Amayeza kunye noNyango lweNkqubela phambili ye-MS

Umxholo

• Amayeza e-PPMS
• I-Ocrelizumab (Ocrevus)
• Unyango lwesitem
• Uvavanyo lwezonyango
• Lipoic acid
• Idosi ephezulu ye-biotin
• IMasitinib (AB1010)
• Ibudilast
• Unyango lwendalo kunye nolongezelelo
• Unyango emsebenzini
• Ulungiso lwenyama
• Ulwimi oluthethwayo (SLP)
• Zilolonge
• Unyango olongezelelweyo nolunye (CAM)
• Ukunyanga iimpawu ze-PPMS
• Amayeza
• Utshintsho kwindlela yokuphila
• Ukubuyisela kwisimo sangaphambili
• Yise kude

Isiseko se-multiple sclerosis (PPMS) esineprayimari yenye yeendlela ezine ze-multiple sclerosis (MS).

Ngokwe-National Multiple Sclerosis Society, malunga neepesenti ezili-15 zabantu abane-MS bafumana ukuxilongwa kwe-PPMS.

Ngokungafaniyo nezinye iintlobo ze-MS, i-PPMS iqhubeka ukusuka ekuqaleni ngaphandle kokuphinda ubuye kwakhona okanye uxolelo. Nangona esi sifo sihlala sihamba kancinci kwaye kunokuthatha iminyaka ukufumanisa isifo, sikhokelela kwiingxaki zokuhamba.

Akukho sizathu saziwayo se-MS. Nangona kunjalo, unyango oluninzi lunokunceda ukuthintela ukuqhubela phambili kweempawu ze-PPMS.

Amayeza e-PPMS

Uninzi lweziyobisi ezikhoyo ze-MS ziyilelwe ukulawula ukudumba kunye nokunciphisa inani lokuphinda ubuye.

Nangona kunjalo, i-PPMS ibangela ukuvuvukala okungaphantsi kokuphinda ubuyise-ukubuyisela ukuphindaphindeka kwesclerosis (RRMS), olona hlobo luqhelekileyo lwe-MS.

Ukongeza, nangona kunokubakho amaxesha amancinci okuphucula, i-PPMS ayinakho ukuxolelwa.

Kuba akunakwenzeka ukuba uqikelele ikhosi yokuqhubela phambili kwe-PPMS kuye nawuphi na umntu onayo, kunzima kubaphandi ukuba bavavanye ukusebenza kwesiyobisi kwesi sifo. Nangona kunjalo, ukusukela ngo-2017, iyeza elinye le-PPMS lifumene imvume kuLawulo lokutya kunye noLawulo lweziyobisi (FDA).

I-Ocrelizumab (Ocrevus)

I-Ocrelizumab (i-Ocrevus) ivunyiwe yi-FDA ukunyanga zombini i-PPMS kunye ne-RRMS.

Yintsholongwane yohlobo olunye ebulala iiseli ezithile ze-B kumajoni omzimba. Uphando lubonisa ukuba iiseli ze-B zinoxanduva lomonakalo kwingqondo nakwizicubu zomqolo wabantu abane-MS. Lo monakalo wenziwe ngamajoni omzimba ngokwawo.

I-Ocrelizumab ilawulwa ngokufakwa ngaphakathi. Iimpembelelo ezimbini zokuqala zenziwa ngaphandle kweeveki ezimbini ngokwahlukeneyo. Ukufakwa kamva kungeniswa rhoqo kwiinyanga ezi-6.

Unyango lwesitem

Injongo yokusebenzisa iiseli ezinamayeza ukunyanga i-PPMS kukukhuthaza amajoni omzimba ukulungisa umonakalo kunye nokunciphisa ukudumba kwinkqubo ye-nervous system (CNS).

Kwinkqubo eyaziwa ngokuba yi-hematopoietic stem cell transplantation (HSCT), iiseli zeziqu ziqokelelwa kwizicubu zomntu, njengomongo wethambo okanye igazi, emva koko ziphinde zenziwe emva kokuba amajoni omzimba sele ecinezelwe. Oku kwenziwa kwisibhedlele kwaye ngoku i-FDA yamkelwe.

