Kev kawm ntawm cov phaus ntxiv yog qhov kev txhawj xeeb heev rau cov neeg muaj ntshav qab zib. Coob leej ntau tus paub tias los ntawm kev txo qhov hnyav, lawv tuaj yeem txhim kho lawv tus mob. Yog tsis muaj kev pab ntawm tus kws tshaj lij, thiab tsis yog txhua tus muaj peev xwm them nws, nrhiav kev noj haus kom zoo thiab nyab xeeb rau kev poob phaus yog qhov nyuaj, yog li tib neeg tab tom nrhiav txoj hauv kev yooj yim thiab mob siab rau kev noj tshuaj. Lub caij no, qhov kev teem caij ywj pheej ntawm cov tshuaj no yog fraught nrog kev muaj mob txaus ntshai. Peb hais kom peb tus kws paub txog endocrinologist Olga Pavlova tham ntau ntxiv txog "kev noj tshuaj noj haus."
Tus kws kho mob endocrinologist, kws kho mob ntshav qab zib, tus kws noj zaub mov noj zaub mov, kws qhia noj haus kev ua kis las Olga Mikhailovna Pavlova
Kawm tiav los ntawm Novosibirsk State Medical University (NSMU) nrog kev kawm tiav qib General tshuaj nrog kev hwm
Nws kawm tiav nrog kev hwm los ntawm chaw nyob hauv endocrinology ntawm NSMU
Nws kawm tiav nrog kev qhuas los ntawm Tshwj Xeeb Dietology ntawm NSMU.
Nws dhau mus ua haujlwm kev saib xyuas yav dhau los hauv Kev Ua Si Dietology ntawm Lub Tsev Kawm Txuj Ci Dag Zog thiab Kev Ua Si ntawm Lub Cev hauv Moscow.
Kis dhau kev kawm kev cob qhia rau lub hlwb ntawm kev hnyav dhau.
Mob ntshav qab zib mellitus yog kev ua txhaum ntawm cov metabolism hauv cov metabolism, thiab nrog lub cev tsis txaus, nce hauv qhov hnyav yog qhov yooj yim heev, tshwj xeeb tshaj yog muaj cov tshuaj tiv thaiv insulin thiab hyperinsulinemia, uas yog, muaj ntshav qab zib hom 2. Cov neeg muaj ntshav qab zib hom 1 feem ntau yog cov rog dhau. Nrog rau cov ntshav qab zib 1, kev kho insulin tas mus li thiab kev noj zaub mov tsis zoo tuaj yeem ua rau lub ntsej muag ntshav qab zib (ntshav qab zib), yog li cov neeg mob, ntshai tsam tus mob no, ntau dhau hwv, thiab ntau dhau los tiv thaiv keeb kwm ntawm insulin txoj kev kho yog txoj hauv kev rau kev rog dhau.
Feem ntau, cov neeg mob ntshav qab zib mellitus ntawm kev txais tos yws tias kev noj zaub mov tsis zoo thiab kev noj zaub mov tsis pab, thiab xav kom lawv sau tshuaj noj "cov ntsiav tshuaj noj", feem ntau hais ntxiv: "Cov tshuaj yog zoo li no thiab (lub npe), kuv tus hluas nkauj tau poob 10-20-30 kg rau lawv thiab kuv xav tau nws heev. " Cov neeg feem coob tsis xav txog qhov tseeb tias cov tshuaj siv rau qhov poob phaus, tshwj xeeb tshaj yog cov tshuaj muaj zog, muaj lawv tus kheej qhia, tsis pom tseeb, ua haujlwm thiab cov kev mob tshwm sim, uas nyob rau hauv cov neeg mob ntshav qab zib tuaj yeem tshwm sim, yam muaj zog. Thiab cov ntsiav tshuaj zoo kawg uas, uas tus neeg mob tus ntxhais tau poob thiab qhov uas tus neeg mob xav tau heev, tuaj yeem tsim kev puas tsuaj rau peb tus neeg mob.
