Kev mob ntawm cov leeg ntawm cov leeg qis hauv qab zib nrog ntshav qab zib tuaj yeem tshwm sim ob qho tib si nrog kev nce ntxiv thiab nrog lub suab thaj hauv cov ntshav qab zib.
Kev cuam tshuam ntawm cov ntshav tsis txaus, nrog rau kev puas tsuaj rau lub paj hlwb peripheral, tsub zuj zuj ntawm cov khoom lom metabolic hauv cov leeg tau pom nyob rau hauv cov ntshav qab zib hauv yuav luag txhua tus neeg mob, tshwj xeeb nrog kev nce ntawm lub sijhawm thiab nrog lub hnub nyoog.
Cov tsos mob ntawm cov nqaij ntshiv puas yog qhia los ntawm qhov mob, leeg tsis muaj zog, ua kom deeg thiab cramps.
Vim li cas ntshav qab zib thiaj ua rau cov leeg mob?
Kev cuam tshuam ntawm cov ntshav hauv cov ntshav qab zib mellitus yog cuam tshuam nrog kev puas tsuaj rau lub nkoj sab hauv phab ntsa, uas muaj cov piam thaj ntau hauv cov ntshav tau raug mob, lipoproteins uas tsis muaj ntau yog tso rau hauv nws, thiab cov leeg nqaij mos ua kom cov hlab vim qhov nce ntxiv.
Neuropathy feem ntau ua rau lub zog ntawm txoj hlab ntshav ntawm qhov qis qis, raws li nws nqaim cov leeg me thiab cov hlab ntsha, thaum cov ntshav ntws los ntawm cov hlab ntsha txhaws nce ntxiv. Nrog cov kev hloov zoo li no, kev noj zaub mov noj thiab roj sib pauv ntawm cov leeg nqaij txuas mus ntxiv kom tsawg dua, ua rau, ntxiv rau qhov mob, qhov hnov mob hauv ob txhais ceg.
Kev puas tsuaj rau cov hlab ntsha hauv cov ntshav qab zib yog txuam nrog kev tso nyiaj ntawm sorbitol, uas ua rau txo qis ntshav hauv sab hauv cov hlab ntsha thiab ua rau lub cev muaj pa oxygen tshaib plab nrog kev ua haujlwm tsis zoo thiab cov qauv ntawm cov hlab ntaws.
Tus ua mechanisms ntawm paj fiber puas hauv ntshav qab zib mellitus:
- Kev puas tsuaj rau lub cell membrane thiab cov protein los ntawm kev tsim cov dawb radicals.
- Glycosylation ntawm cov protein los ntawm cov piam thaj molecules ncig hauv cov ntshav.
- Kev rhuav tshem ntawm cov hlab ntsha uas txhawb nqa cov hlab ntsha.
- Qhov tsim ntawm autoantibodies tawm tsam neurons.
Neuropathic pauv hloov hauv cov leeg hlwb thiab cov leeg ua haujlwm nrog kev loj hlob ntawm hyperglycemia thiab tuaj yeem txo qis nrog them ntshav qab zib. Myalgia kuj tseem tuaj yeem nrog txo qis ntshav qabzib.
Hauv kev tawm tsam sai ntawm hypoglycemia, muaj cov tsos mob cuam tshuam nrog kev ua ntawm catecholamines - adrenaline thiab norepinephrine, uas ua rau qhov tseeb tias caj npab thiab txhais ceg pib mob siab, cov neeg mob piav qhia nws zoo li no: "qab zib poob qis thiab txhua leeg mob"
Kev mob hauv txhais ceg cov leeg ntshav qab zib
Kev tshwm sim ntawm cov leeg mob yog txuam nrog qib ntawm cov ntshav qab zib ntau ntxiv, thaum hyperglycemia ua rau qhov mob qis qis thiab cuam tshuam kev ua haujlwm ntawm analgesics. Feem ntau cov tsos mob hnov mob zuj zus zuj zus, nrog rau kev txhim kho cov tsos mob ntshav qab zib.
