Mishonga uye Kurapa Kwekutanga Progressive MS

Zvemukati

• Mishonga yePPMS
• Ocrelizumab (Ocrevus)
• Stem cell kurapwa
• Kliniki miedzo
• Lipoic asidhi
• Yakakwira-dose biotin
• Masitinib (AB1010)
• Ibudilast
• Natural uye zvinowirirana kurapa
• Kurapa pabasa
• Kurapa kwepanyama
• Kutaura-mutauro pathology (SLP)
• Rovedza muviri
• Inoenderana uye imwe nzira (CAM) yekurapa
• Kurapa zviratidzo zvePPMS
• Mishonga
• Mararamiro anochinja
• Kuvandudza
• Tora woenda nazvo

Primary progressive multiple sclerosis (PPMS) ndeimwe yemhando ina dze multiple sclerosis (MS).

Sekureva kweNational Multiple Sclerosis Society, ingangoita zvikamu gumi neshanu kubva muzana zvevanhu vane MS vanowana kuongororwa kwePPMS.

Kusiyana nedzimwe mhando dzeMS, PPMS inofambira mberi kubva pakutanga isina kudzoka zvakanyanya kana kuregererwa. Kunyange hazvo chirwere ichi chichiwanzo fambira mberi zvishoma uye chingatora makore kuti chionekwe, chinowanzoendesa kumatambudziko nekufamba.

Iko hakuna kuzivikanwa chikonzero cheMS. Zvisinei, mishonga yakawanda inogona kubatsira kudzivirira kufambira mberi kwezviratidzo zvePPMS.

Mishonga yePPMS

Mazhinji aripo emishonga yeMS akagadzirirwa kudzora kuzvimba uye kuderedza huwandu hwekudzokazve.

Nekudaro, PPMS inokonzeresa kushomeka zvakanyanya pane kudzokerazve-kuregedzera akawanda sclerosis (RRMS), irwo rudzi rwakajairika rweMS.

Uye zvakare, kunyangwe paine panogona kuve neapo neapo madiki madiki ekuvandudza, PPMS haina kuregererwa.

Nekuti hazvigoneke kufanotaura kosi yekufambira mberi kwePPMS mune chero munhu anayo, zvinonetsa kuti vaongorori vaongorore kushanda kwechirwere pachirwere chechirwere. Nekudaro, kubva muna 2017, mumwe mushonga wePPMS wakagamuchira mvumo kubva kuKudya neDrug Administration (FDA).

Ocrelizumab (Ocrevus)

Ocrelizumab (Ocrevus) iri FDA-inogamuchirwa kurapa zvese PPMS neRRMS.

Iyo monoclonal antibody inoparadza mamwe maB masero ezvirwere zvemuviri. Kutsvagurudza kunoratidza kuti B maseru ane chikamu chakakonzera kukuvara kwehuropi uye musana tambo tambo dzevanhu vane MS. Uku kukuvara kunogoneswa ne immune immune pachayo.

Ocrelizumab inotumirwa nekuiswa infravenous infusion. Iwo maviri ekutanga infusions anoitiswa mavhiki maviri akaparadzana. Gare gare infusions inoitiswa yega yega mwedzi mitanhatu.

Stem cell kurapwa

Chinangwa chekushandisa masero ekurapa PPMS ndeyekusimudzira immune system kugadzirisa kukanganisa uye kudzikisira kuzvimba mukati epakati tsinga system (CNS).

Nechirongwa chinozivikanwa sehematopoietic stem cell kuisirwa (HSCT), masero emadzinde anounganidzwa kubva munyama dzemunhu, semongo wemapfupa kana ropa, uye wozodzoreredzwa mushure mekudzvanywa kwema immune system. Izvi zvinoitwa munzvimbo yezvipatara uye pari zvino FDA inogamuchirwa.

Zvisinei, HSCT inzira huru ine zvakakomba mhedzisiro. Dzimwe tsvagiridzo uye mhedzisiro kubva kumakiriniki miedzo inodiwa izvi zvisati zvave kurapwa kwakanyanya kwePPMS.