Niaj hnub no peb yuav tham txog cov tshuaj kom poob phaus.
Yog tias peb xav txog cov qauv kev kho mob rau kev kho kev rog, tom qab lub sijhawm 4 pawg ntawm cov tshuaj raug cai siv los txo lub cev qhov hnyav hauv Lavxias. Hauv tsab xov xwm no, Kuv tsis xav txog kev noj zaub mov noj thiab tshuaj kis las - peb tsuas yog tham txog cov tshuaj noj uas pom zoo nrog cov nyhuv pov thawj.
TSEEM CEEB! Cov tshuaj noj rau qhov poob phaus muaj ntau yam kev tiv thaiv thiab kev mob tshwm sim thiab tsuas yog kho los ntawm kws kho mob tom qab kuaj xyuas tag nrho ntawm lub cev.
Txij li thaum mob ntshav qab zib mellitus, txawm hais tias nws yog hom 1 mob ntshav qab zib lossis hom 2 mob ntshav qab zib, cov teeb meem tuaj yeem tshwm sim los ntawm lub raum (mob ntshav qab zib nephropathy), kev mob plawv thiab lub plab hnyuv (ua kom mob ntshav qab zib), tom qab ntawd koj yuav tsum tau kuaj xyuas kom zoo dua ua ntej sau tshuaj kom txo qhov hnyav. dua li cov neeg mob uas tsis muaj ntshav qab zib.
Plaub pawg tseem ceeb ntawm cov tshuaj rau poob phaus
1. Kev ua yeeb yaj kiab hauv nruab nrab - sibutramine (pauv npe Reduxin, Goldline).
Tus txheej txheem ntawm kev ua ntawm cov tshuaj: xaiv inhibition ntawm serotonin thiab norepinephrine reuptake, hauv ib feem dopamine hauv lub hlwb. Ua tsaug rau qhov no, qhov kev xav ntawm kev tshaib plab yog thaiv, thermogenesis (poob thaum tshav kub kub) ua rau muaj zog, muaj lub siab xav tshwm sim mus - peb tau khiav tawm mus rau kev qhia nrog kev lom zem.
- Cov tshuaj cuam tshuam rau cov kev xav hauv nruab siab: feem ntau muaj kev txhim kho hauv kev xav, nce siab ntawm lub zog. Qee tus neeg mob muaj kev tsim txom, muaj kev ntshai.
- Kev pw tsaug zog yog feem ntau sau tseg: tus neeg tsis xav tsaug zog, tsis tuaj yeem pw ntev ntev, thiab sawv thaum sawv ntxov.
- Sibutramine muaj ntau yam kev sib kis. (Kev ua haujlwm ntawm lub plawv, mob siab, mob hlwb) thiab ntau qhov kev phiv, yog li ntawd nws tau noj tsuas yog nyob hauv kev saib xyuas ntawm kws kho mob. Muag los ntawm cov tshuaj.
- Ntawm cov ntshav qab zib mellitus, sibutramine tuaj yeem pab ua rau qhov tshwm sim ntawm kev mob ntshav qab zib (ntshav qab zib hauv lub cev) vim qhov kev nce siab hauv lub cev thiab nce kev ua haujlwm hauv lub cev, yog li ntawd, thaum siv cov tshuaj, ntau dua glycemic tswj thiab, ntawm chav kawm, kho kev kho hypoglycemic ua ke nrog endocrinologist xav tau.
2. Lipase blockers - orlistat (cov npe lag luam ntawm Listat, Xenical).
Tus txheej txheem ntawm kev ua ntawm cov tshuaj: qhov thaiv ib feem ntawm cov enzymes uas zom cov rog hauv cov hnyuv. Raws li qhov tshwm sim, ib feem ntawm cov rog (kwv yees li 30%, txog 50%) yuav tsis nqus, tab sis tawm nrog cov quav, feem, peb poob ceeb thawj thiab peb cov roj cholesterol tsawg.
