiple sclerosis
• matenda ashuga
• nsungu.

Kuphatikiza apo, neuralgia imatha kupweteketsa, zomwe zimayambitsa zomwe zimakhala m'mafupa. Akakula, amafinya mitsempha, ndikupangitsa kuti ipanikizike. Komanso yambitsani chitukuko cha matenda:

• hypothermia wamba kapena yakomweko,
• kupsinjika kwakukulu
• kukhumudwa kwambiri
• kulimbikira ntchito
• kutopa kwa thupi,
• chitetezo chokwanira.

Matenda ena osiyanasiyana omwe amapezeka m'thupi la wodwalayo amathanso kuyambitsa matendawa. Mwachitsanzo, intercostal neuralgia imatha kuchitika chifukwa cha kuwonongeka kwa poizoni, zomwe zimapangitsa ndikugwiritsa ntchito zakumwa zambiri zolimba komanso kugwiritsa ntchito mankhwala kwakanthawi.

Nthawi zambiri, kuvulala kwamankhwala am'mimba kumayambitsa matendawa. Anthu amatha kumva neuralgia chifukwa cha kuvulala kwa msana, kulumala kolumikizana. Nthawi zambiri, matendawa amavutitsa anthu omwe adapezeka kuti ali ndi vuto la ziwalo za m'magazi.

Ngati mukukayikira kuti muli ndi neuralgia ndipo mukukumana ndi zizindikiro zomwe zili pamwambazi, ndiye kuti muyenera kuyamba kulandira chithandizo mwachangu. Osayesa kuthana ndi matendawo inunso. Machitidwe oterewa nthawi zambiri amayambitsa kukulira kwa vutoli. Akatswiri otsatirawa atha kudziwa zoyenera kuchita ndi odwala: neuralgia:

Zizindikiro zoyambirira za matendawa zikaonekera, ndikofunikira kupangana naye madokotala. Ndi okhawo omwe amatha kudziwa bwino matenda, komanso kupereka mankhwala othandiza. Pakusankhidwa koyamba, adokotala amapenda wodwalayo mosamala, kumvera madandaulo ake onse. Dokotala adzakondweretsanso:

1. Zizindikiro zoyambirira za neuralgia zimawoneka nthawi yayitali bwanji?
2. Kodi pali zizindikiro zina za munthu?
3. Kodi nthawi zambiri mwakhala mukudandaula?
4. Kodi munthu amadwala matenda osachiritsika?
5. Kodi waposedwa posachedwapa?
6. Kodi mukumwa mankhwala aliwonse?
7. Kodi amakonda kumwa moledzera?
8. Kodi panali zovuta ngati izi m'mbuyomu?

Zomwe adalandira kuchokera kwa wodwala zithandiza dokotalayo kudziwa mwachangu mtundu womwe chithandizo cha neuralgia chikufunikira. Pambuyo pa izi, wodwalayo amatumizidwa kuti akamuyeze. Ayenera kukayezetsa magazi, kuyezetsa zamagetsi, kuchita ma X-ray, ndikuwunika thupi ndi chithunzi cha maginito. Atalandira zotsatira za maphunziro onse, adokotala amatha kuyamba kuchiza wodwalayo.

Njira zochizira wodwala aliyense zimapangidwa motsatana. Pankhaniyi, dokotala amaganizira msinkhu wa wodwalayo, thanzi lawo komanso zolimbitsa thupi.

Kugwiritsa ntchito moyenera

Kwa wodwala aliyense, madokotala amasankha njira zoyenera zolimbana ndi matendawa. Ngati munthu ali ndi vuto la neuralgia, ndiye kuti chithandizo chambiri chimayamba ndi kupweteka. Mwa izi, mankhwala otsatirawa amalembedwa kwa wodwala:

• ma pinkiller
• anticonvulsants,
• anti-yotupa mankhwala.

Ngati mankhwalawa sathandizira wodwalayo, ndiye kuti madokotala amatha kugwiritsa ntchito narcotic analgesic. M'mavuto ovuta kwambiri, adokotala amatha kulowa mu blockade mu thunthu la mitsempha.

Dokotala adzakuwuzani momwe mungachiritsire matendawa, mutatha kudziwa zomwe zimayambitsa neuralgia. Nthawi zina, physiotherapy yosavuta imathandiza kuthana ndi matenda, komanso mwa ena - zovuta kuchitapo kanthu pakuchita opareshoni. Mankhwalawa mothandizidwa ndi:

• kupweteka kwa laser
• ultrasound
• katemera
• ma radiation a ultraviolet
• electrophoresis
• maginito
• zimachitika mafunde.

Kufunika kwa njira inayake kumatsimikiziridwa ndi adokotala. Ndi iye amene amasankha njira zamankhwala ndikuwunika momwe zimathandizira.

Kodi kuchitira matendawa?

Matendawa sakhala ndi matenda omwe angabweretse ngozi yayikulu kwa anthu. Komabe, Zizindikiro zowopsa zimatha kusokoneza thanzi la wodwalayo. Ngati munthu wapezeka ndi neuralgia, ndiye akatswiri okhawo omwe angakuwuzeni momwe mungachiritsire, chifukwa zizindikiro za matendawa ndizofanana ndi matenda ena.Kuunikiraku kumathandizira kutsimikizira kuti matendawa ndiwachotsa matenda monga:

• myocardial infaration
• yabwino
• aimpso.

Ngati wodwala wapezeka ndi neuralgia, ndiye kuti amamulembera kuchipatala. Kugonekedwa kuchipatala kwa anthu otere ndikosowa kwambiri. Monga lamulo, wodwalayo amapatsidwa njira zingapo pamlungu. Kutalika kwa chithandizo kumatengera mawonekedwe a thupi, zomwe wodwalayo ali nazo, zaka zake. Pafupifupi, mutha kuthana ndi matendawa masabata 3-6 osamalidwa kwambiri.

Matenda omwe amayambitsidwa ndi kuwonongeka kwa mitsempha yotumphera amatchedwa neuralgia. Amawonetsedwa mwakuthupi kudzera muukali wazovuta za paroxysmal kumanzere kapena kumanja, zomwe zimawoneka m'dera lamitsempha. Kuchokera kuzindikirika kwake koyenera zimadalira momwe angachitire neuralgia.

Zoyambitsa Neuralgia

Pogwiritsa ntchito mphamvu yayitali, microtrauma yamtengo wamanjenje imachitika. Vutoli limatha kuchitika chifukwa chakugonjetsedwa kwa zakumwa zamaukidwe osiyanasiyana, zomwe zimayambitsa matenda kapena zimachitika pakumwa zakumwa zoledzeretsa, kumwa mankhwala kapena kulumikizana ndi zitsulo zolemera. Zomwe zimayambitsa, zizindikiritso ndi chithandizo zimadalira mtundu wamatenda: kulumikizana kwa bondo, miyendo yam'munsi, mitsempha yamtundu, solar plexus, pelvic, intervertebral, nerus nerve, ndi zina.

• osteochondrosis,
• hypothermia
• Matenda ogwirizana ndi minofu ndi mafupa olumikizirana mafupa ndi mafupa, kuvulala kwa msana),
• zotupa
• matenda ashuga
• zotumphukira zamitsempha yamagazi zomwe zimasokoneza magazi kuti zikhale ndi minyewa yamitsempha,
• atherosulinosis.

Intercostal neuralgia

Zizindikiro za intercostal neuralgia (ICD-10 code: M79.2) ndizopweteka m'mbali kumanzere kapena mbali yakumanzere yakumanzere, komwe kumakhala lamba ngati kumanzere kapena mbali yakumanja ya thupi. Chochititsa chofala cha osteochondrosis chiri m'dera la msana wa thoracic. Zizindikiro za matendawa zimawonekera ngati munthu atembenuka kwambiri (kuchokera kumanzere kupita kumanja komanso mosemphanitsa). Zowawa zimawoneka mosayembekezereka ndipo zimatsagana ndi kuwonjezeka kwa kuthamanga kwa magazi. Mu achinyamata ndi ana, matendawa samachitika. Chithandizo cha zam'mimba neuralgia zotchulidwa yekha ndi dokotala.

Trigeminal neuralgia

Madokotala adapeza kuti mwa anthu 10,000, 50 amawonetsa trigeminal neuralgia (trigeminal). Amayi atatha zaka 40 ali pachiwopsezo cha matendawa. Zomwe zimayambitsa chitukuko ndi chimfine, matenda, kuvulala ndi hypothermia. Zovuta zowawa zimachitika kwambiri ndi phokoso lalikulu, kuwala kowala, poyankha kudya ozizira kapena chakudya chotentha kwambiri. Kuchiza ndikuchotsa chizindikiro cha matenda amtunduwu kumachitika mwa kuperekedwa kwa trleptal ndi finlepsin. Njira yakuwonongera mizu pawailesi imagwiritsidwa ntchito.

Glossopharyngeal Neuralgia

Mankhwala, glossopharyngeal neuralgia (glossopharyngeal) sapezeka kawirikawiri. Mutha kuphunzira za matendawa ndi zizindikilo zoyamba: kupweteka kwa kupweteka pakhosi, pakhosi, muzu wa lilime, kakhalidwe kofewa, ma toni. Ululu umafikira mpaka kutsaya ndi khutu. Choyambitsa chimatha kukhala matenda opatsirana. Matendawa amaphatikizidwa ndi zizindikiro monga: kuletsa kwa chidwi mu pharynx ndi palate, kusala kwamisala ndikumverera kowoneka kumbuyo kwa lilime m'dera lomwe lakhudzidwa. Mankhwala, pali mitundu iwiri yamatenda yamtunduwu: idiopathic ndi chizindikiro.

Ntchito Yogwira Ntchito Yogwira Ntchito

Matendawa amawonetsedwa ndi zowawa kuyambira kumbuyo kwa mutu kupita kumalo osakhalitsa, omwe amatha kudutsa gawo la maso. Zomverera zowawa zimachitika chifukwa cha kuyipitsidwa kwa mizu ya mitsempha m'chigawo cha occipital. Nthawi zina, msana wawung'ono komanso waukulu wammbuyo umakhudzidwa m'chigawo chachiwiri ndi chachitatu cha khomo lachiberekero. Chizindikiro chachikulu cha neuralgia cha occipital nerve chimatchedwa madokotala kupweteka kwapweteka komwe kumavuta kupirira. Zimachitika ndikusuntha kwamutu ndikukhosomola. Pakakhala vuto, kuyenda kumatha kuyambitsa nseru komanso kusanza kwa wodwala.

Neuralgia yachikazi

Njira ya pathological imadziwika ndi ululu wowawa m'mitsempha. Ululu ndi paroxysmal, "kuwombera" mwachilengedwe. Pangozi ndi anthu azaka zapakati, abambo amatha kukhala ndi neuralgia yachikazi nthawi zambiri kuposa azimayi. Mukamayenda, ndikusintha thupi kukhala limaima, kupweteka kumbuyo ndi miyendo yotambasuka kumaonjezera, dzanzi ndi kuyaka kumawoneka pakhungu.

Kufinya pang'ono pang'onopang'ono kudera lamanjenje kumapangitsa kumva kupweteka kosaletseka. Matendawa amatha kuonekera monga kudalirana pang'onopang'ono. Paresthesia (kusokonezeka kwamphamvu) kumachitika pokhapokha ngati mukuyenda. Choyambitsa chachikulu chomwe chimachitika ndi kuponderezana kwamanjenje yakunja ya ntchafu pansi pa khola la inguinal. Kuphwanya mizu ya mitsempha kumatha kuchitika chifukwa cha kuvulala kwa ziwalo zozungulira, ndikuwoneka ngati zipsera, kukula kwa adipose kapena minyewa ya fibrous, panthawi yapakati

Herpetic neuralgia

Zotsatira za matenda a herpetic ndi herpetic neuralgia. Matenda owopsa nthawi zambiri amapezeka mwa odwala omwe ali ndi chitetezo chokwanira komanso okalamba. Njira ya pathological iyi imasiyana ndi mawonekedwe ena a khungu pakhungu la herpetic. Mtundu wa postherpetic wamatendawa umadziwoneka wokha pambuyo pang'onopang'ono mu mawonekedwe a ululu kuchokera ku zidzolo.

Pterygo-neuralgia

Ganglioneuritis (ganglionitis) amatchedwanso "pterygopalatine neuralgia," Slader syndrome. Amakhudza ma syndromes a neurostomatological (matenda amkamwa ndi kumaso). Matendawa akuwonetsedwa kudzera m'masamba omera. Hafu ya nkhope imatha kukhala yofiyira, kutupa kwa minofu, kuchulukana kumatha kuchitika, kubisalira kumatha kutulutsidwa kuchokera ku theka la mphuno. Kuukira kwa ma paroxysms opweteka kumatha kukhala usiku, komaliza komanso osachokapo masiku opitilira masiku awiri.

Kuphatikizika kwa chizindikirocho kumakhala ndi zowunikira kwambiri ndipo kumatha kufalikira m'malo motere:

• maso
• chibwano chapamwamba
• dera lakanthawi
• khutu
• kumbuyo kwa mutu
• scapula ndi malo oyenera,
• mapewa
• kutsogolo
• maburashi.

Zowopsa

Izi matenda amadziwika ndi kuwonongeka kwa gulu la mitsempha. Odwala omwe ali ndi matenda ashuga, polyneuropathy imakhala yovuta kwambiri.

Zomwe zimapangitsa kuti pakhale polyneuropathy:

• ukalamba
• onenepa kwambiri
• kusowa zolimbitsa thupi
• kuchuluka kosalekeza m'magazi.

Neuropathy imayamba chifukwa chakuti thupi limayambitsa mapangidwe a calcium, chifukwa cha kuchuluka kwa shuga. Chifukwa cha njirayi, kusintha kwa ma neurons kumachitika, ndipo kuthamanga kwa conduction kumachepetsa.

Diabetesic polyneuropathy imatchulidwa kuti ICD-10 monga E10-E14. Nambala iyi yalembedwa pamawu a wodwala.

Zizindikiro zamatsenga

Nthawi zambiri, matenda ashuga polyneuropathy amakhudza malekezero ena ake. Zizindikiro zimatha kugawidwa m'magulu awiri - zizindikiritso zoyambirira ndi zizindikiro zakuchedwa. Kuyambitsa matenda kumadziwika ndi:

• kumverera kogundika miyendo,
• miyendo, makamaka kugona.
• kutayika kwa miyendo.

Nthawi zambiri odwala samalabadira zoyamba za matendawa ndikupita kwa dokotala pokhapokha pakuwonekera pambuyo pake:

• kupweteka kwa mwendo kosalekeza
• kufooketsa minofu ya phazi,
• kusintha kukula kwa misomali,
• Kusintha kwa phazi.

Matenda a shuga a shuga a polyneuropathy, omwe amapatsidwa nambala ya E10-E14 malinga ndi ICD, amabweretsa zovuta zambiri kwa wodwalayo ndipo amakhala ndi zovuta zambiri. Matenda a ululu samachepa ngakhale usiku, chifukwa chake matendawa nthawi zambiri amakhala ndi kusowa tulo komanso kutopa kwambiri.

Chithandizo cha matenda a mtima

Chithandizo cha polyneuropathy chimafuna njira yolumikizira. Mankhwala imagwiritsidwa ntchito:

• mankhwala
• matenda a shuga shuga ndende,
• kutenthetsa miyendo
• olimbitsa thupi.

Mankhwala othandizira odwala amagwira ntchito yolimbitsa makoma amitsempha yamagazi, kukonza momwe amapangira komanso kulimbitsa ulusi wamitsempha. Pankhani ya zilonda zam'mimba, mankhwala am'deralo amafunikanso, pofuna kuchiza kuvulala ndikuchepetsa chiopsezo chotenga kachilonda.

Mu chipinda chopangira masewera olimbitsa thupi, wodwalayo amawonetsedwa zolimbitsa thupi zomwe ziyenera kuchitidwa tsiku ndi tsiku.

Chofunikira pakuthandizira odwala matenda ashuga polyneuropathy ndikuchepetsa kuchuluka kwa shuga m'magazi. Mchere wambiri womwe umakwezedwa wokwanira umapangitsa kukula kwa zilonda zam'mphepete, motero, kusintha kosinthika kwa mkhalidwe wodwala ndikofunikira.

Mitundu ya matenda

Malinga ndi ziwerengero, theka la anthu odwala matenda ashuga ali ndi matenda a shuga.

Ndi matenda a shuga, neuropathy imayamba pang'onopang'ono. Zizindikiro zake ndizofanana ndikuwonetsa matenda ena. Pali mitundu itatu ya matenda:

Cholinga chachikulu cha matenda ndi momwe shuga amachitikira m'misempha yamanjenje kwa nthawi yayitali, chifukwa chomwe minyewa yamitsempha imawonongeka. Kuphatikiza apo, chitukuko cha matendawa chimafunikira zinthu zotsatirazi:

• Kulephera kwa kagayidwe kachakudya, chifukwa komwe kuchuluka kwa shuga ndi mafuta m'magazi kumakwera, pali kuchepa kwa insulin.
• Kuwonongeka kwa maselo amisempha ya mitsempha yakutha kufalitsa chizindikiro, kuphwanya zakudya zawo.
• Kukula mu minyewa yamanjenje ya foci yotupa chifukwa cha vuto la autoimmune.
• Kutengera kwa chibadwa cha matenda amanjenje.
• Kuwonongeka kwa minyewa yamanjenje ndi mowa ndi chikonga.

