Sengoli: Lewis Jackson
Letsatsi La Creation: 7 Mots’Eanong 2021
Ntlafatsa Letsatsi: 10 November 2024
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Litaba

Primary progressive multiple sclerosis (PPMS) ke o mong oa mefuta e mene ea multiple sclerosis (MS).

Ho ea ka National Multiple Sclerosis Society, hoo e ka bang karolo ea 15 lekholong ea batho ba nang le MS ba fumana lefu la PPMS.

Ho fapana le mefuta e meng ea MS, PPMS e tsoela pele ho tloha qalong ntle le ho khutlela morao haholo kapa ho hlakoloa. Le ha lefu lena hangata le tsoela pele butle mme ho ka nka lilemo ho le fumana, hangata le lebisa mathateng a ho tsamaea.

Ha ho na sesosa se tsebahalang sa MS. Leha ho le joalo, kalafo tse ngata li ka thusa ho thibela tsoelo-pele ea matšoao a PPMS.

Meriana ea PPMS

Bongata ba lithethefatsi tse teng tsa MS li etselitsoe ho laola ho ruruha le ho fokotsa palo ea ho khutlela morao.

Leha ho le joalo, PPMS e baka ho ruruha ho fokolang haholo ho feta ho khutla hape-ho ntša multiple sclerosis (RRMS), mofuta o tloaelehileng oa MS.

Ntle le moo, leha ho ka ba le likhato tse nyane tsa ntlafatso ka linako tse ling, PPMS ha e na litlolo.

Hobane ho ke ke ha khoneha ho noha tsoelo-pele ea PPMS ho mang kapa mang ea nang le eona, ho thata ho bafuputsi ho lekola katleho ea moriana nakong ea lefu lena. Leha ho le joalo, ho tloha ka 2017, sethethefatsi se seng sa PPMS se amohetse tumello ho tsoa ho Tsamaiso ea Lijo le Lithethefatsi (FDA).


Ocrelizumab (Ocrevus)

Ocrelizumab (Ocrevus) ke tumello ea FDA ea ho alafa PPMS le RRMS ka bobeli.

Ke antibody e monoclonal e senyang lisele tse itseng tsa B tsa immune system. Lipatlisiso li fana ka maikutlo a hore lisele tsa B li ikarabella ho senya boko le lisele tsa mokokotlo tsa batho ba nang le MS. Tšenyo ena e lumelloa ke sesole sa 'mele ka boeona.

Ocrelizumab e tsamaisoa ka ho tšeloa ka methapo. Li-infusions tse peli tsa pele li tsamaisoa ka libeke tse 2 ka thoko. Lits'oaetso tsa morao li fuoa likhoeli tse ling le tse ling tse 6.

Kalafo ea li-stem

Morero oa ho sebelisa lisele tsa methapo ho alafa PPMS ke ho khothaletsa sesole sa 'mele ho lokisa tšenyo le ho fokotsa ho ruruha tsamaisong ea methapo e bohareng (CNS).

Bakeng sa ts'ebetso e tsejoang ka hore ke hematopoietic stem cell transplantation (HSCT), lisele tsa stem li bokelloa ho tsoa liseleng tsa motho, joalo ka moko oa masapo kapa mali, ebe li khutlisoa hape kamora hore sesole sa 'mele sa bona se hatelloe. Sena se etsoa maemong a sepetlele mme hajoale e amoheloa ke FDA.


Leha ho le joalo, HSCT ke ts'ebetso e kholo e nang le litla-morao tse tebileng. Liphuputso tse ling le liphetho tse tsoang litekong tsa bongaka li hlokahala pele sena e ka ba kalafo e sebelisoang haholo ho PPMS.

Liteko tsa bongaka

Liteko tse 'maloa tsa bongaka li ntse li tsoela pele ho batho ba nang le PPMS. Liteko tsa bongaka li feta mekhahlelo e mengata pele li fumana tumello ea FDA.

Mokhahlelo oa I o shebane le hore na moriana o bolokehile hakae ebile o kenyelletsa sehlopha se fokolang sa bankakarolo.