Kliniki miedzo

Mimwe kiriniki miedzo irikuenderera mberi mune vanhu vane PPMS. Kliniki miedzo inopfuura nepakati pezvikamu zvisati zvawana FDA tendero.

Chikamu I chinotarisa pamusoro pekuti mushonga uyu wakachengeteka zvakadii uye unosanganisira boka diki revatori vechikamu.

Pakati pechikamu chechipiri, vaongorori vanovavarira kuona kuti mushonga wacho unoshanda sei kune mamwe mamiriro akaita seMS.

Chikamu chechitatu chinowanzo sanganisira rakakura boka revatori vechikamu.

Vatsvakurudzi vanotarisawo kune vamwe vanhu, madheji, uye kusanganiswa kwezvinodhaka kuti vazive zvakawanda nezve kuchengeteka uye kushanda kwemushonga.

Lipoic asidhi

Chikamu chemakore maviri chikamu II kudzidza parizvino kuri kuongorora yemumuromo antioxidant lipoic acid. Vanotsvagurudza vari kudzidza kana ichigona kuchengetedza kufamba uye kuchengetedza huropi kupfuura nzvimbo isingashande iri munzvimbo dzinofambira mberi dzeMS.

Ichi chidzidzo chinovakira pachikamu chekutanga chikamu chechipiri chakatarisa vanhu makumi mashanu nevashanu vane chechipiri chinofambira mberi MS (SPMS). Vatsvagiri vakaona kuti lipoic acid yakakwanisa kudzora mwero wekurasikirwa netishu kuenzaniswa ne placebo.

Yakakwira-dose biotin

Biotin chikamu chevhitamini B yakaoma uye inobatanidzwa mukukura kwemasero uye metabolism yemafuta uye amino acids.

Chidzidzo chekucherechedza chiri kutora vanhu vane PPMS vari kutora yakakwira dosi yebiotin (300 milligrams) zuva nezuva. Vatsvakurudzi vanoda kuona kana zvichibudirira uye zvakachengeteka mukuderedza kufambira mberi kwekuremara kune vanhu vane PPMS. Mune zvidzidzo zvekucherechedza, vaongorori vanoongorora vatori vechikamu vasina kupindira mukuita.

Chimwe chikamu chechitatu cheongororo chiri kuongorora yakakwira-dhizaini biotin yekuumbwa inozivikanwa seMD1003 kuti uone kana ichinyatso shanda pane placebo. Vatsvagiri vanoda kuziva kana ichigona kudzikamisa kuremara kwevanhu vane MS inofambira mberi, kunyanya avo vane gait kukanganiswa.

Chiyero chidiki chakavhurika-cheyero chakatarisa mhedzisiro yeiyo yakakwira-dose biotin mune vanhu vane PPMS kana SPMS. Maitiro akaenzana kubva pamazana kusvika mazana matatu emamirigiramu pazuva kwemwedzi miviri kusvika pamakumi matatu.

Vatori vechikamu mumuyedzo uyu vakaratidza kuvandudzwa kwekuona kwekukanganisa kwakabatana ne optic nerve kukuvara uye zvimwe zviratidzo zveMS, senge mota basa uye kuneta.

Nekudaro, kumwe kuongorora kwakaratidza kuti yakakwira-dose biotin yakapotsa yakapetwa katatu chiyero chekudzokazve muvatori vechikamu nePPMS.

Izvo zvakayambirawo kuti mwero wepamusoro webiotin unogona kutungamira kumhedzisiro yemarabhoramu kune vanhu vane mamwe mamiriro, kusanganisira MS.

Masitinib (AB1010)

Masitinib inorwisa mishonga yekudzivirira mishonga yakagadziriswa senge ingangoita kurapwa kwePPMS.