Zowopsa

Kukhalapo kwa matenda ashuga kumawonjezera mwayi wokhala ndi vuto la neuropathy, koma izi sizitanthauza kuti matenda amtundu wa shuga amakumana ndi aliyense wodwala matenda ashuga. Chowoneka kwambiri cha neuropathy pamaso pa zinthu izi:

• Kutalika kwa matendawo. Matenda a shuga omwe amakhala nthawi yayitali, amakhala pachiwopsezo chachikulu cha matenda.
• Msuzi wa shuga. Kuchepetsa kwa matenda ndi kufanana kwa mulingo wa shuga m'magazi a wodwala.
• Matenda a impso. Matenda a shuga amakhudzana ndi zovuta za impso, zomwe zimasokoneza ntchito yawo ndikupangitsa kuledzera. Chifukwa cha matenda a impso, poizoni wotsalira m'thupi umakhudza minyewa yamanjenje.
• Kulemera kwambiri.
• Kusuta. Izi zimapangitsa kuti mitsempha ikhale m'mitsempha komanso kuti magazi azigundika. Pali zovuta ndi chithandizo cha mabala, umphumphu wa ulusi wamkati wamitsempha yam'mimba umakhudzidwa.

Mu matenda a shuga, dongosolo lamanjenje lamkati silikhudzidwa, chifukwa chake, neurotic, hysterical kapena psychasthenic neuroses mu diabetes ndi osowa ndipo sagwirizana ndi shuga.

Zizindikiro za matendawa

Arrhasmia nthawi zambiri imayendera limodzi ndi mtundu wina wa matenda.

Kuwonetsedwa kwa matenda am'mimba a shuga kumadalira mtundu wake:

• Maonekedwe oyipitsa amadziwika ndi kuwonongeka pamtunda wapamwamba komanso wotsika. Manja ndi miyendo imakhala ndi ululu, kutayika kwa chidwi, kuchepa kwa mgwirizano ndi mawonekedwe, kukokana. Nthawi zina Zizindikiro zimathandizidwa ndi kupangika kwa zilonda zam'mimba, mapindikidwe ndi kupweteka m'malo.
• Maonekedwe odziyimira pawokha amasonyezedwa ndikuphwanya kwam'mimba, kumatuluka / kuchepa thukuta, kukula kwa arrhasmia ndi hypotension. Wodwalayo amakulitsa neurosis ya chikhodzodzo, pali matenda opatsirana mwa kwamikodzo, kukanika kugona.
• Mawonedwe akumaloko amakhudza mitsempha imodzi, yomwe imayendetsedwa ndi ululu, kufooka, kuyendetsa bwino ntchito pa malo a zotupa, mwachitsanzo, kumbuyo kapena phazi. Ngati minyewa ya nkhope yomwe imayang'anira diso ikukhudzidwa, mawonekedwe amawonongeka. Zizindikiro za matenda amtunduwu zimazimiririka okha pakatha miyezi yochepa.

Zifukwa zachitukuko

Mfundo zazikuluzikulu zomwe zimayambitsa kukula kwa matenda ashuga polyneuropathy zimawerengedwa:

1. Kusuta fodya komanso mowa
2. Kusagwirizana ndi kayendedwe ka shuga wamagazi,
3. M'badwo
4. Kupsinjika kwa magazi
5. Kuphwanya chiŵerengero cha lipids (monga zinthu zamafuta) zamagazi,
6. Madzi ochepa a insulin
7. Njira yayitali ya matenda a shuga.

Kafukufuku wambiri akuwonetsa kuti kuyang'anira kuchuluka kwa shuga ndi kuthamanga kwa magazi kumachepetsa kukula kwa matenda.Ndipo kugwiritsa ntchito mankhwala a insulin panthawi yake kumachepetsa chiopsezo chotukuka ndi theka.

Zizindikiro za matenda ashuga polyneuropathy amawonetsedwa ndi zowawa m'munsi yotsika. Kupweteka, kuwawa kapena kuyabwa, kupweteka kwambiri nthawi zambiri, kusoka ndi kuboola. Nthawi zambiri amapezeka kumapazi komanso kumakulirakulira. Mtsogolomo, kupweteka kumatha kuchitika m'munsi mwa mwendo ndi mikono.

Odwala amadandaula za kuchuluka kwa minofu, kupweteka kwapawiri, kusokonezeka kwa gait. Izi ndichifukwa chakutukuka kwa vuto mumanjenje. Zomva kutentha zimatayika, zilonda zam'mimba zitha kuwoneka.

Wodwalayo samva bwino chifukwa chokhudza zovala. Ululu muzochitika zotere ndiwokhazikika ndipo umakulitsa thanzi la wodwalayo.

Momwe mungazindikire ndikumvetsetsa bwino matendawa?

Kuzindikira kwa polyneuropathy kumayamba ndi kupita kwa dokotala yemwe amapeza anamnesis mosamala ndikupereka mitundu yofunikira ya maphunziro.
Phunziro lalikulu, zokonda zimaperekedwa ku electroneuromyography. Kuphatikiza apo, maphunziro a VKSP (odziyimira pawokha achisoni) angagwiritsidwe ntchito.

diagnostika diabeticheskoj polinejropatii

Makina a chitukuko cha matenda ashuga a polyneuropathy pakadali pano amatengera chiphunzitso cholimbitsa metabolism ndi mtima.

Chifukwa cha kuchuluka kwa glucose wamagazi m'maselo, njira zosasinthika zimachitika, zomwe zimakhazikitsidwa ndi vuto la oxygen, limodzi ndi kutulutsidwa kwa zinthu za pathogenic.

Izi, zimabweretsa kusintha kwa maselo am'mitsempha ndi mitsempha. Vuto la kuwonongeka kwa mitsempha yam'maganizo, kuwonongeka kwa kutheka kumachitika, munthu samva kupweteka pakudula, kutentha. Zotsatira zake, zilonda zimawoneka kuti nthendayo ikhoza kugwera, mtsogolo ikhoza kukhala ndi kusinthika, kubala komanso kuduladula mbali ya dzanja.

Zizindikiro zofala kwambiri za odwala omwe ali ndi matenda ashuga polyneuropathy ndi awa:

• Kuchepa kapena kuzimiririka, poyamba pamiyendo, kenako pamaondo (kawirikawiri pamapazi),
• Kuchulukitsa kwamvekedwe m'dera la masokosi ndi magolovu, kupweteka m'misempha ndi m'mitsempha nthawi ya palpation,
• Mphamvu yam'miyendo ya miyendo imachepa kwambiri,
• Wozunzika kwambiri, ziwalo zam'manja zomaliza zimawonedwa,
• Odwala ena amadziwika ndi kusintha kwa thukuta, kupatulira ndi kutsekeka kwa khungu,
• Mkhalidwe wowoneka bwino wa misomali komanso kuchepera kukula kwawo,
• Zilonda pakhungu la miyendo.

Werengani za momwe mungagwiritsire ntchito ming'alu pakati pa zala zam'manja.

Zomwe zimayambitsa chiopsezo cha zizindikiro zoyambirira za matenda ashuga polyneuropathy:

• glycemia wambiri (kubwezeretsa shuga),
• hypothermia
• matenda osiyanasiyana
• kuvulala koopsa
• uchidakwa
• kusuta
• Kusagwirizana ndi ukhondo wamiyendo, misomali yokhala ndi matenda omwe alipo.

Chomwe chimatsogolera pakupezeka kwa matenda ashuga a polyneuropathy ndi angiopathy, omwe amachititsa kuphwanya magazi m'zigawo.

Chithandizo cha matenda a shuga a polyneuropathy

Poganizira kusiyanasiyana kwamakina amomwe amapezeka ndimatenda awa, ndizovuta kupeza chokhacho chothandiza masiku ano. Kupyola muzochita zamankhwala, pamakhala zovuta pamayendedwe odziwika a pathogenesis. Iyenera kuphatikiza mankhwala a antioxidant omwe amayendetsa kukonzanso kwa khungu la mitsempha ndikuchepetsa ululu.

Njira yovomerezeka munthawi yake imachepetsa kuchepa kwa njira ya matenda, ndikukhalabe ndi chidwi cha miyendo, potero kukonza moyo wabwino.

Etiotropic mankhwala

Choyamba, chithandizo chokwanira cha hypoglycemic chikusonyezedwa (mu gawo lovuta la matenda ashuga polyneuropathy, kugwiritsa ntchito insulin kumaphatikizidwanso pamankhwala. Zakudya zapadera ziyenera kuikidwa. Chinthu chosasinthika ndikusuta kutha ndi mowa.

Werengani za momwe mungachiritsire neuropathy ya malekezero otsika kunyumba kuno.

Kukonzekera kwachipatala

• Mavitamini a gulu B (B1, B2, B6, B12) athandizira kuchepetsa zovuta pa ulusi wamanjenje ndikuwongolera kudutsa komwe kumawakhudza kudzera mwa iwo.
• Alpha-lipoic acid imachotsa glucose owonjezera kumapeto kwa mitsempha ndikutsitsimutsa maselo amitsempha owonongeka ndi ma enzymes.
• Kugwiritsa ntchito gulu lapadera la mankhwala (sorbine, olredase) ndi othandizika, omwe amachepetsa kupanga shuga ndikuchepetsa zotsatira zake zoipa pa ulusi wamitsempha.
• Pofuna kuthana ndi khunyu, dzanzi limapatsidwa mankhwala omwe amakhala ndi calcium ndi potaziyamu.
• Zilonda zikawoneka pamiyendo, mankhwala opha tizilombo amasonyezedwa,
• Ma antidepressants amagwiritsidwa ntchito kwambiri pochiza matenda opweteka omwe wodwala akukumana nawo.

Mankhwala osiyanasiyana amagwiritsidwa ntchito pofuna kuchepetsa ululu wa matenda ashuga polyneuropathy:

• anticonvulsants.
• antidepressants.
• mankhwala osapweteka a antiidal.
• lidocaine wa.

Maanticonvulsants amathandiza kwambiri kupweteka kwapweteka komanso paroxysmal. Zaka zaposachedwa, umboni wafalitsidwa kuti amathandizira ntchito ya mitsempha ndikuchepetsa kufa kwake. Ena mwa iwo ndi carbamazepine, diphenyl ndi lomotrigine.

Mankhwala ena

Njira zolimbitsa thupi tikulimbikitsidwa:

• microwave resonance mankhwala.
• hydrogen sulfide osambira.
• kutikita minofu.

Zithandizo za anthu zimathandizanso kuthana ndi polyneuropathy pamtunda wapamwamba komanso wotsika, womwe umagwiritsidwa ntchito kuwonjezera pa chithandizo chachikulu. Ma infusions azitsamba apadera amathandizira kukhala ndi shuga. Chithandizo chotere chiyenera kuchitika m'maphunziro, popeza mudachenjeza adotolo kale.

Sanatorium-resort chithandizo cha odwala imachitika m'malo opadera a odwala matenda a shuga mellitus. Odwala amatumizidwa komweko popanda kupweteka kwambiri, komanso boma lisanafike.

Momwe mungazindikire ndikumvetsetsa bwino matendawa?

Nthawi zambiri amakhala akumabaya, kuwawa, kupweteka kupweteka komwe kumakulirakulira usiku. Choyamba muyenera kupimidwa pafupipafupi, pomwe ma neuropathologist amasankha pakufunika kwazidziwitso.

Nthawi zambiri, pakumufufuza, adokotala amapeza:

• Zowonongeka pamiyendo,
• Kusowa kwa phazi Reflex (Achilles),
• Kuchulukana ndi singano,
• Kutsika kwa bondo.
• Kuchedwa kwamphamvu kukhudza. Poterepa, kuchuluka kwa kutayika kwa kutentha kwa kutentha kuyenera kuyesedwa.

Gawo lotsatira lidzakhala:

1. Electromyography ndi njira yowunikira mitsempha yotumphuka, yomwe imakulolani kuti muweruze mkhalidwe ndi kuchuluka kwa kuwonongeka kwa ulusi. Kuphatikizanso, kuthamanga kwa kuthamanga kwazomwe zimachitika limodzi ndi mitsempha yapang'onopang'ono komanso kuchepa kwa matalikidwe a minofu ntchito (nthawi zambiri miyendo) ndizikhalidwe. Zikatero, mitsempha ya ng'ombe imakopekedwa,
2. Kuyesa kukhudza ndi njira imodzi yatsopano kwambiri yofufuzira pogwiritsa ntchito makina apakompyuta kuti mudziwe momwe uliri ulusi (kugwedezeka, kuzizira, kutentha, malawi.) Komanso, kuwunika kwa mulingo wamtsogolo kumaganizira za munthu payekha.

Mitundu yotsatirayi yamatenda imasiyanitsidwa:

1. Distal peripheral sensory-motor polyneuropathy imadziwika ndi zizindikiro zingapo:

• kupweteka (kukhuthala, kukoka, kuyerekezera, nthawi zambiri m'malo omaliza a miyendo, miyendo, kawirikawiri m'manja),
• zosasangalatsa zomverera, kuzizira, kuzizira, kukwawa, miyendo (paresthesia),
• zomverera zoyaka mu miyendo
• Kutupa kwa m'miyendo, kumapazi, nthawi zambiri usiku, ndi bata,
• kufooka m'miyendo.

1. Diabetesic autonomic polyneuropathy imadziwika ndi nthawi yayitali ya asymptomatic.

Gulu ndi zizindikiro za matenda ashuga

Kudziwa matenda am'mbuyomu omwe ali ndi matenda ashuga, muyenera kuganizira za zizindikiro zomwe zimayambitsa matenda.

Chizindikiro cha matenda am'mimba chimadalira gawo lamanjenje lomwe limakhudzidwa kwambiri. Mwanjira ina, zizindikiro za matendawa zimatha kusiyanasiyana, ndipo zonse zimatengera kuwonongeka kwa thupi la wodwalayo.

Dera lakumpoto likakhudzidwa, Symbolatology imadzipangitsa kumverera pakatha miyezi iwiri.Izi zimagwirizanitsidwa ndikuti mu thupi laumunthu mumakhala kuchuluka kwakukulu kwa kumapeto kwa mitsempha, ndipo kwa nthawi yoyamba, mitsempha yothandizika imaganiza magwiridwe antchito yowonongeka.

Matenda a diabetes a peripheral neuropathy amadziwika chifukwa poyamba manja ndi mapazi amakhudzidwa.

Gulu la anthu odwala matenda ashuga:

• Zizindikiro zowerengera za polyneuropathy syndrome: sensor neuropathy, motor neuropathy, matenda a sensorimotor, matenda a hyperglycemic.
• Diabetesic autonomic neuropathy: urogenital, kupuma, sudomotor, mtima.
• Focal neuropathy: ngalande, cranial, plexopathy, amyotrophy.

Sensory neuropathy ndiko kugonjetsedwa kwa chiwopsezo cha mathero amitsempha ndikusokonekera kwamalingaliro amunthu. Mwachitsanzo, mwendo umodzi umakhala wodekha kuposa winayo. Chifukwa chakuti pa matenda amanjenje amakhudzidwa, pamakhala kufalitsa kosayenera kwa chizindikiritso kuchokera ku zolandilira khungu kupita ku ubongo.

Zizindikiro zotsatirazi zimawonedwa:

1. Kuthana kwambiri kwa zomwe zimakwiyitsa ("ma bumps" amakwawa miyendo, kuwotcha kumaso, kuyabwa, kupweteka kwakanthawi popanda chifukwa).
2. Kuyipa kosasangalatsa. “Wosakwiya pang'ono” atha kukhala chifukwa cha kupweteka kwambiri. Mwachitsanzo, wodwala amatha kudzuka usiku chifukwa cha ululu chifukwa chakhudza bulangeti.
3. Kuchepa kapena kuwonongeka kotheratu kwa chiwopsezo. Poyamba, pamakhala kutayika kwa miyendo yakumtunda, ndiye kuti miyendo yam'munsi imavutika (kapena mosinthanitsa).

Motor diabetesic neuropathy imadziwika ndi kuwonongeka kwa mitsempha yomwe imayendetsa kayendedwe, yomwe imayang'anira kufalitsa kwa mauthenga kuchokera ku ubongo kupita ku minofu. Zizindikiro zimayamba pang'onopang'ono, chizindikiritso cha mkhalidwewu ndi kuwonjezeka kwa zizindikiro pakugona komanso kupuma.

Chithunzi cha chipatala cha matenda amtunduwu chimadziwika ndi kuchepa kwa kukhazikika poyenda, kutsekeka kwa minofu ndi mafupa, kuchepa kwa mphamvu yogwirizana (edema ndi kufooka), ndi kufooka kwa minofu.

Autonomous diabetesic neuropathy (yotchedwanso autonomic neuropathy) ndi chifukwa cha kusokonekera kwa magwiridwe antchito a mitsempha yodziyimira payekha, yomwe imayang'anira ntchito ya ziwalo zamkati.

Zizindikiro za autonomic neuropathy yamtundu wa 2 shuga:

• Kusokoneza kwam'mimba khunyu (kovuta kumeza, kupweteka m'mimba, kusanza).
• Kuphwanya kwa magwiridwe antchito a ziwalo za m'chiberekero.
• Ntchito ya mtima wosavomerezeka.
• Sinthani pakhungu.
• Zowonongeka.

Optical neuropathy ndi njira yomwe ingayambitse kutaya kwa kuwona kwakuthupi kwakanthawi kapena kwakanthawi.

Mawonekedwe a urogenital a diabetesic neuropathy amadziwika ndi kuphwanya kamvekedwe ka chikhodzodzo, komanso kuwonongeka kwa ma ureters, omwe amatha kumayendetsedwa ndi kusungika kwamikodzo kapena kukokoloka kwamikodzo.

Distal neuropathy imachitika pafupifupi theka la odwala matenda a shuga. Kuopsa kwa matenda a m'matumbo kumakhala chifukwa chosasinthika. Distal neuropathy yam'munsi malekezero amadziwika ndi kutayika kwa miyendo, kupweteka ndi mitundu yosiyanasiyana yosasangalatsa - kugwedezeka, kuwotcha, kuyabwa.

