Mob Gout Management

Nws tau kwv yees tias muaj 1-3 cov neeg mob gout hauv txhua 100 tus neeg Suav, thiab hyperuricemia tuaj yeem ncav cuag 14 tus neeg mob, uas qhia tias muaj kev nce zuj zus txhua xyoo. Ntxiv nrog rau kev txhim kho txoj kev ua neej, kev kho tshuaj kuj tseem ua lub luag haujlwm tseem ceeb hauv kev tswj tus mob gout. Muaj qhov sib txawv ntawm kev xaiv cov tshuaj kho mob hauv ntau theem ntawm gout. Niaj hnub no, tus editor tau txheeb xyuas qee cov ntsiab lus ntawm cov tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob nyob rau theem mob gout, vam tias yuav pab koj kuaj mob thiab kho.

Nyem rau Cistanche rau mob raum

Lub hauv paus ntsiab lus ntawm kev kho mob yog ceev ceev tswj kev sib koom ua ke thiab mob. Nyob rau theem mob hnyav, koj yuav tsum tau so hauv txaj thiab tsa cov ceg tawv. Nws yog qhov zoo tshaj plaws los pib siv tshuaj los tswj tus mob o nyob rau hauv 24 teev ntawm qhov pib.

Cov tshuaj kho thawj kab yog colchicine thiab non-steroidal anti-inflammatory tshuaj. Thaum muaj contraindications rau kev kho mob lossis kev kho mob tsis zoo, kev kho mob glucocorticoid tuaj yeem txiav txim siab. Nws feem ntau yog siv rau hauv cov koob tshuaj me me rau kev kho mob luv luv. Thaum cov pob qij txha o thiab qhov mob ploj mus, nws yog ib qho tsim nyog yuav tsum maj mam txo cov koob tshuaj thiab tso tseg cov tshuaj. Yog tias monotherapy tsis zoo, cov tshuaj saum toj no tuaj yeem xaiv rau kev kho mob ua ke. Tam sim no tsis muaj pov thawj los txhawb kev ua tau zoo ntawm cov tshuaj tsis muaj zog opioids thiab opioid analgesics rau mob gout tawm tsam.

Colchicine

Nws raug nquahu kom siv cov tshuaj colchicine qis, 1 mg rau thawj koob, 0.5 mg tom qab 1 teev, thiab 0.5 mg tom qab 12 teev, 1 mus rau 3 zaug / d. Nws yog qhov zoo tshaj plaws los pib noj cov tshuaj tsis pub dhau 12 teev tom qab mob gout. Cov nyhuv yuav txo qis tom qab 36 teev.

Cov neeg mob lub raum tsis txaus yuav tsum tau txo qhov koob tshuaj lossis ncua sijhawm noj tshuaj raws li qhov tsim nyog. Thaum eGFR yog {{0}} ml / min, qhov siab tshaj plaws ntawm colchicine yog 0.5 mg / d; thaum eGFR yog 15-30 ml / min, qhov siab tshaj plaws ntawm colchicine yog 0.5 mg txhua ob hnub; cov neeg mob nrog eGFR<15 ml/min or dialysis patients are prohibited from taking colchicine.

Cov tshuaj no tuaj yeem ua rau mob plab hnyuv, xws li raws plab, mob plab, xeev siab, thiab ntuav. Nyob rau tib lub sijhawm, daim siab thiab lub raum puas thiab pob txha pob txha yuav tshwm sim. Lub siab thiab lub raum ua haujlwm thiab kev kuaj ntshav yuav tsum tau saib xyuas tsis tu ncua. Colchicine yog contraindicated nyob rau hauv cov neeg mob uas siv zog P-glycoprotein thiab / los yog CYP3A4 inhibitors (xws li cyclosporine A los yog clarithromycin).

Nonsteroidal anti-inflammatory tshuaj

Cov mob gout tawm tsam yuav tsum tau kho nrog cov tshuaj uas tsis yog tshuaj steroidal anti-inflammatory txaus kom sai li sai tau, feem ntau suav nrog nonspecific cyclooxygenase (COX) inhibitors thiab COX⁃2 inhibitors tshwj xeeb. Feem ntau siv xws li celecoxib, etoricoxib, diclofenac sodium, thiab meloxicam.

Nonspecific COX inhibitors yuav tsum xyuam xim rau kev pheej hmoo ntawm plab hnyuv xws li plab hnyuv, los ntshav, thiab perforation; Cov kev pheej hmoo ntawm plab hnyuv ntawm cov COX tshwj xeeb -2 inhibitors yog kwv yees li 50% qis dua li cov uas tsis yog COX inhibitors, tab sis nquag plab hnyuv los ntshav thiab perforation tseem yog contraindications.