Nangona kunjalo, i-HSCT yinkqubo enkulu eneziphumo ebezingalindelekanga ezimandundu. Olunye uphando kunye neziphumo ezivela kuvavanyo lweklinikhi ziyafuneka ngaphambi kokuba le ibe lonyango olusetyenziswa ngokubanzi lwe-PPMS.

Uvavanyo lwezonyango

Izilingo ezininzi zeklinikhi ziyaqhubeka ngoku kubantu abane-PPMS. Uvavanyo lwezonyango luhamba ngezigaba ezininzi ngaphambi kokufumana imvume ye-FDA.

Isigaba I sigxile kukhuseleko lwechiza kwaye libandakanya iqela elincinci labathathi-nxaxheba.

Ngexesha lesigaba II, abaphandi bajolise ekuqinisekiseni ukuba ichiza lisebenza njani kwiimeko ezithile ezinje nge-MS.

Isigaba III sibandakanya iqela elikhulu labathathi-nxaxheba.

Abaphandi bajonge nabanye abantu, idosi, kunye nokudityaniswa kweziyobisi ukufumana okungakumbi malunga nokuba likhuseleke kwaye lisebenza njani ichiza.

Lipoic acid

Isifundo seminyaka emibini yesigaba II ngoku sivavanya i-lipoic acid yomlomo. Abaphandi bafunda ukuba ingaba inokugcina ukuhamba kwaye ikhusele ingqondo ngaphezu kwe-placebo engasebenziyo kwiifom eziqhubela phambili ze-MS.

Olu phononongo lwakha kwisigaba sokuqala sophando esajonga abantu abangama-51 abane-MS (SPMS) yesibini eqhubekayo. Abaphandi bafumanise ukuba i-lipoic acid ikwazile ukunciphisa izinga lokulahleka kwezicubu zobuchopho xa kuthelekiswa ne-placebo.

Idosi ephezulu ye-biotin

I-Biotin licandelo lobunzima bevithamini B kwaye iyabandakanyeka ekukhuleni kweeseli kunye nasekuguqulweni kokutya okunamafutha kunye neeamino acid.

Isifundo sokujonga siqesha abantu abane-PPMS abathatha idosi ephezulu ye-biotin (300 milligrams) mihla le. Abaphandi bafuna ukubona ukuba kuyasebenza kwaye kukhuselekile ekunciphiseni ukuqhubela phambili kokukhubazeka kubantu abane-PPMS. Kwizifundo zokujonga, abaphandi bajonge abathathi-nxaxheba ngaphandle kokungenelela kwinkqubo.

Olunye uphononongo lwesigaba se-III kuvavanya ukwenziwa kwe-biotin yedosi ephezulu eyaziwa ngokuba yi-MD1003 ukubona ukuba iyasebenza ngakumbi kune-placebo. Abaphandi bafuna ukwazi ukuba kungacutha na ukukhubazeka kwabantu abane-MS eqhubekayo, ngakumbi abo banesiphene.

Uvavanyo oluncinci lweelebhile ezivulekileyo lujonge kwiziphumo zedosi ephezulu ye-biotin kubantu abane-PPMS okanye i-SPMS. Iidosi zisusela kwi-100 ukuya kwi-300 milligrams ngemini iinyanga ezi-2 ukuya kwezi-36.

Abathathi-nxaxheba kolu vavanyo babonisa ukuphucuka kokungaboni kakuhle okunxulumene nokulimala kwe-optic nerve kunye nezinye iimpawu ze-MS, ezinje ngemoto kunye nokudinwa.

Nangona kunjalo, olunye uphononongo lufumanise ukuba idosi ephezulu ye-biotin iphantse yaliphinda kathathu inqanaba lokuphinda ubuye kubathathi-nxaxheba nge-PPMS.

Ikwalumkisile ukuba idosi ephezulu ye-biotin inokukhokelela kwiziphumo zeelebhu ezingachanekanga kubantu abaneemeko ezithile, kubandakanya iMMS.

IMasitinib (AB1010)

I-Masitinib sisiyobisi somlomo sokunyanga esiye senziwa njengonyango lwe-PPMS.

Unyango sele lubonakalisile ngesithembiso kwilingo lesigaba sesibini. Kungoku nje iphantsi kophando kwisigaba se-III kubantu abane-PPMS okanye i-SPMS engenakho ukubuyela umva.

