Hais txog tus kab mob xws li eczema, kws kho mob paub ob peb centuries ua ntej peb lub sijhawm. Tom qab ntawd cov neeg tuaj rau Greek Aesculapius thaum ub nrog kev tsis txaus siab ntawm cov tawv nqaij txawv txawv. Tus kab mob no tau koom nrog lub npe menyuam yaus "eczeo", txij li hauv kev txhais lus los ntawm Greek lo lus no txhais tau tias "to boil". Qhov tseeb tiag, cov pob khaus eczematous zoo li ntau dua li qhov kub hnyiab.
Hnub no, kwv yees li 40% ntawm cov neeg mob uas mus ntsib kws kho mob dermatologist ntsib qhov xav tau los kho eczema. Cov kab mob ntawm daim tawv nqaij no tsis yog tsuas yog tshwm sim, tab sis kuj tseem ceeb rau kev sib raug zoo. Raws li kev txheeb cais, hom kab mob dermatosis no ua rau muaj kev tsis taus ib ntus hauv peb ntawm kaum tus neeg mob.
thawj qhov uas yuav tsum nkag siab yog tias eczema yog mob ntev. Tus kab mob pib nrog relapses, uas yog hloov los ntawm luv luv los yog tsis tu ncua remissions. Qhov thib ob feature ntawm no allergic dermatosis yog tsis muaj ntaub ntawv tseeb txog nws etiological yam. Qhov tseeb, qhov no piav qhia qhov ua tsis tau ntawm ib puas feem pua kho kho los ntawm eczema.
Tsi xavNco ntsoov tias eczema tsis ua rau muaj kev phom sij rau lwm tus, vim nws tsis yog kab mob sib kis.
kab mob ntawm daim tawv nqaij zoo li cas
Pathology tuaj yeem txhim kho txhua lub hnub nyoog, suav nrog menyuam yaus. Thawj cov tsos mob ntawm tus kab mob yog profuse vesicular pob liab liab nyob rau hauv lub hyperemic cheeb tsam ntawm lub epidermis. Nyob rau hauv nws cov tsos, ib pob me me zoo li ib tug gurgling, bubbling nto.
Ob peb hnub tom qab qhov tshwm sim ntawm cov npuas qhib, tawm hauv lawv qhov chaw, lub npe hu ua "serous wells". Sai li qhov erosive weeping ntu ntawm daim tawv nqaij pib qhuav tawm, cov ntaub ntawv daj-grey crusts. Cov pob khaus nyob hauv zos thiab sib luag - qhov no yog qhov tseeb ntxiv rau kev kho mob eczema. Nyob rau hauv daim duab, cov tsos mob ntawm sab nraud manifestations yog pom meej heev. Cov txheej txheem inflammatory sab nraud yog nrog rau khaus khaus heev, kub hnyiab, mob. Lub epidermis ntawm qhib qhov chaw ntawm lub cev yog feem ntau cuam tshuam. Pib kev kho mob eczema ntawm ob txhais tes yog qhov laj thawj tshaj plaws rau kev hu rau tus kws kho mob dermatologist nyob rau lub caij nplooj zeeg-caij ntuj no thiab lub caij nplooj ntoos hlav, txij li tus kab mob no zuj zus thaum lub caij txias.
Pathogenesis
Qhov tseeb, cov pob khaus ntawm daim tawv nqaij yog tshwm sim los ntawm cov kab mob metabolic hauv lub cev. Lub hauv paus chiv keeb ntawm tus kab mob no tseem tsis to taub tag nrho. Qhov tsuas yog qhov uas cov kws tshawb fawb paub tseeb yog tias lub luag haujlwm tseem ceeb hauv kev loj hlob ntawm tus kab mob belongs rau qhov tsis ua haujlwm hauv kev ua haujlwm ntawm lub cev tiv thaiv kab mob, endocrine, hauv nruab nrab thiab autonomic paj hlwb. Txawm li cas los xij, qhov notsis txaus los pib cov txheej txheem pathological. Txhawm rau qhib cov kab mob dermatological, ib txhij ua ke ntawm ntau yam yog tsim nyog. Qhov "trigger" nyob rau hauv rooj plaub no tuaj yeem yog ib qho kev txhawb nqa sab nraud lossis sab hauv. Yog li ntawd, kev tshem tawm ntawm cov txheej txheem uas ua rau cov ntaub so ntswg deterioration yog lub hauv paus ntsiab lus ntawm kev kho eczema. Cov tsos mob thiab cov tsos mob sab nraud ntawm tus kab mob no tshwm sim tawm tsam keeb kwm ntawm cov kab mob hauv qab no hauv lub cev:
- qaug zog tiv thaiv kab mob.