Tsis tas li ntawd, cov tshuaj nonsteroidal anti-inflammatory kuj tuaj yeem ua rau lub raum puas, yog li ua tib zoo saib xyuas lub raum ua haujlwm; Cov neeg uas muaj lub raum tsis ua haujlwm yuav tsum tau muaj dej txaus thiab saib xyuas lawv lub raum ua haujlwm. Cov nrog eGFR<30ml/min and who are not on dialysis should not use them.

Tshwj xeeb COX-2 inhibitors kuj tseem tuaj yeem ua rau muaj kev pheej hmoo ntawm cov hlab plawv, yog li cov pab pawg muaj kev pheej hmoo siab yuav tsum siv lawv ceev faj.

Glucocorticoids

1. Prednisone

Nws yog tsuas yog siv rau mob gout tawm tsam nrog cov tsos mob ntawm lub cev, lossis rau cov neeg mob uas tsis muaj txiaj ntsig lossis tsis pom zoo siv colchicine thiab nonsteroidal anti-inflammatory tshuaj, lossis raum tsis ua haujlwm.

Nws feem ntau pom zoo kom noj 0.5mg·kg-1·d-1 ntawm prednisone rau 5 ~ 10 hnub thiab tom qab ntawd nres, lossis maj mam txo cov koob tshuaj tom qab 2 ~ 5 hnub ntawm kev siv. , nrog rau tag nrho cov chav kawm ntawm 7 ~ 10 hnub. Nws tsis haum rau kev siv mus ntev.

Thaum siv glucocorticoids, ua tib zoo saib xyuas cov kev tsis zoo xws li kub siab, hyperglycemia, hyperlipidemia, dej thiab sodium retention, kab mob, plab hnyuv los ntshav, thiab osteoporosis. Vim tias cov tshuaj hormones tuaj yeem cuam tshuam kev loj hlob thiab kev loj hlob ntawm cov menyuam yaus, kev siv sijhawm ntev yuav tsum tau ceev faj.

2. Kev txhaj tshuaj betamethasone

Yog tias mob gout raug mob hnyav thiab koom nrog cov pob qij txha loj, lossis kev kho qhov ncauj tsis ua haujlwm, glucocorticoids tuaj yeem muab rau hauv cov leeg lossis intramuscularly, tab sis kev sib koom ua ke yuav tsum raug cais tawm thiab rov txhaj tshuaj dua nyob rau lub sijhawm luv luv yuav tsum zam.

(1) Cov Neeg Laus: ① Intramuscular txhaj: Thaum muab tshuaj, pib nrog 1.00~2.00ml. Kev tswj hwm rov qab tuaj yeem ua tau yog tias tsim nyog. Qhov koob tshuaj thiab tus naj npawb ntawm txhaj tshuaj yog nyob ntawm tus mob thiab tus neeg mob cov lus teb. Tsis txhob siv mus ntev. ② Intra-articular txhaj: Cov koob txhaj tshuaj hauv zos yog 0.25 ~ 2.{{10}}ml (nyob ntawm qhov loj ntawm qhov sib koom tes lossis qhov chaw txhaj tshuaj). Siv 1.00~2.00ml rau pob qij txha loj (lub hauv caug, lub duav, lub xub pwg nyom); 0.50~1.00ml rau cov pob qij txha nruab nrab (lub luj tshib, dab teg, pob taws); 0.25 ~ 0.50ml rau cov pob qij txha me (ko taw, tes, hauv siab); tsis txhob rov siv dua nyob rau lub sijhawm luv luv.

(2) Cov menyuam yaus: Cov khoom no muaj benzyl cawv thiab txwv tsis pub txhaj tshuaj intramuscular rau menyuam yaus.

CEEB TOOM! Kev tswj tus mob gout tawm tsam nrog tshuaj tua kab mob

Thaum muaj kev mob tshwm sim tshwm sim, cov pob qij txha raug mob sai sai, o, kub, mob thiab ua haujlwm tsis ua haujlwm yuav tshwm sim. Feem ntau cov neeg mob tau nce erythrocyte sedimentation tus nqi thiab C-reactive protein, uas yooj yim rau misdiagnosed raws li tus kab mob hauv zos. Kev siv cov tshuaj tua kab mob ntau yam tsis raug xws li penicillin rau kev kho mob yuav tsis muaj txiaj ntsig rau cov neeg mob.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rauraumnoj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tswv yim.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov tshuaj tiv thaiv kab mob. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.