Chithandizo cha matenda ashuga a Neuropathy

Chithandizo cha matenda a shuga a shuga Choyamba, ndikofunikira kuti muchepetse kuchuluka kwa shuga m'magazi, chachiwiri, kuchepetsa thanzi la wodwalayo, kuletsa kupweteka kwam'mimba, ndipo, chachitatu, kubwezeretsa ululu wamitsempha wowonongeka.

Ngati wodwala ali ndi matenda ashuga a m'mimba, chithandizo chimayamba ndi kukonza magazi. Ntchito yayikulu ndikukhazikika kwa glucose komanso kukhazikika kwake pamlingo wofunikira. Pachifukwa ichi, mankhwala omwe amathandizira kuchepetsa shuga m'thupi la wodwalayo amalimbikitsidwa.

Mapiritsi ochepetsa shuga am'magazi amagawika m'magulu atatu. Gawo loyamba limaphatikizapo mankhwala omwe amalimbikitsa kupanga kwa insulin m'thupi la munthu (Gliclazide).

Gawo lachiwiri limaphatikizapo mankhwala omwe amalimbikitsa chidwi cha minofu yofewa kupita ku mahomoni - Metformin. Ndipo gulu lachitatu lilinso ndi mapiritsi omwe amalepheretsa kuyamwa kwa mafuta am'mimba m'matumbo am'mimba - Miglitol.

Ndikofunikira kudziwa kuti ndi genesis iyi, adokotala amasankha mankhwala payekhapayekha kwa wodwala aliyense. Pafupipafupi mankhwala ndi mtundu wa mankhwala amtundu wa 2 wa matenda ashuga amatha kusiyanasiyana.

Zimachitika kuti ndizotheka kukhazikitsa shuga m'magazi, koma wodwalayo amakhala ndi chidwi chachikulu cha matenda a shuga. Chizindikiro ichi chimatha kuchotsedwa kokha ndi ma painkillers, ndipo chikuwonetsa kuti kusintha kwa thupi la munthu kumasinthika, ulusi wamitsempha unayamba kuchira.

Mankhwala othandizira kupweteka komanso kubwezeretsa ntchito ya mitsempha:

• Tiolepta (alpha lipoic acid ndi gawo). Mankhwalawa amathandizira kuyendetsa kagayidwe kachakudya, amateteza maselo amitsempha kuti asaoneke ndi poizoni komanso zopitilira muyeso.
• Cocarnit ndi zovuta za mavitamini ndi zinthu zomwe zimakhudza kagayidwe ka munthu. Ili ndi zotsatira za analgesic ndi neurometabolic. Cocarnit imayendetsedwa intramuscularly, 1-2 ampoules patsiku. Kutalika kwa mankhwalawa kumasiyana nthawi zonse kutengera chithunzi cha matenda.
• Nimesulide (non-steroidal anti-yotupa mankhwala) amathandizira kutupa kwa mitsempha, amathandizanso kupweteka.
• Maloiletine (wothandizira antiarrhythmic) amatseketsa njira za sodium, chifukwa chomwe kufalikira kwa zopweteka zimasokonekera, zimathandizira kuti kayendedwe kazolowera mtima.

Ndi diabetesic neuropathy, Zizindikiro zimasiyana kwambiri, ndichifukwa chake mankhwala awiri kapena angapo amagwiritsidwa ntchito nthawi zonse kuti apeze chithandizo chofunikira.

Ndizofunikira kudziwa kuti mawonekedwe opweteka a matenda amitsempha ya m'mimba amafunika pakanthawi yomweyo mankhwala a analgesic, anticonvulsants ovuta.

Mankhwala aliwonse amakhala ndi zotsatirapo zake, choncho amakuperekedwa ndi adokotala.

Matenda a matenda ashuga - ndi chiani?

Matendawa amagwira bwino ntchito mu zotumphukira za mitsempha yotupa. Amatha kukhala ochulukirapo kapena am'deralo, okhudza machitidwe angapo kapena chinthu chimodzi chokha. Pakusankhidwa kwa adotolo, neuropathy imapezeka wodwala aliyense wachisanu ndi chiwiri yemwe ali ndi matenda a shuga, mothandizidwa ndi njira zamagetsi zamagetsi - sekondi iliyonse.

Chizindikiro choyamba cha matendawa ndi kuchepa kwa kuchuluka kwa kufalikira kwa zotsekemera mu minyewa ya mitsempha. Kwa mitundu yayikulu ya neuropathy, kusokonezeka kwa chidwi ndi chikhalidwe, kupweteka kwambiri, kulephera kwa ziwalo, kufooka kwa minofu mpaka kulumala ndikotheka.

Zowawa zolimbitsa thupi za neuralgia

Pofuna kuchepetsa ululu, dokotala amakupatsani mankhwala a ululu a neuralgia. Pakati pa mankhwala a analgesic omwe adalembedwa Nise (Nimesil), Analgin, Movalis, Baralgin. Kuchepetsa kuphipha kwa minofu, Midokalm imagwiritsidwa ntchito. Kupweteka kwapang'onopang'ono kumatha kusokoneza kwa maola angapo. Kwa nthawi yayitali, muyenera kutsatira dongosolo la makonzedwe: kamodzi katatu tsiku lililonse mukatha kudya. Njira yayitali yotsogola imayambitsa matenda a chiwindi, m'mimba. Kuchiza ndi analgesics sikuchitika.

Mankhwala osokoneza bongo a nonsteroidal a neuralgia

Kuphatikiza kwa mankhwalawa kumaphatikizapo mankhwala omwe si a steroidal anti-yotupa a neuralgia (NSAIDs), omwe amatha kuthana ndi matendawa, amachepetsa ululu, komanso amakhala ndi anti-yotupa. Mitundu ya kumasulidwa kwa mankhwalawa: jakisoni, mafuta amkati, mapiritsi a rectal, mapiritsi a neuralgia. Jekeseni wa Ketorol, Analgin kapena Ketonal nthawi yomweyo chotsani zizindikiro zopweteka kwa maola atatu. Mankhwala a NSAID a neuralgia:

• Ketoprofen
• Ibuprofen
• Indomethacin
• Naproxen
• Piroxicam
• Diclofenac.

Mafuta ofunda a neuralgia

Zomwe zimapangitsa kutentha kwanyengo ndi neuralgia kumatheka chifukwa cha kuchuluka kwa magazi.Pazinthu zopakidwa minofu ya minyewa yosakhazikika, bwino umadzaza, umakhala wothandiza makamaka pambuyo pa hypothermia, kupsinjika, kuwonongeka. Mphamvu ya vasodilating imapangidwa mwachilengedwe (mafuta ofunikira, camphor, turpentine, tincture wa tsabola, njoka kapena ziphe njuchi) kapena zopangira zoletsa (nonivamide, dimethyl sulfoxide, nicoboxyl, benzyl nicotinate). Mafuta oterowo amaphatikizapo menovazine.

Pepper pulasitala ya neuralgia

Kunyumba, zochiritsira, ndikupanga zomwe zimakhumudwitsa, gwiritsani ntchito chigamba cha tsabola cha neuralgia, chomwe chimatentha malowa, chimatha kuchepetsa ululu. Musanayambe kugwiritsa ntchito chigamba, muyenera kuchotsa malo opweteka ndi cologne kapena mowa. Pukutani ndi nsalu yoyera. Mukawona kuti kutentha kufalikira thupi, ndiye kuti chigamba chake chikuyenera kuchotsedwa. Kuchiza ndi chida ichi kumawonetsedwa kudzera pakubwezeretsa bwino, kupumula kwa minofu.

Chithandizo cha neuralgia ndi wowerengeka azitsamba

Ngati pazifukwa zina simungathe kufunsa dokotala kuti akuthandizeni, mutha kugwiritsa ntchito mankhwala a neuralgia ndi wowerengeka azitsamba. Kugwiritsa ntchito bwino ndi decoction wa msondodzi, womwe uyenera kutengedwa 1 tbsp. l Kanayi musanadye. Kukonzekera zomwe mukufuna:

• makungwa osowetsa msondodzi (10 g) kuthira madzi otentha (200 ml),
• simmer kwa mphindi 20,
• Vutitsani cheesecloth, imwani mukamazizira.

Mutha kuthandizidwa ndi osakaniza othandizira kunyumba, omwe muyenera kugwiritsa ntchito tsiku lililonse kwa mwezi umodzi:

1. Mwofanana, sakanizani ayodini, glycerin mu botolo lagalasi lakuda.
2. Sansani botolo, nyowetsani swab yoyera ndi yankho.
3. Mafuta owawa, kupatula msana.

Kanema: kodi neuralgia ndi chiyani

Ph.D. I.A. Rows, Department of Endocrinology and Diabetesology RMAPO,
A.N. Barinov, MMA yotchedwa I.M. Sechenov
M.B. Novosadova, I.N. Mamedova, O.A. Markina
Dipatimenti ya Endocrinology ndi Diabetes RMAPO

Chimodzi mwazinthu zovuta kwambiri za matenda a shuga mellitus (DM) ndi matenda ashuga polyneuropathy (DPN), omwe amachititsa kutsika kwa moyo, kulemala ndi kufa kwa odwala. Ndi chidziwitso cha matenda a shuga opitilira zaka 25, DPN imakula pafupifupi 50% ya odwala.

Limagwirira kukula kwa polyneuropathy mu shuga

Ngakhale atachita bwino kwambiri kuti amvetsetse za pathogenesis ya kuwonongeka kwa mitsempha yodwala m'matenda a shuga m'zaka zaposachedwa, palibe njira yothandizira yomwe yapangidwa mpaka pano yomwe ingakhale "muyezo wagolide" wogwiritsa ntchito bwino mankhwala a DPN.

Chithandizo cha DPN chitha kukhala ndi cholinga chothetsa mawonetseredwe ake ndikuchepetsa kupitirira kwa kuwonongeka kwa mitsempha (ngati mankhwala a pathogenetic amagwiritsidwa ntchito) kapena pokhapokha pothana ndi mawonetseredwe a DPN, mwachitsanzo, ululu wammbuyo, ngati mankhwala othandizira agwiritsidwa ntchito.

Chithandizo chamakono cha DPN

Kulipira shuga

Hyperglycemia imayambitsa kusowa kwa metabolic ndi mitsempha yomwe imayambitsa kukula kwa DPN. Pachifukwa ichi, choyenera kukhala ndikuchepetsa kuchuluka kwa shuga pamazinthu abwinobwino. Kafukufuku wa nthawi yayitali akuwonetsa kuti kusamalira kwambiri matenda ashuga okhala ndi shuga wambiri pafupi ndi standardoglycemia kumachepetsa mwayi wokhala ndi DPN. Chiwopsezo cha DPN chinali chachikulu pagulu lomwe limayang'anira matenda ashuga poyerekeza ndi gulu lomwe limalandira chithandizo chachikulu. Nthawi yomweyo, panthawi yosamalidwa kwambiri kwa matenda ashuga, odwala ena adayamba DPN. Izi, zomwe zikuwoneka, zikuwonetsa kuti kusinthasintha kwakang'ono komanso kosakhalitsa kwa shuga m'magazi kungayambitse kukula kwa DPN, ndikugogomezera kufunika kwa mankhwala owonjezera a DPN, kuphatikiza prophylactic.

Mu hyperglycemia, njira zambiri - autooxidation wa glucose, kuphatikiza mapangidwe omaliza a mapuloteni ochulukitsa glycation (AGEs), kutsegula kwa lipid peroxidation, NO synthase imatsogolera pakupanga kwakukulu kwama radicals - ma molekyulu, omwe nthawi zambiri amakhala ndi atomu ya oxygen yokhala ndi ma elekitirofoni osavomerezeka komanso kuchuluka kwachulukidwe .Ma radicals aulere amasokoneza ntchito zama cellular cell, makamaka endothelium, imayambitsa endoxial hypoxia ndikuwatsogolera pakupanga DPN. Zochita za thupi la antioxidant dongosolo ("misampha" ya ma radicals aulere - superoxide dismutase, catalase, glutathione ndi ena) mu matenda a shuga amachepetsa, mwina chifukwa cha majini. Izi zimapangitsa kuti pakhale chodabwitsa cha kuphatikiza kwa oxidative - kuphwanya koyenera kwa anti-and prooxidant system m'malo mwa omaliza. Pansi pa zovuta za oxidative, kapangidwe ka nitric oxide (NO), woyang'anira wamkulu wa kupumula kwa khoma lamitsempha, imalephereka, ndipo nyukiliya (NF-kB) imayendetsedwa, yomwe imayambitsa kumasulidwa kwa zinthu zomwe zimalepheretsa kuthamanga kwa magazi, mwachitsanzo, endothelin-1. Pakadali pano, gawo la nkhawa la oxidative pakupanga DPN limawerengedwa kuti ndi amodzi akutsogolera. Chifukwa chake, kugwiritsa ntchito mankhwala omwe ali ndi antioxidant zotsatira ndizomveka.

Malo oyamba pakati pa antioxidants komanso mankhwala omwe amagwiritsidwa ntchito pochiza matenda a DPN amakhala ndi a-lipoic (thioctic) acid (TK), a lipophilic antioxidant wachilengedwe. Kuthekera kwa ma TCs kuchepetsa nkhawa za oxidative mu shuga kwatsimikiziridwa mu maphunziro angapo. Zinawonetsedwa poyesa kuti mwayi wofunikira wa TC ndi mphamvu yake osati pochepetsa nkhawa za oxidative, i.e. pa mtima zigawo, komanso kuwonjezeka kwa zomwe zili mu mitsempha, mwachitsanzo, kukula kwa mitsempha. Zawonetsedwa pazachipatala kuti makonzedwe a TC amatulutsa matenda a NO amatsika mu shuga ndikuwonjezera kapangidwe ka zotupa zamagulu otentha.

Kugwiritsa ntchito koyamba kwa TC kuchipatalachi pochiza DPN kunachitika mu 1959. Zotsatira za kafukufuku wa ALADIN, zomwe zidafalitsidwa mu 1995, zinawonetsa kuti kuyang'anira kwa TC kumadalira mlingo wa DPN (kupweteka, dzanzi, kutentha, paresthesia), zotsatira za placebo ndi Mlingo wa 100 mg sizosiyana, ndipo Mlingo wa 600 ndi 1200 mg kwambiri umachepetsa mawonetseredwe a DPN. Mpaka pano, maphunziro ena angapo adachitidwa pogwiritsa ntchito intravenous (600 mg) kapena makonzedwe apakamwa (600 mpaka 1800 mg) ya TC. Mankhwala a TC, kuchepa kwa chiwonetsero chachikulu cha DPN, kusintha kwa magwiridwe antchito amitsempha yamagalimoto ndi mauronomic, ndi kuchepa kwa lipid peroxidation m'magazi ndi erythrocyte membranes. Zotsatira za kafukufuku wa ORPIL zidapangitsa kuti maulalo a 1800 mg a TK atengedwa pakamwa ali ofanana ndi mphamvu ya kukonzanso kwa 600 mg, zomwe zimagwirizana ndi deta kuti mulingo wa TK mu plasma ndi chimodzimodzi ndi mitundu iwiriyi yoyendetsera. Tsopano ku USA ndi Russia, maphunziro a NATAN ndi aku Sydney akuchitika, zotsatira zake zidzatipatsa mwayi wakuwunika kantchito ya TC. Tiyenera kudziwa kuti maphunziro amakono azakuyenda bwino kwa matenda a TC (osachitidwa khungu, owongoleredwa ndi khungu), zotsatira zake zomwe zaperekedwa pamwambapa, adachitidwa pogwiritsa ntchito mankhwalawa "Thioctacid".

Amawerengedwa kuti ndi woyenera kufotokoza kumayambiriro kwa chithandizo cha kukoka kwa magazi kwa Thioctacid (600 mg pa 200 ml ya mchere wa thupi) kwa masabata atatu (osiyidwa 15), akutsatiridwa ndi 600 mg ya mankhwalawa monga mapiritsi (kamodzi pa tsiku kwa mphindi 30 mpaka 40 musanadye) mkati mwa miyezi 1-2.

Amadziwika kuti TC ili ndi katundu wina wofunikira - imapangitsa kuti shuga igwiritsidwe ntchito, kuchepetsa insulin. Pankhaniyi, mankhwala ochepetsa shuga omwe amachokera ku Thioctacid, omwe pakali pano akuyesedwa kuchipatala, ali ndi chidwi. Titha kuyembekezera kuti mankhwalawa, kuphatikiza pakuchepetsa mphamvu ya shuga, azitha kuteteza motsutsana ndi DPN, zomwe zingapangitse kuti azigwiritsa ntchito zonse poteteza komanso kuchiza DPN. Ena mwa mankhwala amakono omwe amachepetsa shuga, mwachitsanzo, troglitazone, amakhalanso ndi masinthidwe okonza njira za chitukuko cha DPN, koma luso lawo lachipatala pankhaniyi silinatsimikizidwe.

Mwa antioxidants ena, gingko biloba tsamba yotulutsa imakopa chidwi. Phunziro lathu, lomwe linapangidwa mchaka cha 2000, pochiza odwala 58 omwe ali ndi matenda ashuga kwa miyezi itatu ndi mlingo wa tsiku lililonse wa 120 mg, kuchepa kwakukulu kwa DPN komanso kusintha kwa magawo a EMG. Antioxidant ndi mankhwala osankhidwa pochiza odwala okalamba omwe ali ndi matenda ashuga (pambuyo pa zaka 70).

Ndi matenda a shuga, kuchepa kwa zomwe zili ascorbic acid ndi tocopherol m'magazi ndi zimakhala za chitetezo cha mthupi cha antioxidant zimawonedwa. Poyesera, kugwiritsa ntchito mavitaminiwa kunachepetsa kuwonetsa kwa DPN, koma palibe chidziwitso chotsimikizika pakuchita bwino kwawo kwachipatala chomwe chalandilidwa mpaka pano.