- Qhov tshwm sim lub ntsiab yog qhov quav tuaj yeem xoob. Yog tias peb rog dhau rog, cov rog hauv lub siab tsis yoo, yog qhov tseeb, yuav muaj mob plab zawv. Hais txog kev mob zawv plab, Kuv nyiam xau, txij li nws muaj cov quav stabilizer - cov tshuaj yog cov pos hniav, yog li cov tsos ntawm cov quav xoob thaum siv nplooj soob tsis tshua muaj.
- Cov tshuaj yog kws kho mob sau los ntawm kws kho mob, muag yam tsis muaj ntawv yuav.
- Ntawm cov ntshav qab zib mellitus, cov tshuaj tau nthuav meej meej vim nws lub peev xwm los txo cov roj ntshav siab (vim tias cov neeg mob ntshav qab zib feem ntau raug kev txom nyem los ntawm cov roj (cholesterol)), zoo li yog vim lawv txoj haujlwm me me (nws ua haujlwm hauv lub lumen ntawm lub plab zom zaub mov tsis muaj teebmeem kev cuam tshuam ( ncaj qha cuam tshuam) ntawm cov hlab ntsha, raum, lub plawv, uas yog, muaj kev nyab xeeb).
Cov lipase blockers tuaj yeem siv rau mob ntshav qab zib thiab hom 1 thiab 2.
3. Cov npe ntawm GLP-1 (glucagon-zoo li peptide-1) - liraglutide (cov npe lag luam Saksenda - cov tshuaj uas rau npe rau kev kho mob rog, thiab Victoza - tib yam liraglutide sau npe rau kev kho mob ntshav qab zib mellitus hom 2).
Tus txheej txheem ntawm kev ua ntawm cov tshuaj: liraglutide - ib qho piv txwv ntawm peb cov roj ntsha plab hnyuv muaj zog ntxiv (cov tshuaj ntawm GLP 1), uas yog ua tom qab noj mov thiab thaiv kev tshaib kev nqhis (feem ntau yog tom qab peb tsis xav noj cov khoom noj muaj roj thiab qab zib), txawm tias tawm ntshav qab zib thiab txhim kho cov metabolism.
- Ntawm cov tshuaj no, cov neeg mob xav tias tag nrho, lawv cov nqaj rau cov rog thiab qab zib yog sim.
- Cov tshuaj pab ua kom lub cev yuag vim yog rog vim rog hauv plab, uas yog, peb poob ceeb thawj hauv lub duav. Tom qab siv cov tshuaj, daim duab hloov mus rau qhov zoo nkauj.
- Cov tshuaj ua haujlwm rau txhua qhov hnyav - tsawg kawg 120 kg, tsawg kawg 62 - nyob rau hauv txhua kis, yog tias koj xaiv txoj cai noj tshuaj thiab kho cov zaub mov kom tsawg, cov nyhuv yuav haum.
- Cov tshuaj yog muaj zog, tab sis kim thiab muaj contraindications, qhov tseem ceeb ua rau mob taub hau mob, mob raum thiab mob siab.
- Lub ntsiab cuam tshuam yog qhov xav me ntsis ntawm xeev siab. Yog tias, ntawm keeb kwm ntawm kev noj liraglutide, koj tau noj cov rog lossis qab zib, tshwj xeeb tshaj yog nyob rau yav tsaus ntuj, koj tuaj yeem hnov mob heev, txawm tias ntuav. Qee tus neeg mob nyiam cov nyhuv no - lawv ntuav peb zaug, Kuv tsis xav ua txhaum kev noj haus ntxiv lawm.
- Cov tshuaj yog kws kho mob sau los ntawm kws kho mob, muag yam tsis muaj ntawv yuav. Cov koob tshuaj yog xaiv nkaus xwb los ntawm kws kho mob - nws nyuaj heev rau nws tus kheej xaiv koob tshuaj.
- Thaum noj cov tshuaj, lub xeev ntawm lub siab, lub raum thiab lwm qhov tsis xws luag (saib xyuas los ntawm tus kws kho mob, biochemical thiab kev kuaj mob hauv cov ntshav yuav tsum tau kuaj tsis tseg), vim tias qhov tshuaj muaj zog.
