There is no cure for MCAS. Nokho, kunendlela esungulwe kahle enezinyathelo eziletha izimpawu ngaphansi kokulawulwa okunengqondo kwenani elikhulu leziguli.
Ukuphatha kwakhelwe phezu kwezinsika ezimbili - ukunciphisa lokho okucasula ama-mast cells, kanye nokuzinza ukuthi asabela kanjani kalula. Ayikho enye esebenza kahle ngaphandle komunye.
Uhlaka
Umgomo wesibili ukuthi izilingo zidinga isikhathi. Izinzinzisi ze-mast cell ikakhulukazi zingathatha amasonto ukukhombisa umphumela wazo ogcwele, futhi ukuzishiya kusenesikhathi kuyindlela evamile yokulahla okuthile obekungasebenza. Ukuhlolwa okungamaviki amane kuya kwayisithupha ngoshintsho kuyisimiso esivame ukucashunwa, nakuba isikhathi esifanele sihluka ngokwe-ejenti kanye nokwahlulela kodokotela.
Ukuphatha kwakhelwe phezu kwezinsika ezimbili - ukunciphisa lokho okucasula ama-mast cells, kanye nokuzinza ukuthi asabela kanjani kalula. Ayikho enye esebenza kahle ngaphandle komunye.
Isimiso esibusayo siwukukhuphuka kancane kancane. Ukwelashwa ngokuvamile kuqala ngezinketho ezinqunyiwe neziphansi kakhulu zobungozi, kugcina ngakunye isikhathi eside ngokwanele ukwahlulela ngokwethembeka, futhi kwengeze amanye ama-ejenti kuphela lapho kudingeka. Ukuqala imishanguzo eminingana ngasikhathi sinye kulinga lapho izimpawu zizimbi, kodwa kwenza umphumela ungachazeki - uma izinto ziba ngcono, akekho owaziyo ukuthi yiluphi ushintsho olube nesibopho, futhi uma okuthile kubangela ukusabela, akekho owaziyo ukuthi yini okufanele ayiyeke.
Isigaba sokuqala - ama-antihistamine e-H1. Izivimbeli ze-H1 zesizukulwane sesibili ziyisiqalo esijwayelekile, esikhethelwa iphrofayili yomphumela ongathandeki. Babhekana nezimpawu eziqhutshwa yi-histamine iziguli eziningi ezizibona kuqala: ukulunywa, ukushaywa umoya, ukuqunjelwa, i-rhinitis. Abanye odokotela basebenzisa imithamo engaphezu kwesilinganiso sokungezwani komzimba esivamile esifweni se-mast cell, okuyisinqumo somuntu onikezwe imithi esikhundleni sendaba yokuzilungisa.
Isigaba sesibili - ukwengeza ama-antihistamine e-H2. I-histamine isebenza ohlotsheni olungaphezu kolulodwa lwama-receptor, futhi ama-H2 receptors agxile emgudwini wamathumbu. Ukuvimba i-H1 ne-H2 ndawonye kuvame ukukhiqiza ukulawula okungcono kunokwedwa, ikakhulukazi ku-reflux, isicanucanu, kanye nezimpawu zesisu ezishiywa ama-H1 engakathintwa.
Isigaba sesithathu - ama-mast cell stabilizers. Esikhundleni sokuvimbela umphumela wabalamuli abakhululiwe, lezi zihlose ukunciphisa ukukhululwa kwasekuqaleni. I-Cromolyn sodium ne-ketotifen yizinto ezisetshenziswa kakhulu. Ayanensa ekusebenzeni, adinga amasonto okusetshenziswa okungashintshi ngaphambi kokuba inzuzo ibonakale, futhi i-cromolyn esesimweni somlomo isebenza ikakhulukazi emathunjini.
Isigaba sesine - ama-leukotriene inhibitors nama-ejenti engeziwe. Ngenxa yokuthi ama-leukotrienes anesandla ezimpawu zokuphefumula nezamathumbu ezingafinyeleli ama-antihistamine, abaphikisi be-leukotriene receptor bavame ukungezwa. Ngale kwaleli phuzu, abaphathi baya endaweni ehluka kakhulu ngesiguli kanye nochwepheshe, okuhlanganisa i-aspirin ye-prostaglandin-mediated flushing ezigulini ezikhethiwe, kanye nokwelashwa kwe-biologic njenge-omalizumab ezimweni eziphikisayo. Lezi zithwala ubungozi obuzwakalayo kanye nokuphikisana okuthile futhi zihambisana ngokuqinile nochwepheshe.
Wonke umenzeli oshiwo lapha unikezwa njengokuqondiswa kwendlela eshicilelwe - hhayi njengesincomo. Umthamo, ukulandelana, ukusebenzisana, nokufaneleka kuncike emlandweni womuntu ngamunye, kanye nezinqumo zokunquma ezikadokotela wakho.
Wonke umenzeli oshiwo lapha unikezwa njengokuqondiswa kwendlela eshicilelwe - hhayi njengesincomo. Umthamo, ukulandelana, ukusebenzisana, nokufaneleka kuncike emlandweni womuntu ngamunye, kanye nezinqumo zokunquma ezikadokotela wakho.