Kunena zowona, chithandizo cha mavitamini a gulu B sichingafanane ndi chithandizo cha mankhwala a DPN, popeza kuchepa kwa zomwe mavitamini a gululi ali ndi matenda ashuga m'mwazi kapena minofu sikuwonetsedwa pakuyesera kapena kwa odwala matenda ashuga. Tinaona kuti ndizofunikira kuwonjezera pa gawoli pazifukwa zotsatirazi: Poyamba, amatha kulimbikitsa njira za chitukuko cha DPN, mwachitsanzo, kupititsa patsogolo chitetezo cha mitsempha ndi kuthekera kwa mitsempha kubwezeretsanso, chachiwiri, kufunikira kwawo kwamankhwala pakuchiritsa ululu DPN, ndipo amagwiritsidwa ntchito kwambiri pachifukwa ichi m'maiko ena, kuphatikiza Russia, Germany ndi Japan.

Mphamvu yachipatala ya mitundu yosungunuka ya mavitamini a B ndiyotsika kwambiri chifukwa cha kuchepa kwachilengedwe. Kupambana koyenera pakugwiritsa ntchito mankhwala a vitamini pochizira DPN kunali kupanga mitundu yosungunuka ya vitamini B1 - allithiamines, yomwe benfotiamine ali ndi bioavailability wapamwamba kwambiri. Poyerekeza ndi mitundu yosungunuka ya vitamini B1, benfotiamine imayamwa mwachangu ndikusungira kuchuluka kwa magazi ndi maselo motalika. Maphunziro angapo osasinthika, akhungu awiri, owongolera malo osokoneza bongo a benfotiamine kapena kuphatikiza kwake ndi mavitamini B6 ndi B12 adachitidwa, omwe adawonetsa kuchepa kwakukulu kwa ululu ndi paresthesia, kuchepa kwa malire a kugunda kwa chidwi, komanso kuwongolera kwapadera kwa EMG kwa magwiridwe antchito. Ubwino wofunikira wa benfotiamine ndi mwayi womwe ungagwiritsidwe ntchito mwa ana omwe ali ndi matenda ashuga, chifukwa mankhwalawa amatengedwa pakamwa ndipo samakhala poizoni kwambiri poyerekeza ndi mitundu yosungunuka ndi madzi. Chithandizo cha benfotiamine muyezo wa 100 mg kapena 150 mg umachitika kwa miyezi 3-6 ndi mlingo wa tsiku lililonse wa 200-300 mg.

Mankhwala opweteka

Kuwongolera kwapweteka kwa DPN nthawi zambiri kumakhala vuto lalikulu. Chofunikira kwambiri pakuchiritsa odwala motere ndikukhazikitsidwa kwa kayendetsedwe kabwino ka matenda ashuga. Nthawi zambiri, kuchepa kwa shuga m'magazi kunthawi zonse kumayambitsa kukonzanso kwa ululu. Ngakhale muzochitika zomwe mawonekedwe a ululu wamankhwala amaphatikizidwa ndikuchepa kwambiri kwa glycemia motsutsana ndi maziko okhazikitsira kapena kulimbikitsa kuwongolera matenda a shuga, palibe chifukwa chochepetsera shuga. Muzochitika zomwe kupweteka kwa neuropathy kumalumikizidwa ndi kuchepa thupi, kukhazikitsidwa kwa chiwongolero cha glycemic kumabweretsa osati kuchepetsa ululu, komanso kubwezeretsa thupi.

Kupezeka pafupipafupi kwa kuvutika mtima kwa odwala omwe ali ndi vuto loperewera kwa shuga Kafukufuku wachipatala adatsimikizira kuchuluka kwa chithandizo cha TCA m'mitundu yopweteka ya DPN. Mphamvu yodalira mlingo wa ma TCAs pokhudzana ndi kupsa ndi kuwombera kunawonetsedwa onse kwa odwala omwe ali ndi nkhawa komanso osakhumudwa, ngakhale momwe chithandizo chamankhwala kwa odwala omwe ali ndi nkhawa zimakhudzira. Kuphatikiza kwakukulu kwambiri komwe kunawonedwa ndikugwiritsa ntchito amitriptyline mu mlingo wa 150 mg usiku. Njira yomwe TCA ingagwire ndikulepheretsa kubwezeretsanso kwa norepinephrine pamagetsi apakati pazotsutsana.

Kugwiritsa ntchito bwino kwa anticonvulsants (carbamazepine) pochiza neuralgia ya trigeminal kunakhazikikanso ngati maziko ogwiritsira ntchito mitundu yopweteka ya DPN.Makina a zochita za gululi la mankhwalawa, komanso mankhwala a antiarrhythmic (lidocaine ndi mexiletine) ndikukhazikitsa ziwalo zamitsempha chifukwa chotseka njira za sodium. Mankhwalawa akamathandizidwa ndi antiarrhythmic mankhwala, zotsatira zoyipa sizinatchulidwe kwenikweni kuposa ma anticonvulsants. Lidocaine wa mawonekedwe a kulowetsedwa pang'onopang'ono (mphindi 30) pa mlingo wa 5 mg / kg umachepetsa ululu mu DPN. Mphamvu yotsutsana ndi mawonekedwe amkamwa a mexiletine pa 450-600 mg / tsiku. zatsimikiziridwa mu kafukufuku wambiri wakhungu, wowongoleredwa ndi placebo. Pa kuchuluka kwa ululu, kuwongolerako sikunali kwakukulu, koma kuwunika kosakanizika kunawonetsa kuchepa kwakukulu kuwombera, kuwawa kuwawa, kumva kwa mantha, ndi kumva kutentha.

Kugwiritsa ntchito mutu wa capsaicin (zotsekemera tsabola wa alkaloid) mu mawonekedwe a mafuta onunkhira a khungu ndi mafuta kunawoneka kukhala kothandiza pochotsa kupweteka kwaposachedwa ndikusisita osayambitsa mavuto akulu. Komabe, odwala ena adakakamizidwa kusokoneza chithandizo kumayambiriro chifukwa sakanatha kulekerera kuwonjezeka komwe kumachitika sabata yoyamba yamankhwala ndikubwezeretsanso.

Otsutsa okondwerera okondwerera a N-methyl-D-aspartate (NMDA) amachotsa bwino mawonetseredwe a kupweteka kwa mitsempha mu zitsanzo zoyesera, koma zovuta zazikulu za neuropsychotropic zamankhwala monga ketamine amachepetsa kugwiritsidwa ntchito kwake pakuchita zamankhwala. Dextromethorphan, yemwenso ndi blocker wa NMDA receptors, ali ndi mitundu yambiri ya njira zochiritsira komanso zovuta zochepa, zomwe zimapangitsa kugwiritsa ntchito kwachipatala. Mphamvu ya piritsi ya dextromethorphan muyezo wa 380 mg / tsiku. ndi mawonekedwe opweteka a DPN, adatsimikiziridwa mu kafukufuku wosasankhidwa, wakhungu wakawiri, wama placebo.

Njira zingapo za physiotherapeutic zochizira ululu mu DPN zimagwiritsidwa ntchito, monga percutaneous electroneurostimulation ndi acupuncture, koma kugwira ntchito kwawo sikunachitike. Kugwiritsa ntchito kukondoweza kwa magetsi kwa nyanga zam'mbuyo za chingwe cha msana pakuyika ma elekitirogiramu kumakhala kothandiza mu 80% ya milandu pamene ululu wammbuyo suyimitsidwa ndi standardacotherapy wamba. Chisamaliro chiyenera kuthandizidwa posankha ma physiotherapeutic othandizira, monga kusokonezeka kwa chidwi chazovuta komanso kudziyimira pawokha mu DPN kutengera mapangidwe a zopsa ndi zilonda zam'mimba.

Magulu onse ali pamwambawa omwe ali ndi mphamvu yosiyanasiyana amachepetsa ululu, osachotsa chomwe chimayambitsa - kuwonongeka kwa mitsempha yomwe imayambitsidwa ndi hyperglycemia. Mfundo zazikuluzonse zochizira ululu mu DPN ziyenera kukhala kuikidwa kwa mankhwala oyambira a pathogenetic ndikuphatikizira kwa zina zowonjezera monga chithandizo.

Chithandizo cha mitundu ina yamavuto azidziletsa

Orthostatic hypotension (OG) imapezeka mu 1-3% ya odwala matenda ashuga. Kwa mitundu yofatsa ya mpweya wotayira, tikulimbikitsidwa kuti mudzuke pang'onopang'ono, perekani mphamvu zolimbitsa thupi, kuletsa mankhwala osokoneza bongo, kugona pabedi ndi mutu wokweza, kudya kwambiri mu sodium (sodium chloride), miyendo yomangidwa ndi bandeji zotanuka. Muzochitika zovuta kwambiri zomwe zimapangitsa kuti wodwalayo akhale ndi vuto, wodumpha wapadera (suti yonyamula anthu ambiri) ndi pharmacotherapy amagwiritsidwa ntchito. Chothandiza kwambiri ndikusankhidwa kwa mineralocorticoid 9-a-fludrocortisone pa mlingo wa 0-1-1 mg / tsiku. Monga mankhwala owonjezera osagwiritsa ntchito 9-a-fludrocortisone kapena monotherapy ngati sizotheka kugwiritsa ntchito, ephedrine, clonidine, ndi yohimbine amagwiritsidwa ntchito. Caffeine ndi prostaglandin synthase inhibitors (indomethacin, naproxen, ibuprofen) ndi ena mwa mankhwala ena omwe sagwiritsidwa ntchito ngati monotherapy.

Thukuta la chakudya . Kutuluka thukuta kwambiri ndikudya akangopezeka kumutu, kumaso, kukhosi komanso pachifuwa, kuyerekeza hypoglycemia, ndikusokoneza mtima wodwalayo. Kukonzekera kumakonzekera - glycopyrrolate, yemwe ali ndi antimuscarinic, mankhwala apakhungu apakhungu, omwe amachepetsa thukuta kwambiri.

Gastroparesis. Choyamba, kulimbikitsidwa pakudya, kutafuna mokwanira, kugwiritsa ntchito madzi amadzimadzi kapena homogenized ndikofunikira. Mankhwala omwe amawonjezera mphamvu ya matumbo amatha kukhala ndi zotsatira: cisapride ndi agonist of serotonin receptors, erythromycin ndi mankhwala othandizira gulu la macrolide, omwe onse ndi cholinomimetic komanso agonist of receptors a motilin, metoclopramide ndi dopamine antagonist omwe ali ndi cholinergic recortort34 of 3thin4 of 3thort4ation of the pheninergiceptid - wowerengeka wotsutsana ndi dopamine receptors, ofanana ndi metoclopramide mu kapangidwe ndi kachitidwe ka zochita, koma ndi zotsatira zoyipa zochepa. Kuchepetsa zizindikiro monga nseru ndi kusanza komwe kumayendera limodzi ndi gastroparesis, TCAs (amitriptyline 10-25 mg kawiri pa tsiku), opioid receptor agonists - fedotosin, antotonists a serotonin - ondasetron ndi granisetron amagwiritsidwa ntchito. Mankhwala opangira opaleshoni (anteromy, vagotomy, gastrectomy, kapangidwe ka anastomoses ndi pyloroplasty) nthawi zambiri samathandiza, kupatula kufalikira kwa kapamba.

Matenda a shuga Mankhwala osokoneza bongo amaphatikizapo mankhwala omwe amalepheretsa matumbo kuyenda: loperamide, verapamil, octreotide. Kukula kwa matenda otsegula m'mimba kumatha kutsitsa kuchepa kwamadzi m'matumbo a mucous motsogozedwa ndi kuchepa kwa zotsatira za a2-adrenergic. Kupezeka kwa a2-adrenomimetic katundu ndiye maziko achire zotsatira za clonidine mu matenda am'mimba mwa odwala matenda ashuga. Clonidine imabwezeretsa kubwinobwino kwamadzi m'matumbo mucosa ndikuchepetsa mphamvu ya parasympathetic pa peristalsis yake. Pazifukwa zomwezo, codeine ndi diphenoxylate amagwiritsidwa ntchito - opiates omwe amawonjezera kubwezeretsanso kwamadzi m'matumbo. Hypokalemia, yomwe nthawi zambiri imakhudzana ndi matenda a shuga, imatha kutsitsa matumbo. Kuthana ndi mankhwala okhala ndi potaziyamu mwa odwala koteroko kungachepetse kuopsa kwa matenda am'mimba.

Kukanika kwa Erectile . Ndi kukanika kwa erectile, pafupifupi 50% ya odwala ali ndi kupatuka mu malingaliro. Ichi ndichifukwa chake psychotherapy imakhala malo otsogolera othandizira odwala otere. Organic zimayambitsa kukanika kwa erectile zimaphatikizapo autonomic neuropathy ndi mtima wamitsempha. Ngati pali zovuta zina, chithandizo chamankhwala chitha kukhala chothandiza. Choyamba, ndikofunikira kupenda ndipo, ngati kuli kotheka, m'malo mwamankhwala omwe wodwala amalandira. Amadziwika kuti mankhwala ochizira ochepa matenda oopsa komanso antidepressants angayambitse kusokonekera kwa erectile. Trazodone, wokhala woletsa, amabwezeretsanso erection atamwa mankhwala a 50 mpaka 150 mg / tsiku. Kukhazikitsidwa kwa mankhwala a mahomoni (testosterone) ndikoyenera kwa odwala omwe ali ndi hypogonadism kuti achulukitse libido ndikusintha erection. Yohimbine, preynaptic a2-blocker, amachepetsa kutuluka kwa magazi kuchokera mu minofu ya cavernous ndipo amatha kukhala ndi gawo lapakati pakuwonjezera libido. Mankhwala amodzi omwe amayambitsa "ngati pakufunika" erection amaphatikiza mtundu 5 cyclic guanosine monophosphate phosphodiesterase (cGMP) inhibitor, sildenafil. Kuchokera pamankhwala omwe si a pharmacological, zida za vacuum, jakisoni wa mankhwala osokoneza bongo (papaverine) m'matupi a cavernous, intraurethral makonzedwe a prostaglandin E1 (PGE-1) ndi ma prosthetics amagwiritsidwa ntchito. Kuphwanya ukodzo kumatha kuwonetsedwa ndi kufowoka kwa mbeu kapena kubwezeretsa kumera (chifukwa cha kufooka kwa chikhodzodzo). Kugwiritsa ntchito sympathomimetics kumakupatsani mwayi wobwezeretsa. Ephedrine ndi imipramine amagwiritsidwa ntchito mphindi 60 asanagone.

Matenda a shuga wodziwika ndi chikhodzodzo chopanda kanthu amafunika kusintha kwa wodwala. Kuyeserera kuyenera kuchitidwa kuti mukodze maola anayi aliwonse, kaya mukukodza kapena ayi. Mwa kukonzekera kwa pharmacological, a-blockers, komanso cholinergic agonist betanicol, amagwiritsidwa ntchito kukonza chofufumitsa. Ndi kuphwanya kwambiri, aseptic catheterization ya chikhodzodzo amalumikizidwa maora aliwonse a 4-6 ndi odwala omwe akuphunzira njirayi.

Ngakhale pali mankhwala osokoneza bongo ambiri omwe agwiritsidwa ntchito moyenera pochiza DPN, chithandizo cha mitundu yambiri yamavuto azodziwikiratu ndi chizindikiro. Izi zikufotokozedwa ndi kusasinthika kwathunthu kwa kuwonongeka kwa ulusi wamasamba kumbuyo kwa chida cha pathogenetic chomwe chikugwiritsidwa ntchito pano, chomwe chikugogomezera kufunikira kwapadera podziwonera komanso kupewa pathogenetic panjira yodwala matenda obwera chifukwa cha matenda ashuga. Pamaululira zovuta zakumasamba koyambirira, ndikofunikira kupereka mankhwala a pathogenetic, kuphatikiza, ngati kuli kotheka, ndi chithandizo chowonjezera cha mankhwalawa, kutengera mtundu wa zovuta za autonomic.

Buku:
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19. Gulu Lophunzira la Capsaicin Chithandizo cha matenda am'mimba opweteka a matenda ashuga okhala ndi matenda opatsirana a mitundu ingapo, akhungu lambiri, loyendetsa galimoto Arch Intern Med, 1991, v 151.2225-2233
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29. Cameron N E, Cotter M A, Horrobm D H et al Zotsatirapo za-lipoic acid pamayendedwe a mitsempha yokhudzana ndi matenda am'magazi odwala matenda ashuga okhathamira ndi mafuta acids a Diabetesologia, 1998, v 41, 390-399.

Kulipira kwakanthawi kokwanira, chifukwa cha matenda ashuga kumatheka kokha ndi odwala omwe amalangidwa kwambiri. Ena onse posakhalitsa amayamba kusokonezeka, chimodzi mwazomwe zimadziwika kwambiri ndi matenda a shuga.

Ndikofunikira kudziwa! Nkhani yatsopano yomwe ikulangizidwa ndi ma endocrinologists a Kuwunika Kwachisawawa Kokulu! Ndi zofunika tsiku lililonse.

Matenda a matenda ashuga - ndi chiyani?

Matendawa amagwira bwino ntchito mu zotumphukira za mitsempha yotupa. Amatha kukhala ochulukirapo kapena am'deralo, okhudza machitidwe angapo kapena chinthu chimodzi chokha. Pakusankhidwa kwa adotolo, neuropathy imapezeka wodwala aliyense wachisanu ndi chiwiri yemwe ali ndi matenda a shuga, mothandizidwa ndi njira zamagetsi zamagetsi - sekondi iliyonse.

Chizindikiro choyamba cha matendawa ndi kuchepa kwa kuchuluka kwa kufalikira kwa zotsekemera mu minyewa ya mitsempha. Kwa mitundu yayikulu ya neuropathy, kusokonezeka kwa chidwi ndi chikhalidwe, kupweteka kwambiri, kulephera kwa ziwalo, kufooka kwa minofu mpaka kulumala ndikotheka.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

Matenda a shuga ndi omwe amayambitsa pafupifupi 80% yonse yamikwingwirima ndi kuduladula. Anthu 7 mwa anthu 10 amafa chifukwa cha mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chomaliza ndi chimodzimodzi - shuga wamwazi.