Tsis tshua muaj, mob hnyav tshwm sim zoo thiab muaj nrog kev ntxhov siab txog kev pw tsaug zog, kev ntxhov siab, tsis qab los thiab tus nqi sai sai ntawm kev poob phaus. Cov chaw kho mob zoo li no tshwm sim nrog mob ntshav qab zib ntev thiab tsis paub txog qhov tseem ceeb, ntxiv rau yog tias tus neeg mob tsis raug kho.
Cov tsos mob tej zaum yuav tshwm sim thaum pib kho mob ntshav qab zib, lawv tshwm sim los ntawm txoj kev no:
- Qhov mob yog yam ntxwv, khaus, hlawv.
- Feem ntau pib los ntawm txhais taw thiab nce mus rau ntawm lub duav, qee zaum los ntawm qhov pib heev rau cov leeg ntawm anterior saum npoo ncej puab mob.
- Kev txwv ntawm kev txav yog txuam nrog cov tsos mob mob thiab mob leeg tsis muaj zog.
Hauv cov xwm txheej zoo li no, qhov feem pua ntawm cov piam thaj hauv lub cev yuav tsum raug txo, thiab kev ruaj khov ntawm cov piam thaj kom tiav tiav.
Kev mob nqaij thiab mob ib ce txhawm rau hmo ntuj, thaum so, rau cov neeg mob ntshav qab zib, mob caj dab kuj yog yam ntxwv - zoo nkaus li nqig, loog, ceg yuav tuaj yeem tsis tuaj yeem nrov nrov, nrov nrov. Feem ntau cov feem ntau, plab hlaub cov leeg muaj kev cuam tshuam, tsawg dua cov poj niam fem thiab sab caj npab.
Hauv cov xwm txheej hnyav, qhov mob pib thoob plaws lub cev, hypersthesia, hauv qhov ntawd txawm tias qhov kov ntawm ib daim ntawv ua rau mob hnyav thiab kub. Thaum kuaj xyuas cov neeg mob zoo li no, poob qis rau txoj kev rov qab mob leeg dua, yog li ntawd qhov kev txo qis ntawm txhua yam rhiab - nruj, kev tshee, kev hnov mob thiab qhov chaw. Nyob rau theem no, mob ntshav qab zib ua ko taw nce qib.
Ib qho kev kawm uas txo cov ntshav qab zib tuaj yeem ua rau muaj teeb meem xws li ntshav qab zib ntshav qab zib. Txij li cov piam thaj yog qhov tseem ceeb ntawm cov khoom noj rau lub cev ntawm lub paj hlwb, thaum nws pib poob, neuroglycopenic tshwm sim:
- Txo dua kev nthuav dav, ntshai, plawv dhia sai.
- Mob taub hau thiab kiv taub hau.
- Kev qoj ib ce, nkag, nqaij hauv lub cev.
- Cov leeg ua pob tw nyob rau ntau qhov chaw ntawm lub cev.
- Nqaij tsis muaj zog.
- Tsis mob hnyav cov leeg ntawm ntau qhov chaw.
Kev mob ntshav khov yog nrog los ntawm kev nce hauv cov leeg tsis muaj zog, tsis nco qab, ua kom mob huam tuaj. Yog hais tias tsis kho, tus neeg mob poob rau hauv lub plawv dhia tsis ua pa tsis nco qab.
Kev kho mob caj pas mob hauv cov neeg mob ntshav qab zib
Txog kev kho mob ntawm myalgia, peb cov lus qhia tau siv: kev them nyiaj mob ntshav qab zib, kev kho mob nrog cov tshuaj pleev xim thiab kev kho kom rov zoo li qub rau cov leeg hlab ntsha thiab cov hlab ntsha.
Kev them nyiaj ntawm ntshav qab zib yog ua raws li kev noj haus kev kho kom haum thiab ruaj khov ntawm cov piam thaj. Hauv qhov no, kev saib xyuas tas li ntawm cov piam thaj thoob plaws ib hnub, nrog rau kev kawm txog glycated hemoglobin, yog qhov tseem ceeb. Txoj kev kho yog nqa tawm nyob rau hauv xws li txoj hauv kev los tiv thaiv kev nce siab sai ntawm ntshav qab zib.