Ibudilast

I-Ibudilast inqanda i-enzyme ebizwa ngokuba yi-phosphodiesterase. Isetyenziswa njengeyeza lesifuba ikakhulu e-Asiya, ikwabonakalisile ukukhuthaza ukulungiswa kwe-myelin kunye nokunceda ukukhusela iiseli zemithambo-luvo ekonakaleni.

U-Ibudilast wanikwa igama elikhawulezileyo yi-FDA. Oku kunokukhawulezisa ukukhula kwayo kwexesha elizayo njengonyango olunokubakho lwe-MS eqhubela phambili.

Iziphumo zetyala lesigaba II kwizigulana ezingama-255 ezine-MS eziqhubela phambili zapapashwa kwiThe New England Journal of Medicine.

Kwisifundo, ibudilast yayinxulunyaniswa nokuhamba kancinci kwengqondo kwe-atrophy kune-placebo. Nangona kunjalo, ikwakhokelela kumanqanaba aphezulu enkqubo yokugaya ukutya, iintlungu, kunye noxinzelelo.

Unyango lwendalo kunye nolongezelelo

Olunye unyango oluninzi, ngaphandle kwamayeza, lunokunceda ekuphuculeni ukusebenza kunye nomgangatho wobomi ngaphandle kwesiphumo sesifo.

Unyango emsebenzini

Unyango lwasemsebenzini lufundisa abantu ngezakhono ezisebenzayo abazidingayo ukuze bakwazi ukuzikhathalela kokubini ekhaya nasemsebenzini.

Iingcali zasemsebenzini zibonisa abantu ukuba bangawagcina njani amandla abo, kuba iPPMS ibangela ukudinwa kakhulu. Banceda abantu ukuba bahlengahlengise imisebenzi yabo yemihla ngemihla kunye nemisebenzi yasekhaya.

Iingcali zonyango zinokucebisa ngeendlela zokuphucula okanye zokuhlaziya amakhaya kunye neendawo zokusebenza ukuze zibenze bafikeleleke ngakumbi kubantu abakhubazekileyo. Banokukunceda ekunyangeni iingxaki zememori kunye nengqondo.

Ulungiso lwenyama

Abanyangi ngokwasemzimbeni basebenzela ukwenza iindlela ezithile zokuzilolonga ukunceda abantu bandise uluhlu lwabo lokuhamba, bagcine ukuhamba kwabo, kunye nokunciphisa ukungangqinelani kunye neenyikima.

Iingcali zonyango zinokucebisa ngezixhobo ukunceda abantu abane-PPMS bajikeleze ngcono, njenge:

• izitulo ezinamavili
• abahambahambayo
• imisimelelo
• isithuthuthu

Ulwimi oluthethwayo (SLP)

Abanye abantu abane-PPMS baneengxaki ngolwimi lwabo, intetho, okanye ukuginya. Iipathologists zingafundisa abantu ukuba:

• lungisa ukutya ekulula ukukuginya
• yitya ngokukhuselekileyo
• Sebenzisa ityhubhu yokondla ngokufanelekileyo

Banokucebisa ngoncedo oluncedo lweefowuni kunye nezandisi-lizwi zentetho ukwenza ukunxibelelana kube lula.

Zilolonge

Ukuzivocavoca umzimba kunokukunceda ukunciphisa ukungakhathali kunye nokugcina uluhlu lwezindululo. Ungazama iyoga, ukuqubha, ukuzolula, kunye nezinye iindlela zokuzilolonga ezamkelekileyo.

Ewe kunjalo, kuhlala kungumbono olungileyo ukuxoxa ngalo naluphi na uhlobo lomthambo omtsha kunye nogqirha wakho.

Unyango olongezelelweyo nolunye (CAM)

Unyango lwe-CAM luthathwa njengonyango olungaqhelekanga. Uninzi lwabantu lubandakanya uhlobo oluthile lonyango lweCAM njengenxalenye yolawulo lwe-MS.

Kukho uphando olulinganiselweyo oluvavanya ukhuseleko kunye nokusebenza kweCAM kwi-MS. Kodwa unyango olunje lujolise ekuncedeni ukuthintela isifo ukuba singonakalisi inkqubo yakho yemithambo-luvo kunye nokugcina impilo yakho ukuze umzimba wakho ungaziva kakhulu kwiziphumo zesifo.

