Ukhukuliseko lwamathambo kunye neRheumatoid Arthritis: Uthintelo kunye noLawulo

Umxholo

• Ushwankathelo
• Kutheni le nto kwenzeka ukhukuliseko lwamathambo?
• Ulawula njani ukhukuliseko lwethambo kunye neRA
• Ukuthintela ukhukuliseko lwamathambo ngeRA
• Ukuthatha

Ushwankathelo

I-Rheumatoid arthritis (RA) sisifo esinganyangekiyo esidumba ngokuchaphazela malunga nezigidi ezi-1.3 zaseMelika, ngokweAmerican College yeRheumatology.

I-RA sisifo sokuzimela komzimba apho amajoni omzimba ahlasela ngempazamo izicwili kunye neeseli zomzimba. Esi sifo siyahluka kwezinye iimeko zomzimba zokuzikhusela kuba sichaphazela ikakhulu ulusu lwamalungu.

Esi sifo siqhubela phambili asibangeli ukudumba ngokudibeneyo, kodwa sinokukhokelela ekonakaleni nasekudeni kwamalungu. Umonakalo sisiphumo sokhukuliseko kwamathambo.

Ukhukuliseko lwamathambo yinto ephambili yeRA. Umngcipheko unyuka ngobukrakra besifo kwaye ubonakaliswa kukuphulukana nethambo kwiindawo ezithile zomzimba.

Nangona kungekho nonyango ye-RA, kunokwenzeka ukulawula nokunciphisa ukukhula kwethambo. Nantsi into ekufuneka uyazi malunga nokukhukuliseka kwamathambo, kubandakanya neengcebiso zothintelo kunye nolawulo.

Kutheni le nto kwenzeka ukhukuliseko lwamathambo?

I-RA ibangela ukudumba okungapheliyo, okukhokelela kukhukuliseko lwamathambo ngokuthe ngcembe. Iimpawu ze-RA zakudala zibandakanya ukudumba kwamalungu, ukuqina ngokudibeneyo, kunye nentlungu edibeneyo. Abanye abantu banokudinwa kunye nokuphelelwa ngumdla.

I-RA ihlala ichaphazela amalungu amancinci njengezandla zakho, iinyawo, kunye neminwe, ke ukwanda kwethambo kunokwenzeka kula malungu. Inokuchaphazela amanye amalungu omzimba wakho njengamadolo akho, iingqiniba, iinyonga kunye namagxa.

Ukhukuliseko lwamathambo kunye neRA zidibene kuba ukudumba okungapheliyo kuvuselela ii-osteoclast, eziyizisele ezaphula izicwili zethambo. Oku kukhokelela kwinkqubo eyaziwa ngokuba kukufakwa kwamathambo.

Ngokwesiqhelo, ukubuyiswa kwethambo yinxalenye yommiselo oqhelekileyo wezimbiwa ezifunekayo ukulinganisela ukugcinwa, ukulungiswa kunye nokulungiswa kwamathambo. Inkqubo, nangona kunjalo, ayilinganisi kubantu abane-RA, ekhokelela ekonakaleni okukhawulezayo kwezicubu ezinamaminerali.

Ukhukuliseko lwamathambo lunokwenzeka kwakhona xa kukho inani elibalulekileyo lee-cytokines ezivuthayo emzimbeni. Iiseli zikhupha ezi proteni zincinci ukukhuthaza amajoni omzimba ukulwa izifo.

Ngamanye amaxesha, nangona kunjalo, umzimba ukhupha isixa esigqithisileyo se cytokines. Oku kunokukhokelela kukudumba kunye nokudumba, kwaye ekugqibeleni kudityaniswe, ithambo kunye nomonakalo wethishu.

Ulawula njani ukhukuliseko lwethambo kunye neRA

Ukhukuliseko lwamathambo lunokukhula kwangoko luze lube mandundu ngokuthe ngcembe. Kwabanye abantu, ukhukuliseko lwethambo lungaqala kwisithuba seeveki zokufumana isifo kwi-RA. Phantse iipesenti ezili-10 zabantu abafumana ukuxilongwa kwe-RA banomhlaba emva kweeveki eziyi-8. Emva konyaka omnye, ukuya kuthi ga kwiipesenti ezingama-60 zabantu bafumana ukhukhuliseko.

Kuba ukhukuliseko lwethambo oluqhubekayo kunokubangela ukukhubazeka, ukuthoba isantya okanye ukuphilisa ukhukhuliseko kunokunceda ekuphuculeni umgangatho wobomi bakho. Nangona kunjalo, xa ukhukuliseko lwenzeka, kunqabile ukuba lubuyiselwe.

Akunakwenzeka, nangona kunjalo. Kukho ezinye iingxelo ezidibanisa ukusetyenziswa kweziyobisi eziguqula i-antirheumatic drugs (i-DMARD) kunye nokukwazi ukunciphisa ukuqhubela phambili kwethambo.