Rau qhov no, kev noj haus muaj cov txwv tsis pub muaj cov ntsiab lus carbohydrate nrog rau kev ua kom tiav ntawm sucrose thiab qib siab cov hmoov nplej cov khoom lag luam. Nws kuj tseem pom zoo kom txo qis kev noj ntawm cov nqaij, tshwj xeeb tshaj yog cov nqaij rog thiab cov nqaij mos, kom cais tawm cov cawv.
Kev tshem tawm ntawm qhov mob tshwm sim yog nqa tawm los ntawm cov tshuaj tsis siv tshuaj, uas suav nrog:
- Galvanization.
- Tshuaj electrophoresis.
- Darsonvalization.
- Laser Kho
- Kev phais mob decompression ntawm lub qab haus huv.
- Hlau nplaum kho.
- Kev siv hluav taws xob kev siv los ntawm sinusoidally hloov qhov tam sim no.
Ib qho yeeb yaj kiab ntawm kev kho mob nrog mob ntshav qab zib yog qhov tsis muaj txiaj ntsig ntawm cov tshuaj loog yooj yim thiab cov tshuaj uas tsis yog tshuaj steroidal. Yog li, cov tshuaj tiv thaiv kab mob hlwb, tshuaj tua kab mob, opioid analgesics thiab cov tshuaj loog hauv zos yog siv rau kev kho.
Anticonvulsants daws qhov mob vim qhov thaiv ntawm sodium channel thiab maj mam kis ntawm cov mob impulses. Cov tshuaj hauv qab no yog siv: Finlepsin, Gabapentin, Pregabalin.
Qhov tshuaj tiv thaiv zoo tshaj plaws rau kev txo qis mob yog amitriptyline. Nws yog siv hauv qhov ntau thiab tsawg. Vim tias muaj kev mob tshwm sim, kev ceev faj yuav tsum tau siv rau hauv cov neeg mob ntshav liab, lub plawv tsis ua haujlwm, mob txha caj dab. Hauv cov neeg mob laus, tricyclic antidepressants tuaj yeem ua rau gait tsis khov, tsis meej pem.
Opioid analgesics yog siv rau hauv qee qhov xwm txheej tsis tshua mob nrog qhov mob ua ntu zus thiab mob hnyav vim tias muaj kev txhim kho ntawm lub hlwb thiab lub cev. Tramadol feem ntau yog siv, uas yog cov quav tshuaj tsawg dua. Feem ntau cov feem ntau, nws siv yuav ua rau orthostatic hypotension, kiv taub hau.
Kev kho mob hauv zos yog nqa nrog plasters thiab tshuaj pleev nrog lidocaine (Versatis), Capsaicin, uas muaj peev xwm ua kom tsis muaj qhov tsis zoo ntawm tus neeg sib kho ntawm qhov xaus ntawm cov leeg ntshav ntawm lub cev thiab yuav pib nce qhov mob thiab kub hnov ntawm qhov chaw ntawm daim ntawv thov.
Txhawm rau kom rov ua txoj haujlwm ntawm cov hlab ntsha uas tau puas lawm, cov tshuaj hauv qab no yog siv:
- Thioctic acid: Berlition, Espa-Lipon, Thiogamma, Dialipon.
- Benfotiamine, Cyanocobalamin.
- Qhov tsis tau loj hlob ntawm paj hlwb - Neurophazole.
- Alpha reductase inhibitor - Avodart.
- Protein kinase inhibitors - Nexavar, Txau, Tasigna.
- Composite vitamin npaj - Neurorubin, Milgamma.
Cov tshuaj uas cuam tshuam rau neuromuscular conduction thiab kev rov qab ntawm cov hlab ntaws siv tau tsawg kawg ib hlis, raws li cov txheej txheem rov ua dua qeeb, tshwj xeeb tshaj yog muaj mob ntshav qab zib thiab carbohydrate thiab rog metabolism.
Nws kuj tseem pom zoo rau kev tiv thaiv kev nce qib ntawm cov leeg mob hauv cov txheej txheem txhua hnub kom suav nrog kev teeb tsa ntawm kev tawm dag zog, txiav kev haus luam yeeb, uas nce vascular spasm thiab cuam tshuam cov ntshav mus rau cov nqaij mos. Daim vis dis aus hauv tsab xov xwm no hais txog cov tsos mob tseem ceeb ntawm ntshav qab zib.