Iziguli zivame ukubika ukuthi ukwehlisa inani le-trigger load kuzenzela okuningi njenganoma yimuphi umuthi owodwa. Zombili zisebenza ndawonye - ukulawulwa kwemithi kuphakamisa umkhawulo, ukunciphisa i-trigger kugcina umthwalo wansuku zonke ngaphansi kwakho.
Umgomo wokupakisha kusuka Izicupha isebenza ngqo lapha. Ngoba ukwenza kusebenze kukhombisa umthwalo okhulayo, ukususa ngisho nokucasula okumbalwa okuthembekile kungakha i-headroom eyanele ukuthi ukuchayeka okuvamile kuyeke ukubangela ukusabela. Lokhu kuvame ukuvela lapho izinzuzo zakuqala eziphawuleka kakhulu.
Izinyathelo ezisebenzayo ezivelayo kuma-akhawunti esiguli zihlanganisa ukugcina izinga lokushisa lendawo lizinzile, ukukhetha imikhiqizo engenamakha, ukubeka kuqala ukudla okusha kunokudla okudala noma okugcinwa isikhathi eside, ukuvikela ukulala, nokwakha umsebenzi womzimba kancane kancane kunokuwuyeka. None of these is dramatic on its own; together they change the baseline.
Iziguli zivame ukubika ukuthi ukwehlisa inani le-trigger load kuzenzela okuningi njenganoma yimuphi umuthi owodwa. Zombili zisebenza ndawonye - ukulawulwa kwemithi kuphakamisa umkhawulo, ukunciphisa i-trigger kugcina umthwalo wansuku zonke ngaphansi kwakho.
Kuyafaneleka ukuqamba igama lesicupho ngokuqondile: kungenzeka ukunciphisa izimbangela ngobudlova kangangokuthi ukuphila kuvumelana cishe lutho. Uhlelo oluqeda ukusabela ngokuqeda umsebenzi, isikole, izinhlobonhlobo zokudla, nokuxhumana nabantu luye lwahweba uhlobo oluthile lokulimaza lwaba olunye. Umgomo impilo ebanzi kunazo zonke ezosekelwa yi-physiology yakho, hhayi impilo encane egwema izimpawu.
Kuyafaneleka ukuqamba igama lesicupho ngokuqondile: kungenzeka ukunciphisa izimbangela ngobudlova kangangokuthi ukuphila kuvumelana cishe lutho. Uhlelo oluqeda ukusabela ngokuqeda umsebenzi, isikole, izinhlobonhlobo zokudla, nokuxhumana nabantu luye lwahweba uhlobo oluthile lokulimaza lwaba olunye. Umgomo impilo ebanzi kunazo zonke ezosekelwa yi-physiology yakho, hhayi impilo encane egwema izimpawu.
Ukuphepha
Uhlelo olubhaliwe lwesenzo esiphuthumayo, okuvunyelenwe ngalo nodokotela wakho, luwumkhuba ojwayelekile. Kufanele ibeke izimpawu eziyisixwayiso ezibonakalayo, ukuthi iphathe ini futhi nini, futhi nini lapho kufanele ishayele abezimo eziphuthumayo. Amakhophi anikezwe umndeni, ozakwenu, noma abasebenzi besikole asho ukuthi abantu abaseduze nawe bangakwazi ukwenza okuthile uma ungakwazi.
Ezinye iziguli ezinesifo se-mast cell zisengozini ye-anaphylaxis - ukusabela okusheshayo, okunzima, okungase kube yingozi empilweni. Lapho lobo bungozi busebenza khona, ukuyihlela akuyona into ozikhethela yona, futhi kuyingxoxo ongaba nayo nodokotela wakho ngaphambi kokuba idingeke kunangesikhathi.
Iziguli ezibhekwa njengezisengozini ngokuvamile zinikezwa ama-epinephrine auto-injection futhi ziyalelwa ukuthi ziwathwale njalo. I-epinephrine iwumugqa wokuqala wokwelapha we-anaphylaxis; ama-antihistamine awathathi indawo yawo futhi akufanele kuthenjelwe kuwo ekuphenduleni okunzima kakhulu.
Lesi sigaba sichaza okuvamile futhi asikwazi ukumiselela uhlelo olwakhelwe emlandweni wakho. Uma ungazange uxoxe nodokotela wakho ngokuhlela izimo eziphuthumayo, leyo ngxoxo kufanelekile ukuyicela ngesikhathi sakho esilandelayo.
I-Outlook
Intuthuko kulula ukuyibona uma ikalwa. Ukulandelela imvamisa yezimpawu nobukhulu, izinsuku zomsebenzi olahlekile, nokuthi ububanzi bakho obubekezeleleka buvuleleke kangakanani kunikeza isignali ecacile kunenkumbulo eyenza - futhi inkumbulo ayithembeki kuzo zombili izinkomba ngesikhathi sokwelula okunzima.
I-MCAS yisimo esingelapheki futhi ukuphathwa kwamanje kuwuphawu kunokwelapha. Ukubeka okulindelwe ngokwethembeka ekuqaleni kwenza inqubo ibe lula kakhulu ukuyigcina.
Ukuze uthole isithombe esigcwele somtholampilo, okuhlanganisa izimpawu ngohlelo lwesitho, isimo socwaningo, nemithombo ekhonjiwe, bheka Umhlahlandlela Wezemfundo we-MCAS. Ukuze uthole ukwesekwa abantu abaphila nesimo esifanayo, yethu ziyindawo enhle yokuqala.