Nakong ea karolo ea II, bafuputsi ba ikemiselitse ho fumana hore na moriana o sebetsa hantle hakae maemong a mang a kang MS.

Karolo ea III hangata e kenyelletsa sehlopha se seholo sa bankakarolo.

Bafuputsi ba boetse ba sheba batho ba bang, litekanyo, le metsoako ea lithethefatsi ho fumana lintlha tse ling mabapi le hore na sethethefatsi se bolokehile ebile se sebetsa hantle hakae.

Asiti Lipoic

Boithuto ba mokhahlelo oa II oa lilemo tse peli hajoale bo ntse bo lekola asiti ea molomo ea antioxidant lipoic. Bafuputsi ba ntse ba ithuta hore na e ka boloka ho sisinyeha le ho sireletsa boko ho feta sebaka sa "placebo" se sa sebetseng ka mefuta e tsoelang pele ea MS.


Phuputso ena e haha ​​holima thuto ea pejana ea II e neng e shebile batho ba 51 ba nang le MS (SPMS) ea bobeli bo tsoelang pele. Bafuputsi ba fumane hore lipoic acid e khona ho fokotsa sekhahla sa tahlehelo ea lisele tsa boko ha e bapisoa le placebo.

Biotin e phahameng

Biotin ke karolo ea sebopeho sa vithamine B mme e nka karolo kholong ea sele le metabolism ea mafura le liasiti tsa amino.

Phuputso e shebiloeng e hira batho ba nang le PPMS ba ntseng ba nka tekanyetso e phahameng ea biotin (300 milligrams) letsatsi le letsatsi. Bafuputsi ba batla ho bona hore na e ea sebetsa ebile e bolokehile ho fokotsa tsoelo-pele ea bokooa ho batho ba nang le PPMS. Liphuputsong tsa ho shebella, bafuputsi ba lekola barupeluoa ntle le ho kenella ts'ebetsong.

Phuputso e 'ngoe ea mokhahlelo oa boraro e lekola tlhahiso e phahameng ea biotin e tsejoang e le MD1003 ho bona hore na e sebetsa hantle ho feta sebaka sa placebo. Bafuputsi ba batla ho tseba hore na e ka fokotsa bokooa ba batho ba nang le MS e tsoelang pele, haholo-holo ba nang le bofokoli ba gait.

Teko e nyane e bulehileng e shebileng litlamorao tsa biotin e nang le lethal dose ho batho ba nang le PPMS kapa SPMS. Tekanyo e ne e tloha ho limiligrama tse 100 ho isa ho tse 300 ka letsatsi likhoeli tse 2 ho isa ho tse 36.

Barupeluoa tekong ena ba bonts'itse ntlafatso ea bofokoli ba pono bo amanang le kotsi ea methapo ea mahlo le matšoao a mang a MS, joalo ka ts'ebetso ea makoloi le mokhathala.

Leha ho le joalo, phuputso e 'ngoe e fumane hore biotin ea tekanyetso e phahameng e batla e imenne habeli sekhahla sa ho khutlela morao ho bankakarolo ba PPMS.

Hape o hlokomelisitse hore tekanyetso e phahameng ea biotin e ka lebisa liphethong tse sa nepahalang tsa labor bakeng sa batho ba nang le maemo a itseng, ho kenyeletsoa le MS.

Masitinib (AB1010)

Masitinib ke sethethefatsi sa molomo sa ho itšireletsa mafung se entsoeng joalo ka kalafo ea PPMS.

Kalafo e se e bontšitse tšepiso tekong ea karolo ea II. Hajoale e ntse e etsoa lipatlisiso phuputsong ea mokhahlelo oa III ho batho ba nang le PPMS kapa SPMS e sa khutleng.

Ibudilast

Ibudilast e thibela enzyme e bitsoang phosphodiesterase. E sebelisoa e le meriana ea asthma haholo-holo Asia, e boetse e bontšitsoe ho khothaletsa ho lokisoa ha myelin le ho thusa ho sireletsa lisele tsa methapo tšenyo.