Shuga akhoza ndipo amayenera kugwetsedwa, apo ayi.Koma izi sizichiritsa matendawa, koma zimangothandiza kulimbana ndi kufufuza, osati zomwe zimayambitsa matendawa.

Mankhwala okhawo omwe amalimbikitsidwa moyenera pochiza matenda ashuga komanso amagwiritsidwa ntchito ndi ma endocrinologists pantchito yawo ndi awa.

Kugwiritsa ntchito bwino kwa mankhwalawa, kuwerengera malinga ndi njira yokhazikika (kuchuluka kwa odwala omwe achiwonjezere kuchuluka kwa odwala omwe ali pagulu la anthu 100 omwe adachitiridwa chithandizo):

• Matenda a shuga - 95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kulimbitsa tsiku, kukonza kugona usiku - 97%

Opanga si bungwe lazamalonda ndipo amalipidwa ndi chithandizo cha boma. Chifukwa chake, tsopano wokhala aliyense ali ndi mwayi.

Ndani ali pachiwopsezo

Chiwopsezo chachikulu kwambiri chotenga matenda a neuropathy chili mwa odwala omwe alibe shuga. Zinapezeka kuti kukwaniritsa shuga wabwinobwino nthawi iliyonse yamatendawa kumachepetsa chiopsezo cha neuropathy ndi 57%. Chithandizo chapamwamba kwambiri cha matenda ashuga kuyambira kumayambiriro kwa matendawa chimachepetsa mwayi wa neuropathy kukhala 2% kwa odwala omwe samadalira insulini komanso 0,56% pakukonzekera insulin.

Kuphatikiza pa shuga wambiri, chiopsezo cha matenda am'mimba amtundu wa shuga chikuwonjezereka ndi:

• kusuta
• uchidakwa -.
• matenda oopsa
• kunenepa
• cholesterol yayikulu
• ukalamba wa wodwala
• zamtundu.

Kuopsa kwa neuropathy kumadaliranso pamene matendawa adapezeka. Ngati kusintha kwa m'mitsempha m'mitsempha kwapezeka m'magawo oyamba, chithandizo chawo ndichothandiza kwambiri.

Kodi mitundu yosiyanasiyana yamitsempha imakhala yotani?

Matenda a diabetes a neuropathy amatha kuwononga minyewa yayikulu komanso yaying'ono, yokhazikika m'magulu osiyanasiyana komanso machitidwe, amakhala ndi mawonekedwe osakanikirana. Ichi ndichifukwa chake ma neuropathies amadziwika ndi mitundu yosiyanasiyana ya zizindikiro - kuchokera kutha kwa chidwi ndi matenda otsekula m'mimba, mavuto a mtima, komanso kuwonongeka kwa mawonekedwe chifukwa cha kusokonekera kwa ophunzira. Matenda a diabetes a neuropathy ali ndi magulu angapo mwatsatanetsatane. Nthawi zambiri pamakhala magawikidwe amitundu, zomvera ndi zamagalimoto.

Nthawi zambiri, zochitika zamagetsi (50% ya milandu), autonomic, motor neuropathies zowonongeka pamizu ya mitsempha ya thoracic ndi lumbar zimapezeka.

Momwe mungathanirane ndi matenda a shuga

Maziko a chithandizo cha neuropathy ndikulipira kwakanthawi kochepa kwa matenda ashuga. Ndi normalization wa shuga ndende, kupitirira kwa matenda ashuga neuropathy amasiya, pali kuchira kwathunthu kwa mitsempha yofatsa gawo la matendawa komanso kusinthika pang'ono kwakasinthidwe koopsa. Pankhaniyi, zilibe kanthu momwe wodwalayo adakwanitsira Normoglycemia, chifukwa chake, kusintha kwa insulin sikofunikira. Njirayi ndi yayitali, kuwongolera kowonekera kumachitika pakatha miyezi iwiri kuchokera pakukhazikika kwa shuga. Nthawi yomweyo, amayesa kusintha kulemera kwa wodwalayo ndikusintha kuchuluka kwa magazi a milomo.

Kuti muchepetse njira yochira, mavitamini B amalembedwa .. Kupititsa patsogolo zakudya m'thupi kumatheka chifukwa cha antiplatelet agents - acetylsalicylic acid ndi pentoxifylline.

Ndi neuropathy, antioxidants, nthawi zambiri thioctic (alpha-lipoic) acid, amaonedwa kuti ndi ovomerezeka. Amatha kukoka ma free radicals, kusintha mayamwidwe a shuga, kubwezeretsa mphamvu mkati mwa mitsempha. Njira ya mankhwalawa imachokera kwa milungu iwiri mpaka inayi ya kulowetsedwa kwa mtsempha, ndipo kenako miyezi 1-3 mutamwa mankhwalawa.

Imodzi ndi kubwezeretsa kwa dongosolo lamanjenje kuti mpumulo wa ululu, chisonyezo cha neuropathy chawonetsedwa:

1. Capsaicin pamagetsi ndi mafuta.
2. Anticonvulsants - Pregabalin, Gabapentin, Topiramat.
3. Ma antidepressants ndi mankhwala onenepa kapena am'badwo wachitatu.
4. Analgesics, kuphatikizapo opioids, ngati simungachite bwino chifukwa cha opaleshoni ina.

Mu ufulu wa anthu odwala matenda ashuga, mankhwalawa angagwiritsidwe ntchito pokhalitsa othandizira - kutupa, vasotropic, mtima mankhwala, othandizira kugaya chakudya. Ndi motor neuropathy yam'munsi kwambiri komanso dera la thoracic, chithandizo chingafune kuthandizidwa ndi mafupa kwa wodwala - ma corsets, mendo, oyenda.

Kupewa

Popewa kukula kwa matenda a diabetesic neuropathy amatha kungoyang'anira thanzi lanu:

1. Magazi amawongolera nthawi yomweyo atazindikira kuti ali ndi matenda ashuga.
2. Kuyesedwa pafupipafupi kwa glycated hemoglobin kuti mupeze kuwonjezeka kwa shuga.
3. Kusiya kusuta fodya komanso kumwa mowa ndi matenda ashuga.
4. Chithandizo cha matenda oopsa.
5. Matenda a kulemera.
6. Onani dokotala nthawi yoyamba atayamba kuonekera.
7. Kuyeserera pafupipafupi muofesi ya wamisala.
8. Kudya kwa vitamini B (mwachitsanzo, piritsi limodzi la Milgamm katatu patsiku kwa masabata atatu) ndi thioctic acid (600 mg patsiku, maphunziro - mwezi umodzi).

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yosungira shuga m'manja? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito.

Neuralgia mwa akazi

Nthawi yapakati, thupi laimayi limasintha mofulumira, mwana akamakula mkatikati. Kulemera kwa amayi amtsogolo kumawonjezeka, malo oyendetsera thupi amasuntha, katundu pamsana ndi miyendo imakhala yolimba. Ngakhale izi ndizokwanira kuti mkazi azitha kupanga zomwe zimatchedwa neuralgia kumbuyo, thoracic msana kapena mitsempha ya sciatic. Ndipo ngati zizindikiro za neuralgia zimamuvutitsa ngakhale asanakhale ndi pakati, ndiye kuti kufalikira kumakhala kotsimikizika. Kodi matendawa amawonekera bwanji?

• Ndi intercostal neuralgia - kupweteka kosalekeza pachifuwa pamene kutsokomola ndi kusisima, pakuseka komanso kuchita masewera olimbitsa thupi.
• Ndi neuralgia m'dera lumbar komanso ndi neuralgia ya sciatic nerve - ululu wakuthwa kumbuyo, "kupatsa" mwendo pansi pa bondo, kupweteka panthawi yamatumbo, kumverera konyowa khungu la ntchafu.

Momwe mungachotsere zovuta zovuta, chifukwa amayi oyembekezera amaletsedwa mankhwala ambiri chifukwa chakuti amadziwikiridwa m'magazi ndipo amatha kuvulaza mwana?

Zochizira neuralgia kunyumba, madokotala amalimbikitsa njira zotetezeka:

• Woimira Kuznetsov - kalabu yokhala ndi zowola pulasitiki. Imasenda khungu ndi minofu, kusintha magazi kulowa mwa iwo ndikuthandizira kuphipha.
• Acupressure kupumula minofu. Kutikita minofu sikungachitike, chifukwa kumatha kupangitsa kuyambika kwa ntchito.
• Kudya kwa mavitamini a B kuti kulipirira kufooka kwawo.
• Ngati njira yochizira neuralgia kunyumba, mutha kugwiritsa ntchito kutentha: thukuta lotentha, thumba lokhala ndi chimanga, mchere kapena mchenga, shawls pansi (pakalibe kutsutsana ndi gynecology)

Ngati njira zochiritsira mofatsa sizinabweretse mpumulo, ndipo ululuwo ukukulirakulira, muyenera kuwona dokotala kuti mupeze mankhwala omwe angagwiritsidwe ntchito kuti izi zisavulaze mwana wosabadwa. Monga lamulo, muzochitika zotere, amayi oyembekezera amayembekezeredwa ma novocaine blockade painkillers.

Neuralgia mwa amuna

Neuralgia mwa amuna siosiyana kwambiri ndi akazi, komabe pali zinthu zingapo zomwe zimagona mu kugonana kwamphamvu:

• Kuwona kukuwonetsa kuti ndi kufalikira kwamawere kwa neuralgia mwa akazi, kupweteka kumalimbikitsidwa kwambiri m'chigawo cha mtima, ndi kwa amuna, pansi pa nthiti kumanzere.
• Popeza abambo amakumana ndi kupsinjika kwakuthupi kwambiri kuposa azimayi, kuvulala, matenda, ndi neuralgia kumbuyo ndi mitsempha yachilengedwe ndizofala pakati pawo.

Amuna, monga lamulo, amachita nawo masewera ovuta komanso ovuta (masewera, nkhonya, masewera andewu, zina), kupirira katundu wolemera, kugwira ntchito yomanga - zonsezi zimabweretsa kuwonekera kwa ma disc a intervertebral disc, protrusion, kupindika kwa msana. Ndipo ngati mukulira kuti musayiwale chithandizo, chomwe ndi chofunikira kwambiri pakugonana, zimawonekera kuti amabwera kwa dotolo “atatentha” kwambiri ndipo amafunikira opaleshoni, kapena ngakhale opareshoni.

Neuralgia mwa okalamba

Neuralgia mu kukalamba ali ndi mawonekedwe ake.

Choyamba, ndizofala kwambiri pakati pa odwala okalamba kuposa odwala achinyamata. Izi ndichifukwa choti pofika zaka zambiri, monga lamulo, kuchuluka kwambiri kwa matenda wamba omwe amachititsa neuralgia: matenda ashuga, chithokomiro, atherosulinosis, aneurysms, etc.

Kachiwiri, senile neuralgia imathandizidwa kwambiri, chifukwa kuchira kwamthupi kumachepa pang'onopang'ono pazaka.

Chachitatu, okalamba samakhala ndi mgwirizano wokwanira wamafupa komanso mafupa osalimba poyerekeza ndi achichepere (makamaka kwa azimayi - mu kusintha kwa mafupa kumachitika nthawi zambiri). Chifukwa chake, mwayi wovulala, ndipo chifukwa chake kuwonongeka kwa mitsempha, umakulitsidwa kwambiri - mwachitsanzo, neipogia ya neripgital imachitika.

Mu ukalamba, pafupipafupi wa postherpetic neuralgia imachulukirachulukira (zaka 30-50, imakula mu 10% ya iwo omwe ali ndi herpes kapena shingles, zaka 50-60 - mu 50%, mu zaka 75 - mwa 75% ya anthu). Ofufuzawo amakhulupirira kuti chifukwa chake ndikuchepa pang'onopang'ono kuthekera kochiritsa minofu okalamba mwachangu, komanso kuchepa kwokhudzana ndi zaka.

Madokotala amati trigeminal neuralgia imakhudzanso azimayi achikulire (azaka 50 ndi akulu) ochulukirapo. Palibe kufotokozera pankhaniyi pano.

Neuralgia muubwana imakhala yocheperako poyerekeza ndi akulu. Komabe, ngakhale makanda oyamwitsa amatha kudwala nawo. Kodi ndichifukwa chiyani izi?

• Kuwonongeka kwa padera kwa dongosolo lamanjenje la mwana - pamenepa, matenda omwe mwana adalandira kuchokera kwa amayi akuyenera kuwimbidwa mlandu.
• Kuvulala kubala kapena kuvulala kwa amayi pamene muli ndi pakati.
• Mkhalidwe wolakwika wa thupi la mwana mutavala m'manja kapena pachikwama
• Hypothermia ndi kuzizira.
• Congenital anomalies mu kapangidwe ka mitsempha yamagazi ndi ziwalo (aneurysms, kupendekera kwa ngalande za mafupa, etc.).
• Kukula kokuchitikira, komwe mafupa ndi minofu imachuluka mwachangu.

Kodi neuralgia amawonekera bwanji mwa ana? Zimatengera mtundu wake. Ngati mitsempha ya trigeminal yakhudzidwa, makanda angakane kuyamwa, kulira, minofu yawo imanjenjemera ndipo milomo yawo imayenda bwino. Ana okalamba amadandaula kuti mutu wawo ndi nkhope zawo zimapweteka. Ndi neuralgia ya patali, ana amalira akamunyamula kapena kuwayika m'khalidwe. Neuralgia ya Occipital imadziwika ndi ululu, womwe umakulitsidwa ndi kuyenda (kutembenuka, kukweza).

Chithandizo chimatengera zaka za mwana komanso zomwe akukula. Itha kukhala:

• Kusambira komanso kutikita minofu
• Kuthira Kutentha Kouma
• Kuvala corsets ndi kolala
• Physiotherapy (electrophoresis)
• Mankhwala osokoneza bongo malinga ndi zaka
• Mankhwala ovomerezeka osagwirizana ndi zaka

Kumbukirani: Mankhwala ndi machitidwe a mwana (makamaka khanda) ayenera kuyikidwa ndi dokotala. Kudzipatsa nokha mankhwala kuopsa!

Zizindikiro zodziwika bwino za neuralgia

Chizindikiro chachikulu cha neuralgia ndi kupweteka. Imatha kukhala ndi chikhalidwe chosiyana: kuyambitsa kutentha, kumva kupweteka kapena msana. Ululu umafalikira limodzi ndi mitsempha komanso m'dera lomwe limathandizira. Kutengera mtundu wa mitsempha yomwe wakhudzidwa, ikhoza kupweteka:

• Nkhope ya theka, mano, nsidze, gawo la khosi - lomwe limakhala ndi trigeminal neuralgia. Nthawi zambiri pamakhala misozi ndi malovu odzipereka. Pankhope ya munthuyu pali magawo oyambira, okhudza omwe amapweteketsa zowawa zatsopano.
• Ndi occipital neuralgia, odwala amadandaula kuti ali ndi zilonda zam'mbuyo za khosi ndi khungu kumbuyo kwa mutu. Zowawa ndizowawa kapena kuwombera.
• Ndi zowonongeka kwa mkati, anthu ali ndi nkhawa ndi kupweteka kwa chifuwa, komwe kumakulitsidwa chifukwa cha kudzoza komanso kuyenda kwa thupi.
• Ngati femur yakhansa yapweteka, izi zikuwonetsa neuralgia yamitsempha yapakhungu la ntchafu.
• Ndi neuralgia ya sciatic, mwendo kumbuyo umapweteka. Popeza mitsempha ndi yayikulu ndipo imakhala ndi nthambi zambiri, zovutazi zimakhala zamphamvu kwambiri.

Chizindikiro china chomwe chingachitike neuralgia ndikutuluka thukuta kwambiri komanso khungu rede lomwe lakhudzidwa.

Intercostal neuralgia imakhumudwitsa mitsempha ya mkati. Ndi nthambi yochokera ku chingwe cha msana, yomwe imadutsa pakati pa nthiti ndi minofu yomwe imayambitsa kuphipha ndi kuphipha. Ndi mtundu uwu wa neuralgia, mitsempha imakwiya mwina mkati mwa malo kapena pafupi ndi msana.

Chizindikiro chachikulu cha matendawa ndi kupweteka. Kutengera kuchuluka kwa zowonongeka, imatha kukhala yakuthwa kwambiri, kuwombera, koma kudutsa mwachangu, kapena kubereka, koma kukhazikika nthawi yayitali. Zomverera zosasangalatsa zimakulitsa pakumwa kutsokomola, kupuma mwamphamvu, ndikuthinira. Zowawa zimakakamiza munthu kuti atenge mawonekedwe osakhala amtundu kapena amabweza mpweya mwa kukanikiza m'manja ndi nthiti zake.

Ngati neuralgia yakhudza nthiti zam'munsi, zotsekemera zimatha kufanana ndi aimpso (kupweteka kumbuyo, "kupatsa" kuginja kapena mwendo).

Kutsitsimuka kwa matendawa kumagonekanso chifukwa chakuti zizindikiro zake ndizofanana kwambiri ndi angina pectoris - zimayeneranso chifukwa chakuti neuralgia kapena vuto la mtima silidutsa piritsi la nitroglycerin. Ndipo ngati poyamba wodwalayo amachita mantha ndikuyimbira ambulansi, akuganiza kuti watenga mtima, ndiye kuti patapita nthawi amangozolowera kupweteka ndipo akhoza kuphonya vuto lenileni la mtima.