- Ntau qib ntawm cov neeg kho mob inflammatory.
- Sensitization ntawm lub cev.
- Tsis muaj kev sib npaug hauv lub siab xav thiab parasympathetic innervation ntawm epidermis.
- Kev hloov pauv hauv cov protein thiab cov rog metabolism, tus cwj pwm los ntawm kev txo qis hauv cov protein thiab nce cov roj cholesterol.
- inhibition ntawm cov khoom antioxidant ntawm erythrocytes thiab plasma.
- tsis ua tiav ntawm pituitary-adrenal system.
Nyob rau hauv thawj qhov txuas ntawm cov saw hlau ua rau kev txhim kho dermatosis, muaj kev tiv thaiv kab mob thiab kev tsis haum tshuaj. Lawv ua rau qhov tsis muaj peev xwm ntawm daim tawv nqaij los tiv thaiv cov teebmeem ntawm exogenous thiab endogenous yam. "Kev pab" hauv qhov no yog muab los ntawm kev cuam tshuam hauv kev ua haujlwm ntawm endocrine system, metabolism, kab mob ntawm lub plab zom mov, daim siab thiab pancreas, nrog rau qhov muaj cov kab mob sib kis thiab mob foci hauv lub cev.
theem tseem ceeb
Eczema, uas tshwm sim raws li "classic" scenario, manifests nws tus kheej twb nyob rau theem erythematous. Nyob rau theem no, muajredness ntawm ib cheeb tsam ntawm daim tawv nqaij. Tsis paub txog qhov ua rau eczema, kev kho mob ntawm tes thiab lwm qhov hauv lub cev pib nrog kev siv tshuaj tiv thaiv kab mob zoo.
theem tom ntej yog vesicular. Nws yog tus cwj pwm los ntawm cov tsos ntawm cov hlwv tshwj xeeb uas muaj cov kua exudative translucent. Qhov loj ntawm cov npuas tsim tsis tshua muaj tshaj lub taub hau ntawm tus pin.
Ntxiv rau cov vesicles, papules thiab pustules tsim rau ntawm qhov chaw hyperemic. Thaum cov pob khaus pib qhib, lawv tham txog qhov pib ntawm lub caij quaj. Thaum lub stratum corneum peels tawm, me me erosive foci npog nrog cov nplais qhuav - serous crusts pom hauv qab nws.
Txawm li cas los xij, kev kho mob ntawm eczema ntawm tes (daim duab qhia pom cov tsos mob ntawm tus kab mob ntawm ib qho ntawm nws theem) tuaj yeem ua kab sib txawv. Lub luag haujlwm tseem ceeb uas cov kws tshaj lij tau teeb tsa rau lawv tus kheej yog txhawm rau txo qhov hnyav ntawm cov tsos mob. Cov neeg mob feem ntau tsis xis nyob nrog:
- khaus khaus khaus tawv nqaij ntawm cov neeg mob. Kev raug mob me me ntawm cov epidermis muaj txoj hauv kev rau kev nkag mus ntawm tus kab mob thib ob.
- Thaum lub sijhawm tshem tawm, dryness, tev thiab redness ntawm daim tawv nqaij nyob rau hauv qhov chaw ntawm eczematous lesions yuav nyob twj ywm.
- Qhov saum npoo ntawm epidermis thickens thaum lub sij hawm (tshwj xeeb tshaj yog ntawm xib teg thiab ko taw), pigmentation tshwm sim, kab nrib pleb tshwm. Tag nrho cov no qhia txog kev loj hlob ntawm hyperkeratosis.
Mechanism ntawm kev loj hlob ntawm pathology
Yog muajlos yog tag nrho cov xwm txheej zoo rau qhov tshwm sim ntawm dermatosis, qhov teeb meem tsuas yog nrog cov provoking yam, i.e., ncaj qha ua rau eczema. Kev kho mob rau cov kab mob ntawm daim tawv nqaij no yog kom kov yeej cov kab mob ntawm cov kab mob autoimmune puas.