Naliphi na ithuba lokulungisa okanye lokuphilisa ukhukhuliseko lwamathambo luqala ngokulawula ukudumba. Ii-DMARD zihlala ziyindlela yokuqala yonyango lwe-RA. Nangona amayeza eentlungu anokunyanga iimpawu ezinje ngeentlungu kunye nokuqina, ii-DMARD zijolise kwiiseli ezithile zomzimba ezijongana nokukhuthaza ukudumba.

Oku kunokunceda u-RA angene ekuxolelweni kunye nokuhamba kancinci kwezifo. La mayeza anokumisa ukhukuliseko lwethambo kwaye ancede ukulungisa nakuphi na ukhukuliseko olukhoyo, nangona amayeza engenako ukulungisa ngokupheleleyo amathambo.

Ii-DMARD zemveli ziqukethe amayeza omlomo kunye nawokutofa njenge-methotrexate.

Xa la mayeza engakwazi ukulawula ukudumba, ugqirha unokucebisa ukuba utshintshele kwi-biologic enje:

• isatifikethi (Cimzia)
• I-etanercept (i-Enbrel)
• adalimumab (Humira)
• Ukubulala (Orencia)
• infliximab (I-Remicade)
• igolimumab (iSimponi)

I-Biologics luhlobo oluthile lwe-DMARD. Ukongeza ekujoliseni iiseli ezithile zamajoni omzimba ezibangela ukudumba, zivimba iikhemikhali ezinje ngeecytokines ezibonisa okanye ezikhuthaza ukudumba.

Nje ukuba ukudumba kuphantsi kolawulo, ukhukuliseko lwethambo lunokucothisa kwaye luqale ukuphola. Ukulawula ukudumba kubalulekile kuba ukudumba okuncinci kunciphisa ukukhuthaza ii-osteoclasts. Nako oku kunokunciphisa ukhukuliseko lwamathambo.

Ugqirha wakho unokucebisa nonyango ukucinezela ii-osteoclast. Oku kubandakanya iziyobisi ezichasayo ezonyanga ukulahleka kwethambo kunye nezinye iingxaki zethambo, ezinje nge-bisphosphonates kunye ne-denosumab (Xgeva, Prolia).

Ukuthintela ukhukuliseko lwamathambo ngeRA

Ukhukuliseko lwamathambo yeyona nto iphambili kwi-RA kwaye ngekhe ukwazi ukuyikhusela ngokupheleleyo. Nangona kunjalo, ukunyanga ukuvuvukala kwangoko yenye yeendlela ezilungileyo zokukhusela amalungu akho. Thetha nogqirha wakho malunga neempawu ezinjengeentlungu ezidibeneyo kunye nokuqina, ubomvu, ukudinwa okungapheliyo, ukunciphisa umzimba, okanye umkhuhlane ophantsi.

Kukho phakathi kokukhukuliseka kwamathambo kunye nokuxinana kwamaminerali asezantsi. Ke ngoko, ukugcina amathambo asempilweni kunokuthintela okanye kunciphise ukhukuliseko lwethambo.

Ezinye iindlela zokomeleza amathambo akho zibandakanya:

• Cinga ukuthatha i-calcium kunye ne-vitamin D. Abantu abadala bafuna malunga ne-1,000 milligrams (mg) yecalcium ngosuku, kunye neeyunithi ezingama-600 zamazwe aphesheya (IU) zevithamin D yonke imihla, ngokweKliniki yaseMayo. Ngaphambi kokuba uqale naziphi na izongezo ezintsha, thetha nogqirha wakho.
• Yenza umthambo rhoqo. Ukwenza umthambo rhoqo kunokuzomeleza izihlunu kunye nokukhuthaza amathambo omelele. Qalisa kancinci kwaye ubandakanye umxube wokuzivocavoca kwe-cardio kunye nemisebenzi yoqeqesho lwamandla. Ukuzivocavoca okunempembelelo ephantsi njengokuhamba, iyoga, kunye nokubhukuda ziindawo ezilungileyo ukuqala.
• Yeka ukutshaya. Ukutshaya kunokuwenza buthathaka amathambo akho, ngokunjalo nokusela utywala kakhulu. Jonga iindlela zokuyeka ukutshaya, kunye nokunciphisa utywala. Ngokubanzi, abasetyhini akufuneki babe nesiselo esingaphezulu kwesinye ngosuku, kwaye amadoda kufuneka anciphise ukutya kwabo kwiziselo ezimbini ngosuku.
• Lungisa amayeza akho. Ukusetyenziswa kwexesha elide kwamanye amayeza aphatha ukuvuvukala, njenge-prednisone kunye ne-methotrexate, kunokonakalisa amathambo akho. Thetha nogqirha wakho malunga nokunciphisa umyinge wakho okanye ukutshintshela kwelinye iyeza lakuba nje ukudumba kulawulwa ngokufanelekileyo.

Ukuthatha

Ukhukuliseko lwamathambo yinto eqhelekileyo kubantu abaphila neRA. Ukwehla kokudumba kunokukunceda uzive ungcono kwaye uthintele ukuqhubela phambili. Ukuqala unyango kwangoko kunokunyusa umgangatho wobomi bakho kunye nokunciphisa umngcipheko wokukhubazeka.