Zizindikiro za Postherpetic Neuralgia

Postherpetic neuralgia imapezeka mwa odwala omwe adwala ndi herpes kapena shingles - ndipo nthawi zina amawonekera pokhapokha zaka zochepa. Kuzindikirika kwa matendawa ndikuwonekanso kuti kumatha kukhala nthawi yayitali (mpaka chaka), kumapangitsa munthu kuvutika. Ndi neuralgia yotere, mitsempha imakhudzidwa ndi kachilombo ka herpes, "kamene kamakhala" mu ganglia ndikudziwonetsa pomwe chitetezo chitagwa - atangopanga zinthu zabwino, kachilomboka amachulukirachulukira ndikusokoneza kutupa kwa mitsempha yamitsempha. Zizindikiro zake zimaphatikizapo:

• Kupweteka kwambiri kapena kudula ululu. Nthawi zina kumatha popanda yopuma, kufinya wodwalayo ndikumupangitsa kuti akhumudwe. Ndi ululu wammbuyo, munthu ayenera kulandira chithandizo kuchipatala.
• Kuyabwa ndi kumva kumverera pakhungu.
• Nthawi zina wodwala amakhala ndi mutu, amamva kufooka m'mitsempha.
• Kwa anthu achikulire, kupuwala mikono ndi miyendo kumatha kuchitika.

Chiwopsezo chokhala ndi postherpetic neuralgia imakulanso kwambiri:

• Ndi zaka: okalamba amadwala pafupipafupi (nthawi zambiri 5-7 kuposa achinyamata ndi anthu azaka zapakati).
• Ngati nkhuku kapena shingles zimangoganizira kwambiri thupi, osati miyendo ndi mutu.
• Ndi mipata yambiri. Madokotala amakhulupirira kuti izi zimachitika chifukwa cha kufooka kwa chitetezo chathupi: thupi laumunthu silitha kupondereza kachilomboka ndikuchepetsa kufalikira kwa gawo limodzi lokha lamitsempha.
• Ndi kupweteka kwambiri pakuwoneka ngati totupa - ndikulimba kwambiri, ndizowopsa za neuralgia.
• Ndi mochedwa-anayamba chithandizo ndi enieniwe antivayirasi.

Ululu ndi neuralgia

Kupweteka ndi neuralgia ndiye chizindikiro chachikulu chomwe chimakupatsani mwayi wodziwikitsa. Chikhalidwe komanso kukula kwa zowawa zimatengera mitsempha iti, malo ake ndi momwe zidawonongeka kwambiri:

• Neuralgia yokhudzana ndi mitsempha ya trigeminal imadziwika ndi ululu wamkati womwe umachitika poyankha kukwiya ndi chakudya, kuwala, mawu, monga njira yokhudza kukhudza madera ena a khungu la nkhope. Ululu umatha kukhudza nthambi imodzi kapena mitsempha yonse. Munthu amachepa, amaundana ndipo amayesa mkhalidwe uku kudikirira kuukiridwa.
• Neuralgia pachifuwa ndi kumbuyo imayendera limodzi ndi ululu wa paroxysmal, womwe umakulitsa poyankha kayendedwe ka chifuwa (kufinya, kutsokomola, kupweteka).
• Kugonjetsedwa kwa mitsempha ya sciatic kumayambitsa kupweteka kwambiri, mpaka mpaka kumiyendo mpaka kumapazi. Wodwala sangathe kutsamira mwendo wake, chifukwa zimapweteka.
• Mitsempha ya occipital ikakhudzidwa, munthu amakhala ndi mutu wopweteka kwambiri kuyambira kumutu mpaka kumaso, amadwala ndipo amatha kusanza.
• Ulnar neuralgia imayendera limodzi ndi kuboola ululu kuchokera m'chiwuno mpaka m'chiwuno.
• Neuralgia ya glossopharyngeal nerve imadziwika ndi kupweteka kwakukulu pamizu ya lilime ndi ma toni ndikubwerera khutu, khosi, komanso m'kamwa. Kuchulukitsa kwa malovu, kutsika kwa magazi ndi kuchepa kwa kugunda kwa mtima, kupweteka pamizu ya lilime pakugona titha kuwona.

Neuralgia yodziwika pachifuwa nthawi zambiri imapereka zizindikiro zomwe wodwala amatenga chifukwa cha vuto la mtima lomwe limayamba. Zimawoneka bwanji?

• Kupweteka kwapachifuwa pang'ono kapena koopsa komwe sikumatha piritsi ya nitroglycerin.
• Kuchulukitsa ululu chifukwa cha kusuntha kwa chifuwa ndi thupi.
• Zowawa zimatha kufalikira m'chifuwa chonse chifukwa chakuti mitsempha imakhala ndi nthambi zambiri.

Kodi odwala ayenera kuchita chiyani omwe zizindikiro za neuralgia zikufanana ndi angina pectoris kapena vuto la mtima? Pankhaniyi, muyenera kufunsa dokotala. Kukambirana ndi mtima kumathandizira kudziwa momwe mtima wam'magazi umagwirira ntchito. Mwina zizindikiro zomwe zimawonekera zimawonetsa kukhalapo kwa matenda a mtima. Kufunsira katswiri wa mitsempha ndikofunikanso (makamaka ngati zonse zili mu dongosolo ndi mtima). Palibe chifukwa chomwe muyenera kudzilingalira nokha kapena kuchedwerako kuchezerako kwa katswiri wazizindikiro zotere. Ndizovuta kwambiri kusiyanitsa zizindikiro za vuto la mtima ndi zizindikiro za neuralgia pazokha, kotero simuyenera kuyika thanzi lanu pachiwopsezo.

Neuralgia ndi kumbuyo

Neuralgia, yotchulidwa kumbuyo, imayamba kuwonetsedwa ndi kupindika kwakanthawi kofupikirako, komwe wodwalayo amafotokozera ndi kusakhazikika kosagona panthawi yogona, hypothermia, komanso kusuntha kwadzidzidzi. Pakapita kanthawi, kukokana kumaloledwa m'malo opweteka, omwe amadziwika ndi:

• Kubwereza kwakanthawi.
• Edema ndi kuwuma minofu.
• Kuwonongeka kwa zomverera chifukwa chosasuntha osasamala, kutsokomola komanso kusisita, kutembenuka.
• Kuchulukitsa thukuta, kufiyira kapena kutsekemera kwa khungu m'dera la minyewa yomwe yakhudzidwa.
• Chizindikiro cha neuralgia ya m'mbuyo ndikuwonjezeka kwa ululu poyankha kukakamira pamzere wa msana.

Choyambitsa neuralgia chagona m'matenda otupa komanso osachiritsika a dystrophic:

• Kutupa: myositis ndi radiculitis yoyambitsidwa ndi hypothermia ndi matenda.
• Degenerative-dystrophic: hernias ndi protrusions, arthrosis, stenosis ya ngalande, kuchoka kwa vertebrae, osteochondrosis.

Mitundu ya Neuralgia

Neuralgia yoyamba ndi kupweteka komwe kumachitika pamene mitsempha imakhumudwitsidwa ndi poizoni, imakhudzidwa ndi ma virus, ndipo imapanikizidwa ndi chotupa kapena aneurysm.

Zimachitika kuti munthu akuvutika ndi zowawa zamkati mwadzidzidzi, chifukwa choti kuphipha kwamisempha kumachitika. Ululu umachitika pazifukwa zosadziwika, ndizosatheka kuneneratu mawonekedwe awo. Amaleka modzidzimutsa komanso mwachangu pomwe ankanyamuka.

Njira inanso ndi pamene neuralgia yoyamba imasokonekera chifukwa cha kukomoka kwa dongosolo lamanjenje lamkati.

Neuralgia yachiwiri

Neuralgia yachiwiri ndi chifukwa cha matenda kapena kuvulala kulikonse. Itha kukhala:

• Matenda a mano.
• Matenda a ziwalo za ENT.
• Zovuta, mabampu ndi mikwingwirima.
• Hypothermia, chifukwa chomwe minofu ndi minyewa yamitsempha, kenako mitsempha imayatsidwa.
• Zachiwiri zimaphatikizapo neuralgia ya thoracic, kumbuyo kapena khosi, yomwe idayamba chifukwa cha osteochondrosis kapena matenda ena a msana.

Kafukufuku wa Laborator

Njira zasayansi zozindikira neuralgia sizigwiritsidwa ntchito kwenikweni, chifukwa:

• Matendawa ali ndi chithunzi chowoneka bwino komanso chowoneka bwino kwambiri kotero kuti palibe mayeso omwe amangofunikira. Mwachitsanzo, neuralgia ya nkhope imawonetsedwa ndi ululu wowopsa, womwe odwala amawauza kuti ndi wosalephera ndipo amatha kuwonetsa nthawi yomwe idachokera.
• Palibe mayeso enieni omwe amawonetsa bwino kukhalapo kapena kusowa kwa neuralgia.

Koma kodi izi zikutanthauza kuti kuyesa kwa labotale kuyenera kusiyidwa kwathunthu ndi njira zodziwira matenda? Ayi! Nthawi zina, zimakhala zothandiza kwambiri:

• Pakakhala kukayikira kuti neuralgia mwa anthu ndi omwe amayamba chifukwa cha matenda ena (mwachitsanzo, matenda a shuga - pamenepa, kusanthula kuchuluka kwa shuga wamagazi ndikofunikira).
• Zizindikiro zikakhala zofanana ndi kuwonekera kwa matenda ena. Chifukwa chake pakumva ululu m'chifuwa, neuralgia imatha kusokonezeka ndi kulowetsedwa kwa myocardial komanso ngakhale ndi thromboembolism ya nthambi zazing'ono zam'mapapo am'mimba (PE), chifukwa madandaulo a wodwalayo pazinthu zonse zitatuzi ndi ofanana: kupweteka ndi kuwotcha pachifuwa, kulephera kwathunthu kupumula, mantha. Ithandizira kumveketsa chithunzichi: ndi thromboembolism, wodwalayo amasintha mu coagulogram, komanso ndi vuto la mtima, m'magawo ena a kafukufuku wamabuku. Neuralgia, monga lamulo, sikuyenda limodzi ndi kusintha pakusanthula.
• Ngati matenda atapezeka pokhapokha, pang'onopang'ono kuchotsa matenda omwe angakhalepo komanso owopsa pamndandanda womwe ungayambitse neuralgia General komanso mayeso ena a labotale amathandizira kutsimikizira kapena kutsimikizira komwe kungatheke.

Njira zopangira zida

Madokotala nthawi zambiri amagwiritsa ntchito maphunziro othandiza kuzindikira neuralgia. Kusankhidwa kwa mtundu wamaphunziro kumadalira madandaulo omwe wodwala apereka komanso zomwe oyambitsa adokotala akuti:

• Electroneuromyography (ENMG) ndi njira yodziwika bwino yogwiritsidwa ntchito pozindikira matenda osiyanasiyana amitsempha.

ENMG ikuwonetsa momwe zimfundo zimafalikira mwachangu kudzera mu ulusi komanso ngati pali zowonongeka mumtsempha. Ili ndi njira ziwiri zosiyana: ma elekitiropu amagwira ntchito yamagetsi mumtunda wofatsa komanso nthawi yamikangano, ma electroneurography akuwonetsa kuthamanga kwa gawo lamagetsi pamagetsi.

Pa electromyography, ma elekitirodi amamangiriridwa pakhungu lomwe limaphunziridwa ndikukulumikizidwa ndi chipangizocho, singano yamagetsi imayikidwa mu minofu. Kwa ola limodzi, chipangizochi chimalembetsa zochitika zamagetsi pamtunda wodekha komanso panthawi yopanga mawonekedwe, zotsatira zake zimalembedwa pa tepi, ngati ECG.

Pa electroneurography, ma electrode amodzi amamangidwa kumalo komwe mitsempha imadutsa, ndipo yachiwiri imalumikizidwa ndi minofu yomwe imalowa. Pakadutsa mphindi 15-60, mphamvu imagwiritsidwa ntchito pa electrode yoyamba, yomwe imalowa mumtsempha ndipo imayambitsa minyewa. Ndime ya zamakono kuchokera ku mitsempha kupita ku minofu imalembedwa ndi chipangizocho.

• Ngati wodwala akudandaula za kupweteka kwambiri kumbuyo kwa sternum, kupuma movutikira, kupuma movutikira, ECG imayikidwa.

Zimakupatsani mwayi wofufuza mwachangu ngati vuto la mtima kapena angina pectoris limabweretsa ululu (mawonetsedwe awo amafanana ndi neuralgia ndi kupweteka pachifuwa)

• Zowawa m'dera la thoracic, FGDS imalembedwanso.

Chifukwa matenda am'mimba ndi esophagus amatha kukhala omwe amayambitsa kupweteka.

• Popeza chomwe chimayambitsa nkhope neuralgia imatha kukhala kupindika kwa mitsempha ndi aneurysm kapena chikhodzodzo cha atherosulinotic plaque, angiography yamitsempha yama bongo imayikidwa kupweteka kwa nkhope ndi mutu.

Chimakupatsani mwayi kuwona mawonekedwe ndi mapangidwe amitsempha yamagazi, kusiyana kwa kapangidwe kake.

• Njira zofufuza za X-ray: MRI, CT, X-ray.

Ndizofunikira kwambiri mukafunikira kuti muwone ngati wodwalayo ali ndi matenda chifukwa cha neuralgia yomwe yakhalapo. Mtundu weniweni wa kafukufuku umatsimikiziridwa ndi adotolo opezekapo, kutengera kutengera kwa anamnesis ndi madandaulo a wodwala. MRI, CT ndi X-ray ndizofunikira kwambiri pakuwonetsa matenda a msana, omwe amatha kukhala chifukwa cha neuralgia ya occipital nerve, nerve ya nerost, mitsempha yokhazikika, etc.

• Mitsempha ya mitsempha imagwiritsidwa ntchito ngati matendawa sanamveke, ndipo chithandizo sichikukonzanso.

Mwanjira iyi, kachidutswa kakang'ono ka mitsempha imayesedwa pansi pa microscope posaka matenda.

Kufunsira kwa Psychotherapist

Chithandizo cha neuralgia nthawi zonse chimakhala chosokoneza, chomwe chimaphatikizapo kumwa mankhwala, ndi physiotherapy, ndi kutikita minofu. Koma zimachitika kuti matendawa ndi ovuta kwambiri kuchiza, ndipo kuchuluka kwake kumachitika mwachangu kwambiri. Wodwalayo amakhala mwamantha ndi kuyembekezera kupweteka, amakhala ndi vuto la kugona ndipo sangathe kugwira ntchito mokwanira. Ngati munthu ali ndi vuto la neuralgia, ululu womwe uli wofanana ndi zizindikiro za angina pectoris ndi vuto la mtima, amapwetekedwa nthawi iliyonse akakomedwa pachifuwa chake.

Odwala oterewa amatha kuthandizidwa ndi psychotherapist yemwe amachititsa kupweteka kwambiri. Ntchito yake ndi chiyani? Imagwira pamayendedwe a psyche yaumunthu pogwiritsa ntchito njira zosiyanasiyana: zamakhalidwe ndi kuzindikira, mankhwala, zokambirana zapadera kufotokoza njira ya mawonekedwe a zopweteka, njira zodzigonjetsera tokha ndikusinthasintha. Kusankha kwa njira zamankhwala kumatengera umunthu wa munthu, mtundu ndi mtundu wa ululu womwe akumva. Ma antidepressants okha ndi ma antipsychotic omwe amachepetsa kuopa kupweteka ndi omwe angatengedwe ngati mankhwala padziko lonse lapansi.

Kusisita ndi njira yapadera yogwirira ziwalo ndi ziwalo zamanja ndi manja kapena zida zapadera. Kupititsa patsogolo izi, akatswiri amagwiritsa ntchito zida zapadera zamafuta ndi mafuta. Pakati pa gawoli, zolandirira minofu ndi khungu zimakhudzidwa, ndipo zizindikiritso zimafalikira ku chapakati mantha dongosolo (CNS). Kutengera mtundu wa kutikita minofu, zizindikirazi zimatha kuletsa komanso kupumula, kapena kudzutsa dongosolo lamkati lamanjenje.

Kodi kutikita minofu kumachitika bwanji?

• Amasintha magazi ndi zamitsempha.
• Amachepetsa ululu.
• Zimatengera kamvekedwe kabwino ka minofu. Zimalepheretsa atrophy ya minofu (izi ndizofunikira kwambiri ndi sciatic neuralgia, pamene minofu kumbuyo kwa mwendo imafooka).
• Imabwezeretsa yachilendo ntchito yolumikizira mafupa a msana, mikono ndi miyendo.
• Amachepetsa edema ndi kutupa m'malo a mitsempha yodwala.
• Imalimbikitsa kukonzanso mwachangu kwa mitsempha yotsogola.

Chitani chithandizo chamankhwala pokhapokha akatswiri okhawo omwe adaphunzitsidwa bwino ndi omwe amadziwa bwino zoyambira za thupi. Chifukwa chake, musanakhulupilire akatswiri othandizira omwe adapeza pazolimbikitsidwa ndi abwenzi, muzifunsabe ngati ali ndi dipuloma kapena satifiketi yoyenera.

Opaleshoni ya Neuralgia

Chithandizo cha neuralgia chimayamba ndi njira zosakhwima. Koma nthawi zina samabweretsa zomwe akufuna, ndipo wodwalayo amapatsidwa opereshoni. Pali mitundu yanji ya magwiridwe antchito yomwe ilipo?

Zochizira trigeminal neuralgia ntchito:

• Gamma-mpeni - ma radiation owongoleredwa, omwe amawononga makamaka mbali yakumanjayo.
• Radiofrequency percutaneous radicular ablation - akulimbana kuwononga kwa muzu ndi cauterization pansi pa x-ray.
• Microvascular decompression - kulekanitsa chotengera ndi mitsempha ndi septum kupatula kulumikizana kwawo ndi kukakamizidwa kwa chotengera pa mitsempha.
• Ngati chifukwa cha neuralgia ndi aneurysm, amathandizidwa ndikutsekemera kwa aneurysm kuti magazi asiye kutuluka m'derali.
• Mitsempha ikapanikizika mkati mwa ngalande za chigaza, makoma a ngalande amakula.