Lub luag haujlwm tseem ceeb hauv kev txhim kho pathology yog ua si los ntawm dysbiosis ntawm epidermis thiab plab hnyuv microflora, uas yog vim muaj kev cuam tshuam ntawm kev loj hlob ntawm "kev noj qab haus huv" kab mob los ntawm opportunistic thiab pathogenic sawv daws yuav, thiab, vim li ntawd, kev hloov pauv ntawm qhov sib piv ntawm lawv.
Kab mob ntawm daim tawv nqaij tuaj yeem tshwm sim los ntawm ntau yam. Kev kho mob eczema nyob rau hauv ib qho ntawm cov chaw kho mob, tsis hais txog ntawm etiology, tsis ua rau kom rov ua tiav. Qhov nyuaj tshaj plaws yog los tiv thaiv kev rov qab los ntawm dermatosis nyob rau hauv ib tus neeg uas muaj kev hloov pauv ntawm tus kab mob no. Los ntawm txoj kev, cov cim caj ces ntawm daim ntawv idiopathic tau lees paub hauv 40% ntawm cov neeg mob.
Ntxiv rau qhov kev hloov pauv, neurogenic, tsis haum, kev tiv thaiv kab mob, endocrine thiab metabolic yam tuaj yeem ua rau eczema. Kev kho mob (daim duab qhia ib txoj hauv kev) yuav tsum tau thaum raug rau cov hauv qab no:
- Kev nyuaj siab.
- Tshuaj tiv thaiv.
- tshuaj.
- Tshuaj.
Ua ib qho kev txhawb nqa rau kev loj hlob ntawm eczema tuaj yeem ua rau lub cev tsis haum rau zaub mov. Cov kab mob feem ntau yog citrus txiv hmab txiv ntoo, qhob noom xim kasfes, strawberries, txiv ntseej, zib ntab, nyuj cov mis nyuj protein.
Ntau yam ntawm dermatosis
UnitedKev faib tawm ntawm eczema nyob rau hauv niaj hnub dermatology tseem tsis tau muaj. Txawm li cas los xij, cov kws kho mob paub tseeb tias tus kab mob no muaj ntau hom, tuaj yeem mob, subacute thiab ntev. Feem ntau, cov kws tshaj lij ua raws li cov kab lus hauv qab no ntawm eczema:
- True (idiopathic).
- xwb.
- Microbial.
- Seborrheic.
- Cov me nyuam.
Cov tsos mob thiab qhov xwm txheej ntawm chav kawm nyob ntawm seb hom kab mob dermatosis, nrog rau cov tswv yim ntxiv rau kev kho mob eczema. Nws yog ib qho nyuaj los txiav txim seb hom kab mob dermatosis los ntawm daim duab ntawm tes lossis lwm qhov ntawm lub cev.
YIdiopathic eczema
Nrog rau ntau yam kev ua xua dermatosis, daim tawv nqaij ntawm cov extremities feem ntau cuam tshuam. Rau hom kab mob no, cov lus piav qhia saum toj no yog cov yam ntxwv. Nyob rau hauv cov ntaub ntawv ntawm ib tug kab mob, pustules nrog purulent ntsiab lus yog tsim. Weeping eczema tsis tshua muaj nyob rau hauv daim ntawv mob.
Idiopathic eczema kuj muab faib ua ob hom:
- Pruriginal. Daim ntawv no yog tus cwj pwm los ntawm qhov me me vesicular pob nyob rau ntawm hyperemic epidermis. Outwardly, nws zoo li millet nplej. Pruriginous vesicles tsis qhib, thiab yog li ntawd tsis tsim erosive foci. Feem ntau yog nyob rau hauv qhov chaw uas lub luj tshib, hauv caug, thiab lub duav yog khoov. Kev tso cai tsis tshua muaj rau qhov muaj tseeb eczema.