Ibudilast o ile a fuoa lebitso la FDA la pina e potlakileng. Sena se ka potlakisa nts'etsopele ea sona ea kamoso e le kalafo e ka bang teng bakeng sa MS e tsoelang pele.

Liphetho tsa teko ea mohato oa II ho bakuli ba 255 ba nang le MS e tsoelang pele li phatlalalitsoe ho The New England Journal of Medicine.

Thutong, ibudilast e ne e amahanngoa le tsoelo-pele e fokolang ea boko ba boko ho feta sebaka sa placebo. Leha ho le joalo, e boetse e lebisitse ho litheko tse phahameng tsa litla-morao tsa sistimi ea tšilo ea lijo, hlooho e bohloko le khatello ea maikutlo.

Phekolo ea tlhaho le e tlatselletsang

Mefuta e meng ea kalafo ntle le meriana e ka thusa ho ntlafatsa tšebetso le boleng ba bophelo leha litlamorao tsa lefu lena li le teng.

Phekolo ea mosebetsing

Kalafo ea mosebetsing e ruta batho litsebo tseo ba li hlokang ho itlhokomela lapeng le mosebetsing.

Lingaka tsa mosebetsi li bontša batho mokhoa oa ho boloka matla a bona, hobane PPMS hangata e baka mokhathala o feteletseng. Li boetse li thusa batho ho fetola mesebetsi ea bona ea letsatsi le letsatsi le mesebetsi ea lapeng.

Lingaka li ka fana ka maikutlo a mekhoa ea ho ntlafatsa kapa ho nchafatsa matlo le libaka tsa mosebetsi ho etsa hore li fihlellehe habonolo ho batho ba nang le bokooa. Ba kanna ba thusa ho sebetsana le mathata a memori le kelello.

Phekolo ea 'mele

Lingaka tsa 'mele li sebetsa ho theha mekhoa e ikhethileng ea boikoetliso ho thusa batho ho eketsa ho sisinyeha ha bona, ho boloka motsamao oa bona, le ho fokotsa botsitso le ho thothomela.

Lingaka tsa 'mele li ka khothaletsa lisebelisoa ho thusa batho ba nang le PPMS ho potoloha hantle, joalo ka:

  • Likoloeana tsa batho ba holofetseng
  • batsamaya ka maoto
  • melamu
  • scooter

Bolwetse ba puo ya puo (SLP)

Batho ba bang ba nang le PPMS ba na le bothata ba puo ea bona, puo ea bona kapa ho metsa. Litsebi tsa mafu li ka ruta batho mokhoa oa ho:

  • lokisa lijo tse bonolo ho koenyeha
  • ja ka polokeho
  • sebelisa liphaephe tsa phepo hantle

Ba kanna ba khothaletsa lithuso tse thusang tsa mohala le li-amplifi tsa puo ho etsa hore puisano e be bonolo.

Ho ikoetlisa

Mekhoa ea ho ikoetlisa e ka u thusa ho fokotsa botsitso le ho boloka motsamao o fapaneng. U ka leka yoga, ho sesa, ho ikotlolla, le mefuta e meng e amohelehang ea boikoetliso.

Ha e le hantle, kamehla ke khopolo e ntle ho buisana ka mokhoa leha e le ofe o mocha oa boikoetliso le ngaka ea hau.

Phekolo e tlatsanang le e meng (CAM)

Phekolo ea CAM e nkuoa e le kalafo e sa sebetseng. Batho ba bangata ba kenyelletsa mofuta o mong oa kalafo ea CAM e le karolo ea taolo ea bona ea MS.

Ho na le lipatlisiso tse fokolang haholo tse lekolang polokeho le katleho ea CAM ho MS. Empa liphekolo tse joalo li etselitsoe ho thusa ho thibela lefu lena ho senya tsamaiso ea hau ea methapo le ho boloka bophelo bo botle e le hore 'mele oa hau o se ke oa utloa litlamorao tsa lefu lena.