Ndi neologicalgia ya sciatic nerve, pamene mizu imapanikizika ndi chophukira kapena makoma a ngalande, ma neurosurgeons amati:

• Microdisectomy - kuchotsedwa kwa disc ya herniated yokhala ndi zida zazing'ono zamagetsi zomwe zimayikidwa mu ngalande ya msana.
• Laminectomy - kuchotsedwa kwina kwa phokoso la vertebral, kenako ndikuchotsa mafupa, hernias, zipsera kuti muchotse kupanikizika kwa mitsempha.
• Kypho- kapena vertebroplasty ndikukhazikitsa kwa vertebra wosweka pogwiritsa ntchito simenti yapadera yolowetsedwa ndi singano.
• Intradiscal electrothermal therapy - singano yokhala ndi chinthu chotenthetsera imayikidwa mu wosanjikiza wa fibrous disc yomwe imayang'aniridwa ndi X-ray. Amawotchera pang'onopang'ono, ndikuwononga mitsempha mkati mwa disc ya intervertebral disc ndikusindikiza macrcroper omwe ali kunja kwa disc.
• Punuction laser discectomy - zimakhala za intervertebral disc zomwe zimapanikiza mathero amanjenje zimachotsedwa ndi laser. Izi ndi zida zina zimayikidwa mwachindunji pakati pa vertebrae, pakati pa diski, ndikuwongolera oyang'anira pa x-ray.
• Ma radio-frequency mafuta annuloplasty - zimakhala kunja kwa disc zimasindikizidwa ndikuwonetsedwa ndi kutentha kwakukulu, chifukwa chake, hernia sangathe kutuluka kupyola disc ndikuphwanya misempha.
• Fasetectomy - kuchotsedwa kwa mafupa pakati pa vertebrae kuti muchepetse kupanikizika kwa mitsempha.
• Percutaneous automated diskectomy - Kuchotsa kumkono kwa msana wa hernia minofu kapena chida cha disc pambuyo pang'ambika. Kuchita opareshoni kumachitika pogwiritsa ntchito chida chaching'ono ndi zida zapadera.

Chithandizo cha Home Neuralgia

Chithandizo cha neuralgia kunyumba chimagwiritsidwa ntchito nthawi zambiri. Komabe, ndikofunikira kukumbukira kuti popanda kufunsa dokotala, ndibwino kuti musayambe chithandizo chilichonse. Makamaka ngati ululu umasokonezedwa nthawi zambiri. Zithandizo zilizonse za wowerengeka zitha kugwiritsidwa ntchito pokhapokha mukaonana ndi katswiri komanso kuwonjezera kwa chithandizo chachikulu.

Kodi chimagwiritsidwa ntchito nthawi zambiri kuchitira neuralgia kunyumba?

• Kutentha malo odwala.

Pulasitiki matebulo ndi malata, matumba okhala ndi mchenga wolusa ndi chimanga, masikono a mpiru, mapiritsi am'madzi ndi magetsi Zochizira za trigeminal neuralgia, dzira lotentha lowiritsa limagwiritsidwa ntchito, ndikusenda: limadulidwa ndikuyika ndi kagawo ka yolk pamalo owawa. Njira zonse zotenthetsera zili ndi cholinga chimodzi - kukonza kayendedwe ka magazi m'dera lomwe lakhudzidwa.

• Odwala ambiri amatenga ma corset, akumva kupumula ndi mawonekedwe oyenera a msana.

Corset imathandiza ngati munthu akudwala neuralgia yoyambitsidwa ndi osteochondrosis kapena scoliosis. Neuralgia ya Occipital imatha kuyendetsedwa ndikuchepetsa kuyenda kwa khosi ndi kolala yapadera.

• Amathandizira ndi neuralgia ndi mankhwala azitsamba.

Chinsinsi chotchuka ndicho tiyi ya mamawort ndi mandimu ndi uchi. Amakhala ndi mphamvu yotsogola, amachepetsa mphamvu yamanjenje. Kulowetsedwa kwa Yarrow ndikothandiza, komwe kumakhala ndi zotsutsa-kutupa ndi zotsatira za analgesic. Peppermint tincture ilinso ndi zinthu zotsutsa-kutupa.

• Njira ina yochizira ndi compress kuchokera ku dongo lakuchiritsa.

Zotsatira zake sizimangotentha malo owawa, komanso zinthu zotsutsa dongo.

• Kuthira mafuta owiritsa pamimba kumathandizira kuti muzitenthetsa malo owawa, kumakhala kovuta.

Chithandizo cha trigeminal neuralgia chimatenga kutenga antiepileptic mankhwala a carbamazepine. Zochita zake zimakhazikitsidwa ndi kusintha kwa malingaliro a zopweteka. Kupitiliza kwa analgesic kwenikweni (kwa maola 3-4) kumachitika pakatha masiku ochepa kumwa mankhwalawa. Ngati wodwala sayenera kugwiritsa ntchito carbamazepine chifukwa cha contraindication (glaucoma, matenda a m'mafupa, khunyu), amamuika diphenin (amakhalanso ndi contraindication, koma amasiyana ndi a carbamazepine - impso, chiwindi, matenda amtima).

Mlingo wa mankhwalawa umasankhidwa payekhapayekha ndipo uyenera kukhala wotero kuti munthu samakumana ndi zopweteka pazomwe zimachitika tsiku ndi tsiku (polankhula, podya). Pakatha mwezi umodzi, mankhwalawo amamwa mankhwala okwanira munthu, kenako amachepetsedwa. Chithandizo cha trigeminal neuralgia ndi carbamazepine kapena diphenin chitha kuyimitsidwa ngati wodwala sakumana ndi vuto losachepera miyezi isanu ndi umodzi.

Monga chida chowonjezera, physiotherapy imagwiritsidwa ntchito:

• Ma modutsa ma Diadynamic
• Kuphatikizika kwa Novocaine
• Ultraphonophoresis yokhala ndi mahomoni osokoneza bongo (hydrocortisone)

Ngati chithandizo champhamvu cha neuralgia chadzitopetsa, ndipo wodwalayo samva mpumulo, njira zopangira opaleshoni zimathandiza. Mitu ikuluikulu ndi:

• Kuchepa kwa microsuction kwa nthambi zamitsempha kumalimbikitsidwa ngati neuralgia ndiyofunikira.

Chomwe chikugwirira ntchito ndikuchotsa kuthina kwa chotengera pafupi ndi mitsempha. Kuti muchite izi, bowo limapangidwa mu chigaza kumbuyo kwa khutu, minyewa yovuta ndi chotengera chimapezeka kudzera mwa iyo mkati mwa bokosi lamkati, ndipo phata lolekanalo limayikidwa pakati pawo, kuti athetse kulumikizana kwawo.

• Radiofrequency percutaneous chiwonongeko (chopukutira) cha mizu yamitsempha ndimachithandizo chothandiza kwambiri kwa neuralgia wamaso.

Moyang'aniridwa ndi ma x-ray m'chipinda chogwiritsira ntchito chofunikira, singano imayambitsidwa ndi wodwalayo pafupi ndi pakamwa ndikuyenda m'mitsempha mpaka malo odwala atatha. Kenako singano imatenthetsedwa ndipo ndiwotcha. Opaleshoni yakumaloko ndiyokwanira kumaliza njirayi;

• Stereotactic radiosurgery ("Gamma Knife") - kuwonongedwa kwa mizu pogwiritsa ntchito ma radiation a gamma.

Tizilombo taumoyo pafupi ndi mitsempha yodwala sitikhudzidwa kwenikweni, popeza kuti ma radiation imayang'aniridwa ndikuwongolera kumalo komwe kuli zovuta. Mpeni wa gamma sufuna opaleshoni, ndipo pachifukwa ichi ndikulimbikitsidwa kwa odwala omwe ali ndi vuto lothandizira opaleshoni chifukwa cha matenda oyanjana. Kubwezeretsa pambuyo pochita opaleshoni kumatha miyezi 1-1,5, ndipo nthawi yomweyo, zotsatira za chithandizo zimawonekera bwino.

Mavuto ndi zotsatira za neuralgia

Neuralgia ndi matenda otchuka kwambiri. M'malo mwake, ndani kamodzi m'moyo wake yemwe sanakhale ndi ululu kumbuyo, chifuwa, kapena osadukiza, chifukwa iye "amawupatsa" mwendo wake? Nthawi zambiri anthu amaganiza kuti mu neuralgia palibe chodetsa nkhawa: zimapweteka ndikudutsa, sizowopsa. Zowona, sizowopsa, koma neuralgia komabe imatha kuvulaza moyo wokangalika. Kodi zimabweretsa zovuta ndi zovuta ziti?

• Mitundu yonse ya neuralgia imadziwika ndi kupweteka kwambiri, chifukwa chomwe odwala amamva kupsinjika ndi kuthedwa nzeru: kukhala ndi malingaliro osalekeza omwe amapweteka kwambiri ndipo nthawi zambiri amakhala ovuta. Odwala amavutika ndi nkhawa, amakhala ndi nkhawa komanso akuchepa mphamvu. Ambiri ali ndi vuto la kugona, ndipo chifukwa cha ichi sangathe kugwira bwino ntchito masana.
• Pankhani ya neuralgia ya patali, wodwalayo amayesa kupuma movutikira, amateteza chifuwa. Kutsika kwa kuchuluka kwa mpweya womwe ukubwera kumabweretsa Hypoxia.
• Ndi trigeminal neuralgia, khungu limasokonezeka nthawi zambiri, limakhala loonda, nsidze ndi eyelashes zimatuluka.
• Ndi neuralgia, mitsempha ilibe kusintha kwamachitidwe, koma neuralgia ya nthawi yayitali imatha kulowa mu neuritis. Neuritis imadziwika ndi kutayika kwa malowo, omwe amathandizidwa ndi mitsempha yowonongeka, mavuto amagetsi amatha.
• Sayansi neuralgia imatha kuthana ndi vuto la minofu ya kumbuyo kwamiyendo, kufooka kwa minyewa yam'miyendo, chifukwa chake, kusowa kwamphamvu kwa gait.

Neuralgia ndimatenda a nthawi yayitali omwe amasokoneza kwambiri moyo wa wodwalayo, amawapangitsa kuti azimva kuwawa. Chifukwa chake, chisankho cholondola ndikumchenjeza, kuti asachiritse. Kodi angachite bwanji?

• Popeza chomwe chimayambitsa matendawa chimatha kukhala hypothermia komanso kuphwanya kayendedwe ka magazi am'deralo chifukwa cha izi, muyenera kuyesetsa kupewa kukonzekera komanso kuvala kutentha.
• Kuti thupi lizitha kuthana ndi matenda komanso hypothermia, muyenera kudya moyenera, kupsya mtima momwe mungathere, kukhala mumzimu watsopano.
• Zochita zolimbitsa thupi zothandiza komanso zolimbitsa thupi, zomwe zimathandizira kulimbitsa minofu: kuyenda, kusambira, masewera abata (yoga, Pilates).
• Masewera ovuta amayenera kuthandizidwa mosamala, chifukwa amatha kupweteketsa, komanso ndi neuralgia ya mitsempha ya sciatic, khosi, msana, ndi ziwalo zina zamthupi.
• Ngati choyambitsa neuralgia ndi matenda osachiritsika, ndiye kuti kupewa kuyenera kuphatikizira chithandizo chake.
• Monga mukudziwira, iwo amene adwala chikuku ndi herpes zoster ali pachiwopsezo chotenga postherpetic neuralgia. Chifukwa chake, katemera (katemera wa Varilrix, ndi zina) ndi njira yabwino yolepheretsira nkhuku, zomwe zimatha kukhala neuralgia.

Neuralgia ndimatenda ofala, koma odwala ambiri sawatenga mopepuka mokwanira, akukhulupirira kuti ingathekonso. Ndipo zidzachitika, koma nthawi ina ikadzapwetekanso. Chifukwa chake odwala amafika kwa dokotala pamene kupweteka kwa neuralgia kumakhala kosapirira kwambiri, ndipo palibe chomwe chimathandiza. Mpaka nthawi imeneyo, amadzazidwa ndi Nise ndi Diclofenac wotchuka, kuyika zotenthetsera ndi compress, idyani phukusi la mankhwala opweteka. Koma musanayambe chithandizo chokha cha neuralgia kunyumba, ndikofunikira kuwunika - chifukwa chomwe chimayambitsa kupweteka kumbuyo, chifuwa kapena mwendo sichingakhale nkhawa wamba, koma matenda oopsa a msana, momwe Diclofenac ndi phukusi lotenthetsera limathandizira pang'ono. Chifukwa chake, ndibwino kuyamba ndi kupita kwa dokotala (wamisala), ndipo adzakuwuzani momwe mungayesedwe ndikuthandizidwanso.

Vutoli ndi ili, amayi anga ali ndi vuto la neuroglia loopsa. Adalemba zinthu zambiri, sindikufuna kuvutitsa a gabantin. Vuto ndilakuti miyendo yake imapweteka nthawi zonse. Amapuma kutikita minofu yaying'ono, popanda iyo, sangathe kugona. Ndi mankhwala ena ati omwe ndingamuthandizire nawo?

Miyendo imatha kupweteka pafupipafupi ndi matenda ashuga chifukwa cha kuperewera kwa madzimadzi, chifukwa chake yesani okodzetsa kapena ingochepetsa kumwa kwanu.

Pali Chinsinsi chotere cha mafuta. Ndikofunikira kusakaniza phula wosweka, sera, ghee ndi uchi wambiri wandiweyani wofanana. Mafuta owiritsa usiku. Mutha kupanga ma compress kuchokera pamasamba a burdock ndi coltsfoot. Njira ina yowonjezerapo ndikutsamira chigamba cha tsabola pa "muzu" wowawa kwambiri (ndiye kuti, pamalo opweteka kwambiri ndi neuralgia). Izi zipangitsa magazi kuyenda bwino, kupangitsa kuti pakhale kutentha komanso kuti muchepetse ululu kwakanthawi.

Kuphatikiza pa kutikita minofu ndikudzipukusa nokha kuti muchepetse kupweteka m'miyendo, mutha kulimbikitsa mayendedwe akunja, zolimbitsa thupi zolimbitsa thupi, koma, podziwikiratu zovuta za matenda a shuga, katundu ndi njira zina zowonjezera ziyenera kugwirizanitsidwa ndi dokotala.

Kodi neuralgia ndi chiyani? Mtsempha wamtundu wanji? Lembani mwatsatanetsatane. Mapazi a matenda ashuga nthawi zambiri amapweteka. Yesani kukhala ndi shuga wabwinobwino. Kuyenda kosavuta.

Monga njira, mutha kubwerezanso zakudya pang'onopang'ono ndikuchepetsa, ngati zingatheke, izi zichotsa katundu kumapazi anu. Koma chithandizo cha wowerengeka chimayang'anitsitsa kuti chikugwirizana ndi matenda anu.

M'mabanja mwathu, mulinso munthu yemwe ali ndi vuto lofananalo. Tikatikita miyendo, ululu umachepa, koma timachitanso zolimbitsa thupi kangapo patsiku.

Yesani kupaka msuzi wakuda wa radish ndi mafuta a lavenda. Gawo la madzi ndi mafuta ndi 20: 1. Pambuyo pa njirayi, miyendo iyenera kukulungidwa ndi mpango waubweya.

Poterepa, musanyalanyaze zomwe dokotala wakupatsani; vuto la matenda a shuga, miyendo imayenera kuthandizidwa mosamala. Yesetsani kuwonjezera mphamvu ya analgesic ya kutikita powonjezera mafuta a camphor. Pamapeto pa njirayi, miyendo imatha kupaka ndi vodika ndikulungidwa. Ndipo usiku ikani ma peels a mandimu m'masokisi anu, mafuta ofunika a mandimu ali ndi phindu pobwezeretsa ulusi wamitsempha.

Aloze amayi anu kuti ayambe asanagone ndipo asadye usiku. Chakudya chomaliza sichikhala pasanathe masiku asanu ndi awiri. Usiku, mutha kumwa mankhwala a mandimu.

Ndi matenda a shuga, zaka zimakhala. Mukufuna nsapato zabwino, zopanda zidendene, mwina zamiyendo. Amayi akamagwira ntchito, zimathandiza kuchepetsa kutupa kumapeto kwa tsiku. Choyambitsa kupweteka nthawi zambiri chimakhala chotopetsa, chokhala phee. Ndipo imwani mankhwala ndi dokotala.

Ndikofunikira kuchita masewera olimbitsa omwe amatambasula minofu ya miyendo ndi matako. Zochita izi zimamasula mitsempha ya sayansi kuchokera pamtolo, imasiya kusefukira ndikuvulaza.

Sindingakulangizeni kuti muthandizidwe ndi njira zina, matenda ashuga si chidole, ndipo zimakhala ndi zotsatirapo zowonjezereka. Chifukwa chake, ndibwino kumvera kwa adotolo, nditha kunena ndi amayi anga, adalandira chithandizo chawanthu, tsopano sangathe kuyenda konse.

Ngati pali zovuta za kunenepa kwambiri, ndiye kuti muyenera kuyesetsa kuti muchepetse, motero kuchepetsa kwambiri miyendo.

Ndipo kulemera kwa amayi anu ndi chiyani, ndikuganiza kuti kutsata matenda a shuga komanso neuralgia yowonjezereka chifukwa cha nkhanza ya chakudya, ndizofala kwambiri, kuyamba ndi kudya ndikuyenda, mutatha kuthamanga, masewera olimbitsa thupi olimbitsa thupi, neuralgia imakhala yachangu, koma mukufunikirabe pitilizani kukonza insulin.