- Dyshidrotic. Nws txawv ntawm tus so los ntawm qhov muaj cov npuas me me nyob nruab nrab ntawm cov ntiv taw lossis ob txhais tes. Kev kho mob ntawm eczema ntawm daim ntawv dyshidrotic txawv ntawm kev kho mob ntawm lwm yam kab mob vim yognta ntawm vesicular theem: cov npuas yuav tsis qhib, tab sis tam sim ntawd tsim ib tug crust. Cov pob pob liab liab tau pom meej meej los ntawm kev noj qab haus huv epidermis los ntawm kev mob hnyav, o thiab hyperemia.
Microbial eczema
hom no muaj qhov sib txawv tshwj xeeb. Microbial eczema tshwm sim thaum ib tug neeg muaj kab mob ntev. Cov txheej txheem pathological ua rau kev txhim kho cov tshuaj tiv thaiv autoimmune. Feem ntau, nws muaj peev xwm provoke kev loj hlob ntawm microbial eczema los ntawm xws li cov neeg sawv cev ntawm pathogenic microflora:
- YStaphylococcus aureus.
- YHemolytic streptococcus.
- Candida.
- E. coli.
- Pseudomonas aeruginosa.
- Proteas.
Cov kab mob microbial eczema tshwm sim los ntawm cov pob khaus asymmetric uas cuam tshuam rau lub ntsej muag, nraub qaum ntawm tes, tawv taub hau. Eruptions tsis kis, thiab lawv nto yog npog nrog daj-ntsuab crusts, qee zaum nrog impurities ntawm lymph thiab ntshav. Subspecies ntawm microbial eczema muaj xws li:
- Varicose. Vesicles tshwm nyob ib ncig ntawm trophic ulcers ntawm ob txhais ceg, uas feem ntau yog tshwm sim los ntawm ib tug muaj zog tsis muaj zog ntawm cov ntaub so ntswg trophism vim varicose leeg. Kev kho tus kab mob eczema ntawm ob txhais ceg pib nrog kev kho tus kab mob hauv qab.
- Post-traumatic. Cov pob khaus eczematous concentrates nyob rau hauv qhov chaw ntawm daim tawv nqaij puas (qhov txhab, nrog rau cov qhov txhab tom qab phais, fistulas, kub hnyiab). Feem ntau tom qab raug mob eczema tshwm sim ntawm cov pob txha tom qab limb amputation.
- Nummular. Lub npe thib ob ntawm daim ntawv no ntawm dermatosis yog npib-zoo li tus, uas tau piav qhia los ntawm qhov lojtxoj kab uas hla (los ntawm ib mus rau ob peb centimeters) vesicles. Tus kab mob pib nrog hnyav edema, quaj. Cov chaw raug cuam tshuam yog cais los ntawm cov ntaub so ntswg noj qab haus huv.
- Nipple eczema. Rau qhov ntau dua yog hais txog cov kab mob tom qab raug mob. Nws feem ntau tshwm sim vim raug mob ntawm lub txiv mis thaum lactation. Kev mob ntawm daim tawv nqaij mus txog tag nrho cov theem piav qhia.
YSeborrheic eczema
Ib yam tshwj xeeb ntawm hom kab mob no yog qhov tsis muaj vesicles. Cov pob liab liab yog nyob rau hauv qhov chaw ntawm cov qog sebaceous (ntawm tawv taub hau, qhov chaw interscapular, décolleté, ntsej muag, caj dab). Sab nraud manifestations ntawm xws li eczema yog txawv los ntawm rounded daj-pinkish me ntsis npog nrog ntom nplai. Hauv cov neeg mob uas muaj tus kab mob seborrheic dermatosis, cov plaub hau sib txuas ua ke hauv pawg, tsis tu ncua ci, thiab serous crusts tsim nyob rau hauv qab-qhov-pob ntseg, uas khaus heev.
Kev ua haujlwm eczema
Tsim tawm tsam keeb kwm yav dhau los ntawm kev sib cuag tas li nrog kev txhawb nqa ntau lawm. Nrog cov kws tshaj lij eczema, lub epidermis cuam tshuam rau thaj chaw uas muaj kev sib cuag ncaj qha nrog cov tshuaj tsis haum, yog li hom dermatosis no tsis tshua muaj tshwm sim ntawm tes. Daim ntawv no yog tus cwj pwm los ntawm kev ua yeeb yam. Qhov ntev ntawm kev sib cuag nrog cov irritant, cov teeb meem ntau relapses. Nws yuav tsis tuaj yeem ua tiav kev txhim kho yam tsis tau tshem tawm qhov ua rau muaj kev cuam tshuam.
kab mob tawv nqaij hauv menyuam yaus
Qhov ua rau eczema hauv cov menyuam mos yog suav tias yog atopic dermatitis, uas tuaj yeem tsim tawm tsam keeb kwm yav dhau los:
- Heredity.