Ngokomphando omnye, ezona ndlela zithembisayo zonyango ze-CAM ze-MS zibandakanya:

• ukutya okunamafutha asezantsi
• I-omega-3 fatty acid yongeza
• izongezo ze-lipoic acid
• ivithamin D izongezo

Thetha nogqirha wakho ngaphambi kokuba ungeze i-CAM kwisicwangciso sakho sonyango, kwaye uqiniseke ukuba uyaqhubeka nokulandela unyango lwakho.

Ukunyanga iimpawu ze-PPMS

Iimpawu eziqhelekileyo ze-MS onokuzifumana zibandakanya:

• ukudinwa
• ukuba ndindisholo
• ubuthathaka
• isiyezi
• ukuphazamiseka kwengqondo
• Ukuxinana
• intlungu
• ukungalingani
• iingxaki zomchamo
• utshintsho lweemvakalelo

Inxalenye enkulu yesicwangciso sakho sonyango iya kuba kukulawula iimpawu zakho. Unokufuna amayeza ahlukeneyo, utshintsho kwindlela yokuphila, kunye nonyango olongezelelekileyo ukwenza oku.

Amayeza

Kuxhomekeke kwiimpawu zakho, ugqirha unokumisela:

• izihlunu eziphumlayo
• iziyobisi
• amayeza ukungasebenzi kakuhle kwesinyi
• amayeza okunciphisa ukudinwa, njengemodafinil (Provigil)
• amayeza entlungu
• izixhobo zokulala ukunceda ngokuphuthelwa
• amayeza okunceda ukunyanga ukungasebenzi kakuhle kwe-erectile (ED)

Utshintsho kwindlela yokuphila

Olu tshintsho kwindlela yokuphila lungenza ukuba iimpawu zakho zilawuleke ngakumbi:

• Yitya ukutya okusempilweni okunotye iivithamini, iiminerali, kunye nee-antioxidants.
• Yenza umthambo wokwakha amandla okwakha izihlunu kunye nokunyusa amandla.
• Zama umthambo omnene kunye neenkqubo ezoluliweyo ezinje nge-tai chi kunye neyoga ukunceda ngokulinganisela, ubhetyebhetye, kunye nokulungelelanisa.
• Gcina indlela efanelekileyo yokulala.
• Lawula uxinzelelo ngokuphulula, ukucamngca, okanye ukwenza i-acupuncture.
• Sebenzisa izixhobo zokuncedisa ukuphucula umgangatho wobomi.

Ukubuyisela kwisimo sangaphambili

Injongo yokuvuselelwa kukuphucula nokugcina umsebenzi kunye nokunciphisa ukudinwa. Oku kunokubandakanya:

• ulungiso lwenyama
• unyango lomsebenzi
• ukuvuselelwa kwengqondo
• ulwimi lwezifo
• ukuvuselelwa emsebenzini

Buza ugqirha wakho ukuba athumele kwiingcali kule mimandla.

Yise kude

I-PPMS ayilulo uhlobo oluqhelekileyo lwe-MS, kodwa abaphandi abaninzi basahlola iindlela zokunyanga le meko.

Ukuvunywa kwe-2017 ye-ocrelizumab kuphawule inyathelo elikhulu lokuya phambili kuba yamkelwe ukubonisa i-PPMS. Olunye unyango olusakhulayo, olunjenge-anti-inflammatories kunye ne-biotin, lufumene iziphumo ezixubeneyo kwi-PPMS ukuza kuthi ga ngoku.

I-Ibudilast ikwafundelwe ngeziphumo zayo kwi-PPMS nakwi-SPMS. Iziphumo zamva nje ezivela kuvavanyo lwesigaba II zibonisa ukuba zibangela iziphumo ebezingalindelekanga, kubandakanya nokudakumba. Nangona kunjalo, yayinxulunyaniswa nenqanaba elisezantsi lobuchwephesha bengqondo.

Thetha nogqirha wakho ukuba ufuna olona lwazi luhlaziyiweyo ngeendlela ezilungileyo zokulawula iPPMS yakho.