Ngati kupweteka kwamiyendo chifukwa cha kutupa, ndiye kuti madzi ozizira amathandiza, pomwe miyendo yotopa imatsitsidwa kwa mphindi imodzi. Popewa, ndikukulangizani kuti mudye kapu yokhala ndi mafuta ochepa tsiku lililonse

Ndidamva kuti ndi matenda ashuga, kutikita minofu m'miyendo sikuthandizira kwambiri ngati zovulaza, koma mphekesera siziyenera kukhulupilira. Ngati kutikita minofu kumathandizira mmalo mwa mapiritsi okongoletsa monga Gabantin, gwiritsani ntchito mankhwalawa komanso yesani zonunkhiritsa zina zilizonse zotentha, zomwe ululu umakhalapo kwakanthawi koma umatha. Zachidziwikire, kupera kulikonse sikungakhale chithandizo, amangochotsa zowawa kwakanthawi.

Osati kutikita minofu kokha, komanso masewera olimbitsa thupi azithandiza. Tsiku lililonse liyenera kuchita. Nthawi yake siyenera kukhala yochepera mphindi khumi. Valani masokosi ofunda kuti miyendo isenthe. Popewa kutopa poyenda, muyenera kuyitanitsa ma insoles apadera. Ndikofunikanso kupewa kuvulala kuti pasakuvulazidwe.

Kutikita singano kumathandizira oimira a Kuznetsov ochokera ku neuralgia. Nthawi yomweyo, ululuwo umazimiririka pang'onopang'ono. Ndipo ngati kuchitidwa pafupipafupi, kusintha kumaoneka kukhala kwabwino, nthawi zambiri kumakhala kugwidwa.

Neuralgia m'miyendo? Miyendo imatha kupweteka chifukwa cha matenda ashuga. Dziwani zambiri. Ndikofunikira kuchitira zomwe zimayambitsa, osati zizindikilo.

Moni Ndakhala ndikugwira ntchito zaumoyo zaka 18, osati dokotala, koma thandizo kuposa madotolo, ndimangopatsa zambiri. Anthu omwe akufuna kukhala athanzi, kuganizira momwe ayenera kukhalira, kulandira chithandizo kwa madokotala ndi ma synthetics ochokera ku malo ogulitsa mankhwala, kapena kudziletsa pa moyo wawo wonse kuti asadutse mawa. Pali ma pharmacies ochulukirachulukira, mankhwala ochulukirachulukira, ndi ochepa komanso ochepa thanzi.Kupewa ndikwabwino kuposa kuchiritsa! Pali chakudya pamaselo a cellular ochokera kwa MULUNGU, chakhala chikukula kwa zaka mamiliyoni ambiri, chimathandiza aliyense ndipo kuchokera pachilichonse, ndi nkhani yanthawi yochepa chabe. Bungwe la NEW ERA Corporation ndi lokhalo padziko lapansi ”CHINA STATE NETWORK CORPORATION” Mwinanso wina wa anthu omwe akuwerenga izi pompano. Ndamva. Amadziwa, ndipo amene sakudziwa, pezani ngati simukulakwitsa posankha chinthu chomwe chimathandizadi, kubwezeretsa, kupeza kapena kusamalira thanzi lanu. WOPHUNZITSA KHALIDWE LABODZA KWA MISILI, BAMBO EMPILA ALITSATIRA MALO OGULITSA, A POLIYO AMADYETSA ZINSINSI ZABWINO. Munthu wathanzi lokha wokhoza kukhala WOPA. China pine mungu, bamboo tsamba kuchotsa, calcium, mafuta otayidwa ndi matenda monga khansa, mutu, prostatitis, kusagwira ntchito, mtima dongosolo, minofu ndi mafupa, kuyeretsa thupi, mitsempha ya magazi, chiwindi, matenda ashuga, matenda oopsa, psoriasis, Viteliga , lupus erythematosus, hernia yammbali mbali ziwiri, thrombophlebitis, kukokana kudutsa, kulemera kumachepa. Ndiyimbireni! Skype: aleksb517, tTS MTS, viber, vatap: 79149125870 Ndimakhala ku Siberia ku Lake Baikal, kusiyana ndi maola 5 ndi Moscow.

Njira za anthu okalamba sizingatheke, mungathe kuchepetsa ululu ndi kutikita minofu, masewera olimbitsa thupi ndi kutentha, kukonza magazi.

Ngati ndi kotheka, sankhani mchere. Muyenera kusuntha kwambiri ngati pali zovuta za kunenepa kwambiri. Kupatula apo, matenda ashuga ndi matenda a anthu onenepa kwambiri (nthawi zambiri). Muzisamba phazi ndi chamomile. Ndi madzi ofunda, osatentha. Inde, inunso mukudziwa mafuta onunkhira ndi mafuta.

Choyamba, ndikofunikira kukhazikika pamlingo wamagazi kuti magazi azikhala bwino, ndiye kuti njira zina zopangira wowerengeka zitha kukhala zapamwamba. Ndikutha kukulangizani kuti mumwe decoction kapena compote kuchokera ku nkhuyu (nkhuyu zimafunika kuthira mchere). Mutha kuyesanso kumwa madzi a dzungu.

Inde, muyenera kuyamba ndi chakudya. Pewani zakudya zamchere kwambiri komanso zonunkhira. Ikani zakudya zanu mwadongosolo. Imwani madzi ambiri ndipo musadye usiku.

Pankhani ya matenda a shuga, ndikukulangizani kuti musayike pachiwopsezo poyesa njira zomwe anthu ambiri amakonda, ndipo onjezani kuyenda mlengalenga kuchithandizo chomwe dokotala wakupatsani.

Anthu omwe amapaka mafuta ochokera ku zinthu zantchi amakhala ndi zinthu zoyenera zothandizira kuthetsa ululu. Yesani mafuta ozikidwa pa phula, masamba amtundu wakuda ndi mafuta a sea buckthorn - mankhwalawo ndi othandizira komanso ogwira ntchito, palibe zotsatira zoyipa (kupatula pazinthu zina zomwe zimapangidwira.

Mwachitsanzo, timagwiritsa ntchito Gevkamen, imakhala ndi kuzizira, komanso mafuta a Doctor Tice pakupera, ndipo mowa wachitatu umathandizanso, vodka.

Ndikugwirizana ndi ambiri, kudzichiritsa nokha sikulimbikitsidwa kuti mupeze matenda otere, mankhwalawa onse ayenera kuyanjanitsidwa ndi adokotala.

Njira yokhayo yakankhwala, mafuta ndi kununkhira ndi koyenera kwa inu, kumwa mankhwala mkati mwake kungapangitse matenda a shuga, ndibwino kuti musayike pachiwopsezo.

Mutha kuyesa kuyika ma miyendo m'miyendo mwanu kapena kupanga milatho ya siliva, ndikuwateteza ndi band-yothandizira m'malo owawa - zonsezi zimathandiza kuchepetsa ululu.

Pali zifukwa zambiri, chifukwa chake, popanda kulongosola molondola, kupereka uphungu ndi mlandu. Kudzichitira nokha mankhwala osokoneza bongo kumawopseza matenda ashuga ndi zovuta zina.

Sindikudziwa, sindingakulangizeni kuti ndichoke ku malangizo a adotolo, muyenera kuwatsata kwathunthu. Nthawi zina, kudzipereka kokha kumangovulaza.

Chofunikira mu matenda a shuga ndikudziwikiratu kwa njira zosachiritsika ndi matenda. Nthawi zina pamakhala matenda a shuga a retinitis komanso atrophy ya mitsempha ya maso.

Matenda a diabetes a amblyopia ali ofanana mu pathogeneis ndi amblyopia ya nikotini. Zikuwoneka kuti Vitamini B wophatikizira amagwira ntchito yofunika kwambiri pathogenesis yake.

Mu madzi a cerebrospinal, shuga amapezeka m'magazi.Acetone mumadzi imatha kupezeka pamaso pa chikomokere, asidi acetoacetic m'madzi amapezeka pokhapokha ngati pali chikomokere. Ndi ketonuria wa nthawi yayitali, matupi a ketone amapita m'madzi.

Vuto lalikulu la matenda ashuga Matenda a hyperglycemic. Chomwe chimayambitsa kuperesa ndi kuchuluka kwa zinthu za metabolic zamafuta acid ndi acetone mthupi. Zosokoneza mu kagayidwe kazakudya zimapangitsa kuti mafuta asatulutse mafuta, komanso mapuloteni, pazinthu zawo zabwinobwino zomaliza. Kuphimba zofunikira zamagetsi, thupi limakakamizidwa kugwiritsa ntchito kuchuluka kwa mapuloteni komanso mafuta. Poterepa, kuthekera kopitiliza kuwotcha matupi a ketone kutayika, komwe kumapangitsa kuti adzikundikire m'thupi komanso kukulitsa acidosis. Beta-hydroxybutyric acid, yomwe imadziunjikira m'thupi, imakhala ndi poizoni m'thupi lamanjenje. Malinga ndi S. S. Genes, B-hydroxybutyric acid imalepheretsa njira za enzymatic mkati wamanjenje ndipo imalepheretsa maselo ake kukhala ndi thanzi labwino. Zovuta zambiri zamankhwala am'mwazi zimatha kupangitsa kuti mapuloteni a cell awonongeke.

Pankhaniyi, potaziyamu ndi phosphate zambiri zimamasulidwa, zomwe zimatuluka mkodzo.

Maonekedwe a chikomokere amatha chifukwa cha kuchepa kwa insulin, cholakwika chakudya, matenda opatsirana, komanso kuvutika m'maganizo. Nthawi zambiri, wodwala matenda ashuga amakula pang'onopang'ono masiku angapo. Poyamba, kusokonezeka m'matumbo kumawoneka ngati kusowa kwa chakudya, kupweteka pamimba, nseru, kusanza, kudzimbidwa kapena kutsegula m'mimba. Posachedwa pamakhala kumva kutopa konsekonse, chidwi, mutu. Kenako kuvuta kupuma kumalumikizana, komwe kumakhala kwakuya komanso kosakwiya (kupumira kwa Kussmaul). Mlengalenga wokhathamira, kununkhira kwa acetone kumamveka. Wodwalayo wagona, kenako kutuluka kwadzidzidzi kumadutsa pansi. Zomwe zimachitika zimachitika pafupipafupi komanso zochepa kwambiri, matenthedwe amakhala abwinobwino kapena otsika, kuthamanga kwa magazi kumatsika. Ana ake amapukusidwa. Tendon Reflexes amachepetsedwa kapena kulibe, kamvekedwe ka minofu kachepetsedwa. Pali kuledzera kwathunthu kwa thupi, komwe gawo lofunikira limakhala poyizoni wamkati wamanjenje, komwe kumayambitsa kupuma, kutsika kwamitsempha, kutsika kwa minofu komanso kuthina kwamphamvu kwamanjenje.

Kusintha kwachidziwitso komwe kumapezeka mu ubongo ali ofanana ndi omwe amawona ndi asphyxiation. Zombozo zimaphika, ma stasis amawoneka mwa iwo. Kuphwanya kwazovomerezeka za capillaries kumayambitsa matenda a edema ndi kufa kwa maselo amitsempha chifukwa cha kusokonezeka kwa metabolic ndi chidwi chawo chachikulu cha kuchepa kwa mpweya.

Mitundu itatu ya zotupa za msana zafotokozedwa:

1. Zosintha mu ma cell a mwendo wam'mimba mwa chingwe cha msana komanso mu tsinde laubongo . Ku chipatalako, nthawi zina, chithunzi cha poliomyelitis chawonedwa. Nthawi zambiri, sizinadziwikebe ngati zosinthazi zinali zoyambirira kapena zachiwiri chifukwa cha kusintha kwa mizu ndi mitsempha yotumphera.

2. Kusintha kwa mizu yakumbuyo ndi zipilala zam'mbuyo, zofanana ndi kusintha kwauma kwa dorsal . Zakhala zikudziwika kale kuti mu shuga, matenda ofanana ndi chingwe cha msana (pseudotabes diabetesica) amatha kuyang'aniridwa. Olemba amakono amakhulupirira kuti kuphatikizika kwa shuga kumachitika chifukwa cha kuwonongeka kwa mitsempha yapamadzi.

3. Zosintha m'makhola am'mbuyo komanso pang'ono pang'onopang'ono, zofanana ndi chithunzi cha myelosis yosangalatsa mu magazi a Burmer's . Grieg ndi Olsen, omwe amafotokoza za mtundu wamtunduwu, akukhulupirira kuti kuchepa kwa mphamvu ya ziwiya ndi makulidwe a makhoma awo kunapangitsa kusowa kwa magazi kwa nthawi yayitali kwa chingwe cha msana, zomwe zinayambitsa kusintha kwazomwezi. Tidawona wodwala wazaka 57 akudwala matenda a shuga kwa zaka 30. Matendawa adachulukirachulukira ndi polyneuritis.Kenako zilonda zam'mapazi zapakati pake, chithunzi chamkati mwa minyewa yamkati ya thoracic yam'mimba imayamba. Tizilombo ta m'mimba tinafotokoza za necrosis ya gawo la thoracic la chingwe cha msana. Pakuwunika kwa histological, kusintha kwa arteriosulinotic kunapezeka popanda chizindikiro cha syphilis.

Zilonda zam'mimba zam'mimba m'matenda a shuga osowa. Waltman ndi Wilder adatola matenda ashuga makumi asanu ndi limodzi m'mabuku momwe kuyezetsa kwa chingwe cha msana kudachitika. Mwa 20 mwa iwo, kusintha kwa msana kunapezeka. Olembawo agogomezera kuti milandu yambiriyi imafotokozedwa asanafike pakuyambitsa kwa Wassermann, koma chithunzi cha anatomical sichimapereka chifukwa chokwanira kupatula syphilis.

Polyneuritis mu shuga imakhudza makamaka miyendo yakumapazi. Olemba ena amakhulupirira kuti polyneuritis imapezeka muoposa theka la milandu yonse ya matenda ashuga, pomwe ena amawapeza m'mavuto osakwana 1%. Kusiyana kwakukulu uku kukufotokozedwa ndi njira yosiyana yaomwe alembi amafotokozera kutsimikiza kwa matenda ashuga a polyneuritis. Ena amakhulupirira kuti polyneuritis iyenera kuphatikizapo milandu yonse yomwe, ngakhale pakalibe cholinga, odwala amadandaula za ululu. Ena amati ndi polyneuritis pokhapokha ngati zizindikiritso zimadziwika. Kutengera kusankhika kokhwima kumeneku, ma rand kuchokera kwa odwala 400 omwe ali ndi matenda ashuga anapeza polyneuritis 4%. Martin adawona zizindikiro za polyneuritis mu 5% ya odwala matenda ashuga, 12% ya odwala amadandaula ndi kupweteka kwa m'mimba ndi ululu, koma sizinapezeke chizindikiro. Nthawi zambiri, kuyambika kwa zizindikiro za polyneuritis kumayambitsidwa ndi matenda omwe amakhala ndi matenda ashuga osagwira bwino, osathandizidwa bwino kapena osathandizidwa konse.

Nthawi zambiri kuposa mawonekedwe opangidwa mokwanira, pali mitundu yovutitsa ya polyneuritis, yomwe nthawi zambiri imakhala yofanana ndi zizindikiro zapadera: kupweteka kwa minofu, paresthesia, kuchepa kwa tendon Reflex, kusokonezeka kwa trophic. Ululu wamiyendo wowoneka ngati chizindikiro chakutali umapezedwa mumitsempha ya ng'ombe, kuyezetsa cholinga nthawi zambiri sikuwulula. Nthawi zambiri pamakhala madandaulo a kutentha, woipa usiku paresthesia m'miyendo ndi kumapazi. Odwala amathandizidwanso pakuziziritsa miyendo yawo ("diabetesic causalgia"). Pomaliza, kufalikira kwakuda kwa bondo ndi mawonekedwe a Achilles ndizofala kwambiri. Malinga ndi Goldflam, zovuta zina zakumanzere zimapezeka 13% ya odwala matenda ashuga.

Matenda a shuga a shuga amayamba pang'onopang'ono, osayamba kugonja. Kupita patsogolo pang'onopang'ono, kumatha kuyamba ndi neuralgia ya mitsempha payokha: mitsempha yachilengedwe, yachikazi, brachial plexus. Ndi chitukuko cha matenda ashuga neuralgia, chidwi chimakopeka kuti chizolowezi cha zilonda zam'mimba, mwachitsanzo, sayansi yapakati pa sayansi ya neuralgia. Neuralgia yachikazi ndizofala kwambiri, kotero mtundu wamtunduwu wosavomerezeka komanso makamaka wa neuralgia uyenera kukweza kukayikira kwa matenda ashuga.

Kumapeto kwa zaka zana zapitazi, Leiden adazindikira mitundu itatu yayikulu ya matenda ashuga polyneuritis: chidwi, motor ndi atactic. Kafukufuku wina wawonetsa kuti mtundu wa matenda ashuga ndiwofatsa, pomwe ululu wosalekeza, kawirikawiri sizitengera mawonekedwe a kupweteka kowombera. Nthawi zambiri, ululu umawonekera m'miyendo, makamaka minofu ya ng'ombe. Nthawi zambiri amakula kwambiri usiku. Ululu umatha kupitilira, koma nthawi zina umachulukirachulukira ndi ma paroxysms.

Oposa theka la odwala, limodzi ndi zowawa, paresthesia amawonedwa ngati mukumeza, kuwotcha, kumva tulo, komanso kupumira. Mokulira, kusokonezeka kwa chidwi kumasonyezedwa makamaka pakusokoneza kwa kugunda kwamphamvu. Zocheperako ndiz kuphwanya mitundu yonse ya zomverera mu zigawo zam'munsi zam'munsi.Mwa zina mwazovuta mawonekedwe a matenda ashuga polyneuritis, kutayika kwa tendon Reflex, makamaka Achilles, kumapezeka. Milandu yophatikizidwa kwa mtundu uwu wa polyneuritis wokhala ndi zizindikiro za retrobulbar optic neuritis akufotokozedwa.