- Kev cev xeeb tub hnyav, uas tau nrog toxicosis.
- Pathology ntawm ob lub raum, pancreas, siab.
- noj tsis zoo.
Nws tsim nyog sau cia tias thaum menyuam yaus, cov menyuam mos feem ntau yuav kis tau tus kab mob eczema, ib lossis ob leeg ntawm cov niam txiv raug mob dermatosis. Feem ntau cov menyuam yaus eczema nrog mob hawb pob, noj zaub mov tsis haum, plab hnyuv dysbacteriosis. Tus kab mob no tshwm sim raws li "tus qauv", qhia nws tus kheej li pob khaus ntawm lub ntsej muag, lub taub hau, caj dab, thiab maj mam kis mus thoob lub cev.
Txoj Kev Kho Mob
Cia peb xav seb yuav kho eczema li cas. Daim duab ntawm ntau yam pob khaus eczematous qhia tias txoj kev kho yuav txawv rau txhua qhov tshwj xeeb. Qhov tseeb, cov txheej txheem dav dav rau kev kho mob eczema yog tsim raws li ib qho kev sib xyaw ua ke, tab sis kev xaiv cov tshuaj yuav nyob ntawm qhov hnyav ntawm cov tsos mob thiab qhov xwm txheej ntawm cov txheej txheem ntawm daim tawv nqaij pathology. Kev kho mob dermatosis yuav tsum muaj kev qhia dav thiab suav nrog cov haujlwm hauv qab no:
- Rau kev kho cov quaj, cov tshuaj pleev ib ce nrog cov tshuaj tua kab mob yog siv: boric acid, "Chlorhexidine", "Resorcinol". Koj tuaj yeem qhuav qhov yaig nrog kev pab ntawm "Fukortsin", ib qho dej cawv ntawm pob zeb diamond ntsuab.
- Txhawm rau tshem tawm qhov mob thaum lub sijhawm exacerbation, hormonal tshuaj pleev yog siv ("Flucinar", "Celestoderm", "Sinaflan", "Advantan", "Afloderm"). Lawv tsis tuaj yeem siv rau qhov chaw ntub dej. Lub sijhawm ntawm kev kho mob yog txiav txim los ntawm tus kws kho mob dermatologist.
- Tawm tsam tus kab mob thib oblos yog daim ntawv microbial ntawm eczema, txoj kev kho mob muaj xws li tshuaj tua kab mob hauv zos (cov tshuaj pleev "Levomekol", "Oxycort", "Pimafukort", "Gyoksizon").
- Txhawm rau pib cov txheej txheem rov tsim dua tshiab thiab kho cov ntaub so ntswg, sulfuric, ichthyol, tar ointments yog siv. Cov tshuaj no feem ntau hloov corticosteroids.
- Salicylic ointment, lotions thiab roj yog siv los ua kom tawv nqaij.
Kev kho mob eczema thaum lub sijhawm exacerbation tsis suav nrog cov txheej txheem dej. Ntxiv nrog rau cov tshuaj hauv zos, lawv kuj siv rau kev siv tshuaj ua haujlwm:
- Antihistamine pab pawg ("Loratadine", "Cetirizine", "Claritin", "Tavegil", "Cetrin").
- Tshuaj tua kab mob, suav nrog kev nkag siab ntawm microflora (Ceftriaxone, Clarithromycin, Erythromycin, Cefuroxime, Ofloxacin, Levofloxacin).
- tshuaj tiv thaiv kab mob (Diclofenac, Indomethacin).
- Cov tshuaj nqus dej kom txo tau kev qaug cawv (kev tso quav ntawm "Sodium thiosulfate", "Calcium chloride").
- tshuaj sedative (tinctures ntawm valerian, motherwort, ua ke cov tshuaj homeopathic, suav nrog Novopassit, Persen, Sedaten).
- YImmunomodulators ("Cycloferon", "Viferon").
- Probiotics ("Linex", "Enterogermina", "Bifiform", "Laktovit").