Mushonga watove wataridza kuvimbisa muchikamu chechipiri II kutongwa. Iko parizvino iri kuongororwa muchikamu chechitatu kudzidza mune vanhu vane PPMS kana kudzokerazve-isina SPMS.

Ibudilast

Ibudilast inhibits enzyme inonzi phosphodiesterase. Inoshandiswa semushonga weasima kunyanya muAsia, zvakaratidzwawo kukurudzira myelin kugadzirisa uye kubatsira kuchengetedza maseru etsinga kubva mukukuvara.

Ibudilast yakapihwa yekukurumidza track kudomwa neiyo FDA. Izvi zvinogona kumhanyisa kukura kwayo kweramangwana senzira inogoneka yekurapa MS inofambira mberi.

Mhedzisiro yechikamu chechipiri chechipiri muvarwere makumi maviri nemashanu vane MS inofambira mberi yakaburitswa muThe New England Journal of Medicine.

Mukudzidza, ibudilast yaibatanidzwa nekunonoka kufambira mberi kwehuropi atrophy kupfuura nzvimbo inonamira. Nekudaro, zvakatungamirawo kumazinga akakwira ekugaya system system mhedzisiro, musoro, uye kushushikana.

Natural uye zvinowirirana kurapa

Mimwe mishonga yakawanda, kunze kwemishonga, inogona kubatsira kugadzirisa mashandiro uye hupenyu hwehupenyu kunyangwe hazvo mhedzisiro yechirwere.

Kurapa pabasa

Kurapa pabasa kunodzidzisa vanhu hunyanzvi hwavanoda kuti vazvichengete ivo vaviri kumba nekubasa.

Vekurapa vekurapa vanoratidza vanhu maitiro ekuchengetedza simba ravo, nekuti PPMS inowanzo kukonzera kuneta kwakanyanya. Ivo zvakare vanobatsira vanhu kugadzirisa zviitiko zvavo zvezuva nezuva nemabasa epamba.

Varapi vanogona kuratidza nzira dzekuvandudza kana kugadzirisa dzimba nenzvimbo dzekushandira kuti zviwanikwe nyore nevanhu vakaremara. Ivo vanogona zvakare kubatsira mukurapa ndangariro uye matambudziko ekuziva.

Kurapa kwepanyama

Varapi vemuviri vanoshanda kugadzira chaiwo maitiro ekurovedza muviri kubatsira vanhu kuwedzera kwavo kwakawanda kufamba, kuchengetedza kwavo kufamba, uye kudzikisira kupenga uye kudedera.

Varapi vemuviri vanogona kukurudzira michina kubatsira vanhu vane PPMS kutenderera zvirinani, senge:

• mawiricheya
• vanofamba
• tsvimbo
• scooter

Kutaura-mutauro pathology (SLP)

Vamwe vanhu vane PPMS vane matambudziko nemutauro wavo, kutaura, kana kumedza. Varapi vepathologist vanogona kudzidzisa vanhu maitiro eku:

• gadzirira chikafu chiri nyore kumedza
• idya zvakanaka
• shandisa kudyisa machubhu zvakanaka

Ivo vanogona zvakare kukurudzira anobatsira mafoni anobatsira uye ekutaura ekuwedzera kuti kuita kutaurirana kuve nyore.

Rovedza muviri

Kuita maekisesaizi kunogona kukubatsira kudzikisira kuzvimba uye chengetedza mafambiro. Unogona kuedza iyoga, kushambira, kutambanudza, uye mamwe maitiro anogamuchirwa ekurovedza muviri.

Ehezve, inogara iri zano rakanaka kukurukura chero hutsva hwekurovedza muviri nachiremba wako.

Inoenderana uye imwe nzira (CAM) yekurapa

CAM kurapa kunoonekwa sekusagadziriswa kurapwa. Vanhu vazhinji vanoshandisa imwe mhando yeCAM kurapa sechikamu chevatariri veMS.

Iko kune kushomeka kutsvagisa kuongororwa kwekuchengetedza uye kushanda kweCAM muMS. Asi kurapwa kwakadai kunoitirwa kubatsira kudzivirira chirwere kubva mukukuvadza system yako uye kuchengetedza hutano hwako kuti muviri wako usanzwe zvakanyanya zvechirwere.

Zvinoenderana neimwe ongororo, marapiro eCAM anovimbisa eMS anosanganisira:

• chikafu chine mafuta mashoma
• omega-3 fatty acid inowedzera
• lipoic acid inowedzera
• vitamini D zvinowedzera

Taura nachiremba wako usati wawedzera CAM kuchirongwa chako chekurapa, uye ita shuwa kuti iwe unoramba uchitevedzera kune ako marapirwo ekurapa.

Kurapa zviratidzo zvePPMS

Kazhinji MS zviratidzo iwe zvaungasangana nazvo zvinosanganisira:

• kuneta
• chiveve
• kushaya simba
• dzungu
• kukanganisa kukanganisa
• kuzvidzora
• kurwadziwa
• kusaenzana
• matambudziko eweti
• manzwiro anochinja

Chikamu chikuru chehurongwa hwako hwese hwekurapa ichave yekugadzirisa zviratidzo zvako. Iwe ungangoda dzakasiyana mishonga, mararamiro anochinja, uye ekuwedzera ekurapa kuti uite izvi.

Mishonga

Zvichienderana nezviratidzo zvako, chiremba anogona kupa:

• tsandanyama relaxants
• mishonga inodzvinyirira
• mishonga ye bladder dysfunction
• mishonga yekuderedza kuneta, senge modafinil (Provigil)
• mishonga inorwadza
• zvinobatsira pakurara zvinobatsira nekushaya hope
• mishonga inobatsira kubata erectile dysfunction (ED)

Mararamiro anochinja

Aya mararamire shanduko anogona kuita kuti zviratidzo zvako zvikwanisike.

• Idya chikafu chine hutano chakazara mavitamini, zvicherwa, uye antioxidants.
• Ita zviitwa zvekuvaka-simba zvekuvaka mhasuru uye kuwedzera simba.
• Edza zvinyoro nyoro kurovedza uye kutambanudza zvirongwa senge tai chi uye yoga kubatsira neyakaenzana, kushanduka, uye kubatana.
• Chengetedza maitiro akakodzera ekurara.
• Chengetedza kushungurudzika nekukwiza muviri, kufungisisa, kana kugadziriswa.
• Shandisa zvinobatsira zvekuvandudza hupenyu.

Kuvandudza

Chinangwa chekugadzirisa ndechekuvandudza nekuchengetedza basa uye kuderedza kuneta. Izvi zvinogona kusanganisira:

• kurapa kwepanyama
• kurapwa kurapa
• kugadzirisa kugadzirisa
• kutaura-mutauro pathology
• kugadzirisa mabasa

Kumbira chiremba wako kuti atumire kune nyanzvi munzvimbo idzi.

Tora woenda nazvo

PPMS haisi rudzi rwakajairika rweMS, asi vaongorori vazhinji vachiri kutsvaga nzira dzekurapa mamiriro acho.

Iyo 2017 mvumo ye ocrelizumab yakaratidza danho hombe kumberi nekuti rinotenderwa for PPMS chiratidzo. Mimwe mishonga irikubuda, yakadai seanorwisa-kuzvimba uye biotin, yakawana mhedzisiro yakavhenganiswa muPPMS kusvika zvino.

Ibudilast yakave zvakare yakadzidziswa nezve ayo mhedzisiro paPPMS uye SPMS. Zvichangoburwa zvabuda kubva muchikamu chechipiri cheyedzo zvinoratidza kuti zvinokonzeresa mhedzisiro, kusanganisira kushushikana. Nekudaro, yaive zvakare yakabatana nehuremu hwepasi hwehuropi atrophy.

Taura nachiremba wako kana iwe uchida ruzivo rwepamusoro-rwe-rwe-rwe pane nzira dzakanakisa dzekugadzirisa yako PPMS.