Kev tswj noj zaub mov ntawm cov neeg mob uas mob raum mob hnyav raws li cov lus qhia tseeb

Nws tau tshaj tawm tias ntawm tag nrho cov neeg mob hauv tsev kho mob uas mob raum raug mob (AKI), 24% -60% ntawm cov neeg mob tsis noj zaub mov tsis zoo, thiab hauv cov chaw saib xyuas mob hnyav, feem ntau ntawm kev noj zaub mov tsis zoo yog siab txog 73% [1,2] . Kev noj zaub mov tsis zoo, tshwj xeeb tshaj yog kev noj protein-zog (PEW), yog ib qho tseem ceeb ntawm kev kwv yees ntawm kev tuag hauv tsev kho mob hauv cov neeg mob AKI, tsis muaj teeb meem thiab comorbidities [2]. Yog li ntawd, nws yog ib qho tseem ceeb los txheeb xyuas cov neeg mob AKI uas muaj kev pheej hmoo ntawm kev noj zaub mov tsis txaus thiab muab kev tswj kev noj haus thaum tsim nyog [2].

Nyem rau Cistanche rau mob raum

Xyoo no, European Society for Clinical Nutrition and Metabolism (ESPEN) thiab British Kidney Association (UKKA) tau tshaj tawm cov lus qhia tshiab (tom qab no hu ua "ESPEN Guidelines" thiab "UKKA Guidelines", feem), uas muab Cov lus pom zoo rau kev tswj kev noj zaub mov ntawm cov neeg mob AKI [2,3]. Kab lus no yuav tsom mus rau cov lus qhia saum toj no thiab suav nrog cov ntaub ntawv pov thawj uas cuam tshuam los ntawm kev sib tham txog qhov tsim nyog ntawm kev tswj hwm kev noj haus rau cov neeg mob AKI thiab cov phiaj xwm tswj kev noj zaub mov zoo sib xws.

Kev tswj kev noj zaub mov ntawm cov neeg mob AKI yog qhov tsim nyog heev

Lub raum tsis ua haujlwm tsis zoo tsuas yog cuam tshuam rau dej, electrolyte thiab acid-base metabolism, tab sis kuj ua rau muaj kev hloov pauv hauv cov protein, amino acid, carbohydrate, thiab lipid metabolism, ua rau muaj kev noj zaub mov tsis zoo. Tsis tas li ntawd, nws muaj cov nyhuv pro-inflammatory thiab tsis zoo rau cov kab mob antioxidant [1,3]. Cov kev tshawb fawb tau pom tias kev noj zaub mov zoo yog qhov tseem ceeb ntawm kev kwv yees ntawm cov neeg mob AKI. Piv nrog rau cov neeg mob AKI tau noj zaub mov zoo, cov neeg mob AKI uas tsis muaj zaub mov tsis txaus muaj cov neeg mob hauv tsev kho mob qis dua, thaum cov neeg mob AKI tsis noj zaub mov ntau dua muaj qhov tshwm sim ntau dua ntawm sepsis, plab hnyuv txhaws, arrhythmia, thiab cardiogenic poob siab. Piv nrog rau cov neeg mob noj zaub mov zoo, cov neeg mob tsis zoo AKI cov neeg mob hnyav muaj ntau dua 1-xyoo kev tuag (50.0% vs. 29.3%) [1].

Yog li ntawd, kev txhim kho kev noj zaub mov zoo yog lub hom phiaj tseem ceeb ntawm kev ua kom zoo rau kev kho mob [1]. ESPEN cov lus qhia hais tias kev kho mob noj zaub mov tuaj yeem txiav txim siab rau txhua tus neeg mob AKI / mob raum mob (AKD), AKI ua ke nrog cov kab mob raum ntev (CKD) uas yuav tsum tau pw hauv tsev kho mob lossis nyob hauv ICU ntau tshaj 48 teev [3].

Kev tswj kev noj zaub mov ntawm AKI cov neeg mob yuav tsum tau ua tus kheej

UKKA cov lus qhia taw qhia tias tag nrho lub hom phiaj ntawm kev txhawb nqa khoom noj khoom haus yog tswj kev noj zaub mov zoo thaum txwv cov teeb meem AKI. Qhov no suav nrog kev tiv thaiv lossis txo qis PEW, tswj hwm lub cev tsis muaj zog, zam kev cuam tshuam ntawm metabolic ntxiv, txhawb kev kho qhov txhab, txhawb kev tiv thaiv kab mob, thiab yog li txo qhov kev pheej hmoo ntawm kev tuag [2]. Ob qho tib si ESPEN cov lus qhia thiab UKKA cov lus qhia tau hais tias cov neeg mob AKI yog ib pawg neeg sib txawv nrog cov yam ntxwv sib txawv ntawm cov metabolism, thiab lawv cov kev xav tau kev noj haus yuav txawv nyob ntawm tus neeg mob tus mob [2,3].

Kev sib koom ua ke ntau cov lus qhia hauv tsev thiab thoob ntiaj teb thiab kev tshawb fawb soj ntsuam, cov khoom noj khoom haus pom zoo rau cov neeg mob AKI hauv cov xeev metabolic sib txawv [2,4,5].

Nws yuav tsum tau muab sau tseg tias rau AKI cov neeg mob nyob rau hauv lub xeev uas tsis yog-catabolic, cov lus qhia tseem ceeb thiab ntau yam kev tshawb fawb qhia txog kev siv txoj kev tswj kev noj haus uas tsis muaj protein ntau, tsis muaj phosphorus, tsis tshua muaj poov tshuaj, calories txaus thiab cov rog zoo sib piv [3,{ {3}}].

ONS pab tswj kev noj zaub mov ntawm AKI cov neeg mob hauv lub xeev uas tsis yog catabolic

Ua kom tiav cov hom phiaj kev noj haus yog ib qho tseem ceeb los tiv thaiv kev poob phaus thiab cov leeg nqaij atrophy. Txawm li cas los xij, cov xwm txheej suav nrog kev poob qab los noj mov, qeeb plab hnyuv, thiab dysphagia tuaj yeem cuam tshuam rau cov neeg mob noj zaub mov noj [3]. ESPEN cov lus qhia tau hais qhia tias rau cov neeg mob uas tsis muaj zaub mov tsis zoo uas tsis muaj mob hnyav hauv tsev kho mob nrog AKI / AKD, nrog rau cov neeg muaj kev pheej hmoo ntawm kev noj zaub mov tsis zoo, leej twg tuaj yeem noj zaub mov kom zoo tab sis tsis tuaj yeem ua tau raws li lawv cov kev xav tau los ntawm kev noj zaub mov tsis tu ncua, noj zaub mov hauv qhov ncauj (ONS) yuav tsum tau muab [3]. Rau ONS, saj thiab calories yog qhov tseem ceeb cuam tshuam rau kev ua raws li tus neeg mob, yog li ob yam no yuav tsum tau txiav txim siab thaum muab ONS [12-14].

Raws li cov lus qhia saum toj no thiab cov ntaub ntawv pov thawj, tam sim no tau pom zoo hauv kev kho mob kom muab cov protein tsawg, tsawg-phosphorus, thiab cov poov tshuaj tsawg ONS raws li kev qhia ntawm kws kho mob noj zaub mov lossis kws kho mob. Xws li ONS muaj cov rog zoo (muaj ω-3 thiab ω-6 polyunsaturated fatty acids) thiab tuaj yeem muab cov calories txaus los pab txhim kho cov neeg mob noj zaub mov zoo thiab txo txoj kev pheej hmoo ntawm kev tuag [15].

Cov kev tshawb fawb cuam tshuam tau pom tias txhawm rau ua kom muaj txiaj ntsig zoo, ONS yuav tsum tau noj 2-3 zaug hauv ib hnub (zoo dua 1 teev tom qab noj mov) thiab tsis tuaj yeem siv los hloov cov zaub mov tsis tu ncua [13]. Qhov kev sim tau stratified los ntawm kev ua raws li kev noj zaub mov noj, thiab nws tau pom tias kev ua raws cai siab tuaj yeem txhawb nqa cov txiaj ntsig kev muaj sia nyob ntau dua [3]. Hom ONS no muaj calorie ntau ntau thiab ntau yam qab, uas tuaj yeem txhim kho kev ua raws li tus neeg mob thiab pab tswj kev noj haus [12-14].

Cov ntsiab lus

AKI cov neeg mob muaj kev pheej hmoo siab ntawm kev noj zaub mov tsis zoo, thiab kev txhim kho kev noj zaub mov zoo yog lub hom phiaj tseem ceeb los txhim kho tus neeg mob cov kab mob. Raws li cov lus qhia tshiab thiab cov pov thawj cuam tshuam, kev tswj kev noj haus ntawm AKI cov neeg mob yuav tsum tau ua tus kheej. Rau cov neeg mob AKI nyob rau hauv lub xeev tsis-catabolic, cov protein tsawg, tsawg-phosphorus, thiab tsawg-potassium ONS raug pom zoo. Hom ONS no muaj qhov sib piv ntawm cov rog zoo thiab muaj calorie ntau ntau thiab ntau yam khoom qab zib, uas tuaj yeem pab txhim kho tus neeg mob qhov kev mob tshwm sim thiab ua raws li kev noj zaub mov noj.

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 nyhuv anti-inflammatory. 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 lub cev thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.