Ho ea ka phuputso e 'ngoe, litlhare tsa CAM tse ts'episang haholo bakeng sa MS li kenyelletsa:

  • lijo tse se nang mafura a mangata
  • omega-3 fatty acid e tlatselletsa
  • lipoic acid e tlatselletsa
  • vithamine D e tlatsetsa

Bua le ngaka ea hau pele u kenya CAM leanong la hau la kalafo, 'me u netefatse hore u tsoelapele ho latela litlhare tseo u li filoeng.

Ho phekola matšoao a PPMS

Matšoao a tloaelehileng a MS ao u ka bang le ona a kenyelletsa:

  • mokgathala
  • ho hloka kutlo
  • bofokoli
  • ho tsekela
  • ho senyeha ha kelello
  • bokgabane
  • bohloko
  • ho se leka-lekane
  • mathata a moroto
  • maikutlo a fetoha

Karolo e kholo ea moralo oa hau oa kalafo e tla ba ho sebetsana le matšoao a hau. U kanna ua hloka meriana e fapaneng, phetoho ea bophelo, le kalafo e tlatselletsang ho etsa sena.

Meriana

Ho latela matšoao a hau, ngaka e ka 'na ea fana ka litaelo tse latelang:

  • mesifa e khathollang
  • ho imeloa kelellong
  • meriana ea ho se sebetse ha senya
  • meriana ea ho fokotsa mokhathala, joalo ka modafinil (Provigil)
  • meriana ea bohloko
  • lithuso tsa ho robala ho thusa ho hlobaela
  • meriana e thusang ho sebetsana le ho se sebetse ha erectile (ED)

Liphetoho bophelong

Liphetoho tsena tsa bophelo li ka etsa hore matšoao a hau a laolehe haholoanyane:

  • Ja lijo tse matlafatsang tse nang le livithamini, liminerale le li-antioxidants.
  • Etsa boikoetliso ba ho aha matla ho aha mesifa le ho matlafatsa matla.
  • Leka ho ikoetlisa ka bonolo le mananeo a otlollang joaloka tai le yoga ho thusa ka ho leka-lekana, ho fetoha le maemo le ho hokahana.
  • Boloka kemiso e loketseng ea ho robala.
  • Laola khatello ea maikutlo ka ho silila, ho thuisa kapa ho hlaba ka linalete.
  • Sebelisa lisebelisoa tse thusang ho ntlafatsa bophelo.

Tlhabollo

Morero oa tlhabollo ke ho ntlafatsa le ho boloka ts'ebetso le ho fokotsa mokhathala. Sena se ka kenyelletsa:

  • kalafo ya mmele
  • kalafo ea mosebetsing
  • tsosoloso ea kutloisiso
  • bolwetse ba puo
  • tlhabollo ea mosebetsi oa matsoho

Kopa ngaka ea hau hore e u romelle ho litsebi tse libakeng tsena.

Tsa Tsau-tsau

PPMS ha se mofuta o tloaelehileng oa MS, empa bafuputsi ba bangata ba ntse ba batlisisa mekhoa ea ho phekola boemo bona.

Kamohelo ea 2017 ea ocrelizumab e tšoaea mohato o moholo ho ea pele hobane e lumelloa bakeng sa pontšo ea PPMS. Mefuta e meng ea kalafo e hlahang, joalo ka li-anti-inflammatories le biotin, e fumane litholoana tse fapaneng ho PPMS ho fihlela joale.

Ibudilast e boetse e ithutiloe bakeng sa litlamorao tsa eona ho PPMS le SPMS. Liphetho tsa morao-rao tse tsoang tekong ea mohato oa II li bonts'a hore li baka litlamorao tse ling, ho kenyeletsoa le khatello ea maikutlo. Leha ho le joalo, e ne e boetse e amahanngoa le sekhahla se tlase sa boko ba boko.

Bua le ngaka ea hau haeba u batla tlhaiso-leseling ea morao-rao ka mekhoa e metle ea ho tsamaisa PPMS ea hau.

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