Nonsteroidal amachiza anti-ukudumba - a ilikhubalo okanye umbulali kade?

Amaninzi isetyenziswa practice protivovspalitelnye iziyobisi nonsteroidal lwezonyango, okanye NSAIDs. Bona oqeshwe kwiinkqubo yokukrala umyalezo ezahlukeneyo for indawo umthombo ukudumba, ntlungu, ifiva, ukunciphisa ingozi thrombosis (isisho yonke aspirin). Ngokwe-manani ze-WHO, la machiza osela abantu abamalunga nezigidi ezingama-30 yonke imihla, omnye kuphela yesithathu kubo - amayeza kagqirha. Nkqu amanani umdla ngakumbi, ingakumbi izifo rheumatism. Kuye kwafunyaniswa ukuba amachiza-ukudumba liyalele alahlwayo malunga nama-80% of rheumatologists.

Kodwa ingaba la machiza azinabungozi popular? ukusebenza kwe alukho mbuzo, kodwa ezinye iintsilelo, kuba iingedosi ezincinane lolawulo elifutshane-gama ukunika iziphumo ebezingalindelekanga kwi-25% yezigulane, yaye ngowe-5% yamatyala ubomi emngciphekweni. Ingakumbi, kumayelana abadala, yaye enyanisweni zenza i-60% yabo bonke abasebenzisi NSAID.

Xa emva kwi-70 wafumanisa siseko amanyathelo kula machiza (inhibition lomsebenzi cyclooxygenase, i-enzayim eziphambili ababandakanyekayo yokucolwa of prostaglandins), kwaye kwacaca ukuba isiphumo icala ubotshiwe ukuba uphuhliso ezingaqhelekanga kwi igazi sezintso, kwaye isiqwenga zesisu. Ngapha koko, prostaglandins (PGs) zidlala indima ebalulekileyo apha. Kule 90, amanqaku amatsha malunga nendima GHG ngexa iinkqubo zibalulekileyo emzimbeni womntu. Ngoko ke, amachiza anti-ukudumba vozdestvuyut lonke uluhlu reactions yobomi, ingakumbi ukuba igazi ekunqandeni nethoni semithambo, ukutya ithambo, embryogenesis, nokukhula iiseli nervous system, wokulungisa izicwili kunye nabanye abaninzi.

Ngelo xesha Wayehlatyelwe ukuba kukho isoforms ezimbini cyclooxygenase: Cox-1 kunye Cox-2. Ngaphezu koko, lo onoxanduva kuqala kwindlela eqhelekileyo yokusebenza amalungu kwinqanaba yeselula, kunye inhibition le yesibini lubonisa nje isiphumo therapeutic. Ngenxa yoko, ukuvelisa amachiza anti-ukudumba ukuba singenza ngokukhetha kwi Cox-2, kunokwenzeka ukuba kuncitshiswe kukuvela iziphumo ebezingalindelekanga kunye nonyango kakhulu ekhuselekileyo.

Enye yezi arhente sikhethe ibuprofen. Phantse kuzo zonke izifundo, umngcipheko kukuvela ezimbi emathunjini kwi yokwamkela walo amancinane xa kuthelekiswa, umzekelo, piroxicam.

Ngokwentelekiso lwafunyanwa kutshanje elinye effect icala ebangela non-steroidal amachiza-ukudumba. Bona kakhulu ukunciphisa isandi semithambo, nto leyo eyingozi ngakumbi kubantu abanengxaki nesifo sentliziyo. Xa izigulane abafumana NSAIDs kwenzeka, njengoko umthetho, ukwanda koxinzelelo lwegazi, kwakunye uninzi abadala makaxele la machiza intlungu samathambo, ngokuqhelekileyo sele unayo imbali lwegazi.

Ukongezelela, NSAIDs ukunciphisa impumelelo amanyathelo umchamo kwabaninzi amayeza umfutho. Ngokukodwa, ngokwemithamo avareji konwaywa indomethacin, naproxen kunye piroxicam ize amayeza equlethe furosemide kunye hydrochlorothiazide, prazosin ezifana namachiza okanye captopril. Noko ke, njengoko oko kwazeka ukuba isenzo uyakhetha ngayo iziyobisi isoforms ezahlukeneyo Cox, njengoko kukhankanyiwe ngasentla, musa kakhulu kuchaphazela nemithambo yegazi. Ngenxa yoko, kusekho intsimi omkhulu womsebenzi kulwenziwo kweziyobisi uyakhetha kakhulu kunye nefuthe oluncinane uxinzelelo lwegazi, kwaye afanelekile kakhulu abadala. Kwaye la mayeza kwaqala ukuvela. Umzekelo, Cox-2 selectivity ilifa ebalulekileyo meloxicam, celecoxib.

Ngelishwa, hayi kuphela Luda abadala badla ngokwabo ukumisela amachiza nonsteroidal anti-ukudumba ngenxa njengomkhuhlane, umzekelo, ngaphandle ekuqondeni zonke iziphumo kunokwenzeka. NSAIDs kunzima ngokwenene ukuba endaweni into, kodwa ukuvavanya ukusebenza isiyobisi nawo wonke ugqirha kuphela imingcipheko kunokwenzeka.