Gout yog ib yam kab mob ntawm pob txha mos. Tus kab mob no tshwm sim, raws li txoj cai, vim muaj kev cuam tshuam cov metabolism, vim tias cov ntsev tsim ntawm uric acid tau tso rau hauv cov pob qij txha. Koj yuav kawm paub ntau ntxiv txog etiology, pathogenesis, chaw kho mob, kuaj mob thiab kho gout tom qab hauv kab lus.
Yog vim li cas
Txhua tus kab mob tib neeg tshwm sim los ntawm ib yam dab tsi, thiab gout tsis muaj qhov zam. Feem ntau ntawm tag nrho cov, cov txiv neej raug kev txom nyem los ntawm nws, cov poj niam ib feem ntawm cov pejxeem tsis tshua muaj kev txom nyem los ntawm tus kab mob no thiab tsuas yog tom qab pib ntawm menopause. Ntawm cov laj thawj tseem ceeb rau nws qhov tshwm sim:
- Obesity (tsis yog rog dhau). Qhov hnyav tshaj yog thaum lub cev qhov ntsuas ntau dua 30. Hauv cov neeg rog rog, uric acid hauv lub cev ntau dua li qub, qhov no ua rau degeneration ntawm cov ntaub so ntswg thiab kev loj hlob ntawm gout.
- Hereditary predisposition. Tus kab mob no tsis tau txais, tab sis ib tug predisposition tsim. Qhov no tsis tau txhais hais tias nws yuav tshwm sim nws tus kheej nrog 100% qhov tshwm sim, tab sis nyob rau hauv lub xub ntiag ntawm provoking yam.xws li kev pheej hmoo zoo heev. Feem ntau, gout yog provoked los ntawm fermentopathy, uas tau txais ntau dua los ntawm cov txiv neej kab. DNA molecules uas tau raug puas tsuaj ua rau lub cev tsis zoo nqus cov enzymes.
- Purine hauv paus noj. Yog hais tias theem ntawm uric acid nyob rau hauv lub cev yog siab dua li ib txwm, thiab lub raum tsis tuaj yeem tshem tawm cov tshuaj, qhov no ua rau nws stagnation. Nws feem ntau tshwm sim thaum lub sijhawm ua haujlwm ntawm ob lub raum, lawv tseem kuaj tau qhov teeb meem uas lawv tsis tuaj yeem tshem tawm cov ntshav ntawm purine metabolites txawm tias lawv cov concentration ib txwm.
Gout tuaj yeem tshwm sim los ntawm kev ua neej nyob tsis muaj zaub mov noj, kub siab, lub raum tsis ua haujlwm, ntshav qab zib ntau yam, noj ntau ntau ntawm kas fes lossis rog, kho mob phais mob pob qij txha, mob hnyav.
Nyob haus cawv
Kev pheej hmoo yog cov neeg nyiam noj mov tsis tu ncua. Ib feem me me ntawm cawv yog txaus, thiab tom qab lub sijhawm luv luv yuav muaj qhov mob hnyav hauv pob qij txha. Ethyl cawv txo cov khoom ntawm cov tshuaj uas yuav tsum tau siv tas li rau gout, thiab ua rau muaj kev phiv ntau ntxiv. Tsis tas li ntawd, cawv khaws cov kua dej hauv cov ntaub so ntswg periarticular, ua rau o, thiab provokes mob hnyav.
Gout tsos mob
Cov kab mob gout yog tus cwj pwm los ntawm kev tawm tsam hnyav. Muaj sijhawm ntev ntawm kev so ntawm lawv. Cov tsos mob ntawm gout tuaj yeem pom tsuas yog thaum lub sijhawm mob hnyavqaug dab peg. Lub ntsiab ntawm lawv yog mob nyob ib ncig ntawm lub pob qij txha. Nws tag nrho pib nrog kev tsis xis nyob, tab sis sai sai mus rau hauv ib tug ntse mob uas tsis tso cai rau koj tsiv mus nyob rau tus ceg ceg. Tsis tas li ntawd, nrog rau gout, cov txheej txheem mob hnyav tau pom, nyob rau hauv uas cuam tshuam kev sib koom ua ke nce loj, thiab daim tawv nqaij hloov liab. Hauv cov txheej txheem inflammatory, qhov nce hauv lub cev kub feem ntau tshwm sim.
Ib qho kev tawm tsam ntawm gout feem ntau kav li ib lub lis piam, tom qab ntawd muaj lub sijhawm so, thiab tag nrho cov tsos mob ploj mus. Nws lub sijhawm yog los ntawm ntau lub hlis mus rau 1-2 xyoos. Hauv cov kab mob gout, qhov zaus ntawm kev tawm tsam nce nrog lub hnub nyoog, thiab lub sij hawm ntawm kev so txo. Cov neeg mob gout tau qhia kom tsis txhob haus cawv thiab rog los ntawm lawv cov zaub mov, vim tias cov khoom noj no ua rau cov uric acid ntau dhau.
Raws li kev tshuaj xyuas kev faib tawm, xya hom kab mob sib txawv:
- classic (typical) nres ntawm mob gouty mob caj dab,
- subacute,
- pseudophlegmonous,
- polyarthritis ntawm hom kab mob sib kis,
- rheumatoid zoo li,
- polysymptomatic,
- periarthritic.
Kev kuaj mob gout
Thaum tus neeg mob yws txog qhov mob ntawm pob qij txha, tus kws kho mob thawj zaug xam phaj nws los txiav txim seb tus kab mob twg nws tau ntsib. Koj tuaj yeem txiav txim siab gout yog:
- tus neeg mob tau mob pob qij txha ntau dua ib zaug, thawj cov tsos mobpib nrog cov pob qij txha me me ntawm tes thiab ko taw;
- muaj mob gout hauv tsev neeg.
Tsis tas li ntawd, yam xws li tus cwj pwm tsis zoo, kev noj nqaij ntau hauv cov zaub mov, haus dej tsis txaus kuj tuaj yeem ua rau tus kab mob no. Tab sis rau qhov tseeb dua lub ntsiab lus ntawm lub tsev kho mob thiab kev kuaj mob ntawm gout, tau kawg, koj yuav tsum tau mus kuaj, uas suav nrog:
- Ultrasound ntawm pob qij txha.
- CT (xws li tomography).
- X-ray.
- Scintigraphy nrog technetium pyrophosphate.
Cov yam ntxwv hloov pauv hauv cov pob qij txha nrog gout thaum lub sijhawm ultrasound tuaj yeem pom tsuas yog thaum muaj tus kab mob hnyav. Txij li thaum mob mob pob qij txha o, cov ntaub so ntswg thicken, thiab lwm yam. