Kuzindikira zomwe zimayambitsa gout kungakuthandizeni kupewa kuwuka

Maphunziro a Zaumoyo

Mumadzuka usiku umodzi ndikumva kupweteka chala chakuphazi. Olowa ndi otupa komanso ouma. Mukagona, mumamva bwino. Tsopano mukumva kuwawa. Chikuchitika ndi chiani?

Mutha kukhala m'modzi wa Anthu aku America okwana 8.3 miliyoni ndi gout, mtundu wa nyamakazi womwe ungayambitse kutupa ndi kupweteka kwambiri. Gout amadziwika ndi zilonda zopweteka , zomwe zimachitika nthawi zambiri usiku, zimatha kukhala milungu ingapo, ndikumva kuwawa koipitsitsa komwe kumachitika m'maola 24 oyamba. Zizindikiro zina za gout zimaphatikizapo khungu lofunda, lofiira mozungulira olumikizidwawo.

Gout zimachitika pakakhala kuchuluka kwa uric acid m'magazi (matenda omwe amatchedwa hyperuricemia). Uric acid ndi chinthu chonyansa chomwe chimapangidwa thupi likawononga purine, mankhwala omwe amapangidwa ndi thupi koma amapezekanso muzakudya zosiyanasiyana. Kwa anthu ambiri, uric acid wochuluka amachotsedwa mumkodzo. Koma kwa ena, uric acid imamangirira (mwina chifukwa kupanga kwake kukuwonjezeka, kuchotsa kwake kumachepa, kapena kuphatikiza zonse ziwiri). Kukhazikika kumeneku kumabweretsa kupangidwa kwa makhiristo ngati singano omwe amakhala mozungulira olumikizana, makamaka chala chachikulu chakumapazi ndi miyendo yakumunsi, zomwe zimayambitsa kutupa ndi kuboola ululu wamagulu. Malinga ndi Arthritis Foundation, kusunga uric acid m'magazi ochepera 6 mg / dl ndikofunika kupewa kuukira kwa gout.

Pankhani yopewa gout, kuzindikira zizindikilo, kuyesetsa kupewa zovuta, ndikupeza chithandizo mwachangu ndi njira zofunika kwambiri zoyambira. Hyperuricemia ndi gout ndizovuta zamankhwala kwakanthawi, akuti Lynn Ludmer, MD , Woyang'anira zamankhwala ku rheumatology ku Mercy Medical Center ku Baltimore. Popita nthawi, gout yosalandiridwa imatha kubweretsa kutupa kosatha komanso kuwonongeka kwamagulu, komwe kumatha.

Zomwe zimayambitsa 8 gout

Kwa zaka mazana ambiri madokotala amaganiza kuti gout imayambitsidwa makamaka ndi zakudya. Kwenikweni, gout nthawi zambiri ankatchedwa matenda a mafumu chifukwa ankakonda kudya zakudya zolemera kwambiri ndi nyama komanso mowa — chakudya chimene anthu olemera okha ndi amene anali nacho.

Asayansi tsopano akudziwa kuti chomwe chimayambitsa gout ndi majini ndipo kukhala ndi mbiri yabanja ya vutoli ndiye vuto lanu lalikulu. Anthu akuyenera kumvetsetsa kuti gout ndi chibadwa osati 'cholakwika' chawo chifukwa chodya, ndemanga Theodore R. Minda, MD, FACP , katswiri wa mafupa ku chipatala cha New York City for Special Surgery. Kusintha kwa zakudya ndi moyo kumathandizadi, koma mwa ochepa ochepa odwala gout ndiwo okwanira.

Koma ngakhale chibadwa ndicho chiopsezo chachikulu cha gout, palinso othandizira ena, kuphatikiza:

1. Kunenepa kwambiri

Mukamayesa kulemera kwambiri, impso zanu zimayenera kugwira ntchito kuti zithetse zinthu zotaya uric acid mthupi lanu. Mmodzi kuphunzira , lofalitsidwa m'nyuzipepalayi Nyamakazi ndi Rheumatology , anthu omwe anali onenepa kwambiri anali ndi chiopsezo chachikulu cha 85% chokhala ndi hyperuricemia (choyambitsa gout) motsutsana ndi anthu olemera. Anthu onenepa anali ndi mwayi wochulukirapo kuwirikiza katatu kuposa anthu onenepa kwambiri kuti akhale ndi uric acid wambiri. Ofufuzawo apezanso kuti 44% yamatenda a hyperuricemia adachitika chifukwa cholemera kokha.

2. Zakudya zina

Chifukwa cha kuchuluka kwa purine, zakudya zina zimatha kukweza uric acid m'magazi. Zikuphatikizapo:

• Nyama yofiira
• Zakudya zamafuta, monga nyama yankhumba
• Nyama zanyama - mwachitsanzo, impso, chiwindi, ndi matumbo
• Zakudya zina zam'madzi, kuphatikiza nsomba, sardini, ndi anchovies; ndi nkhono, monga mussels
• Madzi a chimanga a fructose (omwe amapezeka mumitundu yambiri, makamaka zakumwa zotsekemera monga ma sodas)
• Zakumwa zoledzeretsa, zomwe zimapangitsa kuti gout isangokhala chifukwa cha purine, koma chifukwa zimapangitsa kuti impso zisokoneze uric acid

Ndi zakudya zochuluka motani zomwe zili bwino? Sitimatsutsa zakumwa zakanthawi panthawi yapadera kapena pang'ono pang'ono nyama yofiira kapena nkhanu, koma zochepa ndizabwino, akutero Dr. Fields. Ndi nkhani yochulukirapo, motero timalangiza kukhala ndi zochepa momwe mungathere. Mwamwayi, chakudya cha gout ndichakudya chopatsa thanzi, chifukwa chake ndi phindu lochuluka mmoyo wathanzi kutsatira chakudya chokomera gout.

3. Kuthamanga kwa magazi

Anthu omwe ali ndi kuthamanga kwa magazi (matenda oopsa) ali ndi 2-to-3 khola lawonjezeka chiopsezo chotenga gout. Malinga ndi American Heart Association, kuthamanga kwa magazi kosalamulirika kumatha kufooketsa, kuchepa, ndi kuumitsa mitsempha omwe amanyamula magazi mthupi lonse, kuphatikizapo mitsempha yomwe imapezeka mu impso. Izi zimapangitsa kuti zikhale zovuta kuti impso zizigwira ntchito yotulutsa zinyalala ngati uric acid mthupi. Kuphatikiza apo, okodzetsa (mankhwala omwe amagwiritsidwa ntchito kuonjezera kukodza) omwe nthawi zambiri amapatsidwa kuti athetse kuthamanga kwa magazi atha kubweretsa vuto kuchepetsa kuchuluka kwa urate (chophatikiza cha uric acid) chomwe chimatuluka mumkodzo.

4. Mankhwala ena

Kuphatikiza pa diuretics, zina mankhwala omwe angakulitse kuchuluka kwa uric acid kapena kuchepetsa kutulutsa kwawo ndi awa:

• Asipilini ochepa
• Mwachitsanzo, mankhwala omwe amagwiritsidwa ntchito popewera odwala
• Mankhwala omwe amagwiritsidwa ntchito pochizira TB
• Nicotinic acid, yomwe amachiza ndiine zofooka (niacin ndi vitamini B)

5. Matenda a shuga

Ndi lupanga lakuthwa konsekonse: Gulu la Maphunziro a Gout amanenanso kuti insulin kukana (chiwopsezo chachikulu cha matenda amtundu wa 2) kumatha kubweretsa gout ndikukhala ndi uric acid wambiri m'magazi anu kumatha kubweretsa kukana kwa insulin. Gululi lati 26% ya anthu omwe ali ndi gout ali ndi matenda ashuga amtundu wa 2.

6. Jenda

Amuna ali ndi chiopsezo chowonjezeka kanayi yopanga gout motsutsana ndi akazi. Zikuwoneka kuti mahomoni achikazi a estrogen amathandiza azimayi kuyang'anira uric acid, koma chitetezo chake chimayamba kuzimiririka pakutha kwa kusamba ndikutsika kwa estrogen. Pali malingaliro onena za chifukwa chake estrogen ingateteze azimayi, kuphatikiza kuti impso zitha kutulutsa uric acid wochulukirapo pomwe pali estrogen, akufotokoza Dr. Ludmer.

7. Zaka

Chiwopsezo cha gout chimayamba kukula ndi ukalamba. Izi mwina ndichifukwa choti zifukwa zambiri zomwe zimayambitsa matendawa ndi matenda a shuga, kunenepa kwambiri, komanso kuthamanga kwa magazi - zimakhalanso zowonjezeka tikamakalamba. Amuna amatha kukhala ndi gout azaka zapakati pa 40-60. Kwa azimayi, ali ndi zaka 60-80. Amayi amatha kuthana ndi matendawa kwakanthawi chifukwa cha zomwe zatchulidwazi zoteteza za estrogen.

8. Kusokonezeka kwa mafupa

Anthu omwe anavulala kapena kuchitidwa opareshoni palimodzi atha kukhala ndi gout m'derali. Tikudziwa kuti kupsinjika kwa thupi kumatha kuyambitsa gout, atero Dr. Fields. Mwachitsanzo, anthu ena amatuluka gout atatha kuthamanga. Amakhulupirira kuti kupsinjika kwa chala chachikulu chakumapazi kumatulutsadi timibulu tina ta uric acid mu olumikizana olowa mumadzimadzi olowa, ndikupangitsa kutupa.

Momwe mungapewere kuukira kwa gout

Palibe chomwe mungachite pokhudzana ndi chibadwa chanu, koma mutha kusintha moyo wathanzi womwe ungathandize kuchepetsa mwayi wopanga gout. Zikuphatikizapo:

1. Kuchepetsa thupi ngati mukufuna: Kafukufuku Zikuwonetsa kuti kuchepa kwa mapaundi asanu ndi awiri kungakhale ndi phindu pa gout. Kafukufuku wina adawonetsa 71% yocheperako gout ndikuwonda .
2. Kuchita masewera olimbitsa thupi: Kuchita masewera olimbitsa thupi kumatha kukuthandizani kuti muchepetse kunenepa, komwe kumachepetsa chiopsezo cha gout. Chenjezo limodzi: Osachita masewera olimbitsa thupi pakamatuluka gout.
3. Khalani hydrated: Arthritis Foundation imalimbikitsa kumwa magalasi osachepera 8 a zakumwa zosamwa (makamaka madzi) patsiku . Ndipo ngati muli pakati pa gout, pezani kawiri ndalamazo kuti muthandize kuthira uric acid wochulukirapo m'dongosolo lanu.
4. Malire mowa: Makamaka mowa, womwe umakhala ndi ma purine ambiri! Mowa umodzi womwe umatha kukweza uric acid wambiri 6.5%; mowa wosakhala mowa umatha kutulutsa 4.4%.
5. Kuchepetsa nkhawa: Akatswiri sadziwa kwenikweni momwe, kapena ngakhale ngati , kupanikizika kumatha kubweretsa gout - koma amadziwa kuti kupsinjika kwamaganizidwe kumatha kupangitsa anthu kudya ndi kumwa kwambiri, zomwe zimawaika pachiwopsezo chachikulu cha gout.
6. Onaninso zosankha zanu: Kuwonjezera pa kuchepetsa zakudya zomwe zingayambitse gout, ganizirani kuwonjezera zakudya zomwe zingathandize kulimbikitsa kutuluka kwa uric acid ndi / kapena kukhala ndi zotsutsana ndi zotupa. Malinga ndi Arthritis Foundation, zina mwazinthu izi ndi izi:
   • Mkaka wopanda mafuta ambiri
   • Khofi
   • Zakudya zokhala ndi vitamini C wambiri (sankhani zomwe zilinso ndi shuga wambiri wambiri monga zipatso za zipatso ndi sitiroberi)
   • Mapuloteni osakhala ndi nyama, monga nandolo, mphodza, tofu, ndi masamba obiriwira obiriwira
   • Cherry yamatcheri

Kuchiza matenda oopsa a gout

Ngati mukumva kupweteka kwa gout, onani omwe amakuthandizani pa zaumoyo. Ngakhale simukusowa mankhwala, mutha kukambirana za zakudya komanso kuchepa kwa thupi ndikukambirana nthawi yomwe gout ikufunika kuyendetsa bwino, Dr. Fields akulangiza.

Zithandizo zapakhomo

Njira zodzithandizira zomwe zingachepetse kupweteka kwakanthawi ndizo:

• Ice ndi kukweza cholumikizira chomwe chakhudzidwa
• Imwani madzi ambiri
• Chepetsani zochitika

Mankhwala

Mwa anthu omwe ali ndi ma gout awiri kapena kupitilira apo mchaka chimodzi, kapena gout wokhala ndi mbiri ya impso miyala kapena kuchepa kwa ntchito ya impso, kapena gout wokhala ndi tophi [madipoziti a uric acid pansi pakhungu mozungulira mafupa omwe amafanana ndi zophukira], ndiye kuti amafunikira uric acid wawo wotsitsidwa ndi mankhwala, akufotokoza Dr. Fields.

Pofuna kuchiza matenda anu, wothandizira zaumoyo wanu angakulimbikitseni:

• Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) kuchepetsa ululu ndi kutupa
• Colchicine , yomwe imachepetsa kutupa komanso kuchuluka kwa uric acid
• Corticosteroids kuchepetsa ululu ndi kutupa. Izi zitha kutengedwa pakamwa kapena kuperekedwa kudzera mu jakisoni.

Pofuna kuchepetsa kuchuluka kwa uric acid mthupi lanu ndikupewa kuukira mtsogolo, mutha kulandira mankhwalawa:

• Mwina (probenecid)
• Zamadzimadzi (febuxostat)
• Zyloprim (allopurinol)

Kapena mutha kulandira Krystexxa (pegloticase), mankhwala osokoneza bongo a IV.

Odwala ayenera kukhala omasuka akamakambirana zakuti akhoza kumwa mankhwala a gout ndi dokotala wawo, a Dr. Fields akulangiza. Mwayi 'wochiritsidwa' wa gout ndiwokwera kwambiri, ngati mungakhalebe ndi mankhwala monga allopurinol.