- Rau cov neeg mob ntshav qab zib, Lyraglutide thiab nws cov analogues tau nthuav tias qhov lawv cuam tshuam txog theem ntawm glycemia (ntshav qab zib) yog qhia ntau npaum li ntawm qhov hnyav. Yog li, cov tshuaj no yog ib cov tshuaj uas nyiam tshaj plaws hauv cov neeg mob ntshav qab zib hom 2. Nrog ntshav qab zib hom 1 tsis raug siv!
4. Feem ntau hauv kev kho mob rog, yog tias nws nrog tus mob insulin tsis kam, uas tsuas yog yam mob ntshav qab zib hom 2, tshuaj tau siv metformin (pauv npe Siofor, Glucofage).
Insulin tsis kam yog pom nyob rau hauv 80-90% ntawm cov neeg mob rog, yog li ntawd, cov tshuaj no feem ntau siv hauv kev kho mob rog rog txawm tias cov neeg mob tsis muaj ntshav qab zib.
Cov txheej txheem ntawm kev txiav txim ntawm metformin: nce rhiab heev rau insulin, txhim kho metabolism hauv lub cev thiab ua kom cov kab mob microbiota (microflora nyob hauv lub plab zom mov). Vim qhov no, lub cev qhov hnyav tsawg dua me ntsis thiab qab zib yog li qub. Yog tias ntshav qab zib tsis txaus, nws yuav tsis hloov pauv. Yog tias cov suab thaj nce ntxiv, lawv yuav nqis me ntsis.
- Lub ntsiab lus tseem ceeb rau kev noj cov tshuaj metformin yog qhov ua rau lub siab, mob raum, ntshav tsis txaus, thiab mob plawv heev.
- Cov kev mob tshwm sim tseem ceeb yog xoob xoob thaum thawj hnub thiab, nrog siv sijhawm ntev, yog qhov tsis txaus B vitamins (yog tias peb haus cov tshuaj metformin ntev, peb siv cov vitamins B nyob rau 2 zaug hauv ib xyoos).
- Cov tshuaj yog kws kho mob sau los ntawm kws kho mob, muag yam tsis muaj ntawv yuav.
Cov tshuaj no tuaj yeem siv ob qho tib si thiab hauv kev sib xyaw nrog lwm tus thiab nrog lwm pab pawg siv tshuaj (rau kev kho mob ntshav qab zib mellitus, txhawm rau txhim kho txoj haujlwm ntawm nplooj siab, raum, thiab tshuaj ntsuab).
Kev sib xyaw zoo yog tau nrog kev sib txuam nrog tshuaj los txo qhov hnyav nrog detox, sorbents, tshuaj los txhim kho daim siab ua haujlwm.
Cov tshuaj twg xaiv rau qhov poob phaus hauv T1DM, thiab hom twg rau T2DM?
Nrog ntshav qab zib hom 1 cov tshuaj hauv nruab nrab thiab lipase blockers muaj ntau dua. Metformin tsis yog siv rau cov ntshav qab zib 1, vim ib qho ntawm nws cov kev ua tseem ceeb tshaj plaws yog kev kho mob ntawm cov tshuaj insulin, thiab nws tsis tshua muaj rau ntshav qab zib 1. Cov tshuaj ntawm GLP 1 nrog ntshav qab zib 1 tsis siv.
Nrog DM 2 analogues ntawm GLP 1 thiab metformin yog qhov zoo dua (vim tias peb ua haujlwm nrog ob qho tshuaj tiv thaiv insulin thiab qhov hnyav). Tab sis centrally ua yeeb tshuaj thiab lipase blockers kuj tseem siv tau, uas yog, nrog hom 2 ntshav qab zib muaj kev xaiv ntau dua ntawm cov tshuaj.
Kev sib xyaw cov tshuaj xaiv los ntawm tus kws kho mob tom qab kuaj tag nrho!
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Kev noj qab haus huv, kev zoo nkauj thiab kev zoo siab rau koj!