- Enzyme npaj ("Creon", "Festal", "Mezim").
- Vitamin thiab mineral complexes.
Kev Kho Mob Neeg
Kev kho mob eczema nrog cov tshuaj pej xeem feem ntau siv los txhawm rau txhawm rau txhim kho kev kho mobcuam tshuam. Tsis zoo li cov tshuaj tom khw muag khoom, cov tshuaj hauv tsev tsis muaj kev phiv loj, tab sis qhov no tsis txwv qhov yuav tsum tau sab laj nrog koj tus kws kho mob txog lawv txoj kev siv. Thaum tsis muaj contraindications, cov hauv qab no ntawm lwm txoj kev kho mob eczema yog siv:
- Qos yaj ywm compress. Dhau cov qoob loo nyoos los ntawm cov nqaij grinder thiab cov txiaj ntsig slurry, me ntsis squeezing thiab qhwv hauv cov ntaub paj rwb, siv rau thaj tsam cuam tshuam. Cov txheej txheem yog nqa tawm ob peb zaug hauv ib hnub. Rau qhov ua tau zoo tshaj plaws, qhov compress yog sab laug ib hmos.
- Tshuaj ntsuab birch tar ointment. Rau lub ntsiab tivthaiv nyob rau hauv tus nqi ntawm 1 tbsp. l. ntxiv kua cider vinegar (1 tablespoon) thiab ntses roj (3 tablespoons). Cov sib tov sib xyaw kom huv si thiab siv rau cov pob khaus eczematous ob zaug ib hnub. Khaws cov khoom ntawm daim tawv nqaij tsis pub dhau 15 feeb.
- Kev sib xyaw ntawm qej thiab zib ntab. Ob peb crushed cloves ntawm qej yog tov nrog 50 g ntawm zib mu thiab rubbed txhua txhua hnub rau ntawm qhov chaw ntawm tes.
- Kho eczema ntawm ko taw nrog zaub qhwv. Hla cov nplooj tshiab los ntawm cov nqaij grinder thiab sib tov nrog qe dawb. Semi-kua slurry lubricates qhov cuam tshuam ntawm daim tawv nqaij ob peb zaug hauv ib hnub.
- Walnuts. Feem ntau txoj kev no yog siv los kho tus mob eczema thaum yau. Txiv ntseej (unpeeled) yog ci nyob rau hauv qhov cub, 3-4 pieces yog txaus. Thaum lawv txias lawm, lawv yuav tsum tau crushed kom huv si nrog ib tug ntoo mortar thiab ntxiv me ntsis ntses roj. Cov khoom tiav tiav yog smeared nrog eczema ntawm tes, ntsej muag, thiab lwm qhov chaw.lub cev.
cov lus qhia ntxiv
Ntxiv rau kev siv cov tshuaj no thiab cov tshuaj pej xeem, kev kho mob eczema tuaj yeem ntxiv nrog cov txheej txheem kho lub cev. Thaum tshem tawm, UV irradiation, acupuncture, paraffin da dej yog siv, thiab nrog exacerbated allergic dermatosis, cov txiaj ntsig zoo tuaj yeem ua tiav:
- Kev pw tsaug zog hluav taws xob.
- Course of aeroionotherapy.
- Electrophoresis.
Ntxiv rau, kev kho mob eczema cuam tshuam nrog kev ua raws li qee qhov kev txwv kev noj haus. Cov zaub mov noj zaub mov yog tsim los ntawm kev cais tawm ntawm kev noj zaub mov tsis haum thiab cov khoom noj tsis zoo (cov nqaij haus luam yeeb, khoom qab zib, cov kaus poom, kib, ntsev, ntsim thiab rog). Tsis pub haus cawv, tshuaj yej thiab kas fes.
Kev kho tus kab mob eczema yuav tsum yog txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau nws nws yog ib qho tsim nyog yuav tsum noj zaub mov kom raug, zam cov xwm txheej ntxhov siab, ntxiv dag zog rau lub cev tiv thaiv kab mob nrog cov vitamins thiab probiotics. Kev saib xyuas koj cov tawv nqaij zoo thiab ua kom nws noj qab haus huv nrog cov tshuaj pleev thiab cov tshuaj pleev ib ce yog qhov tseem ceeb.
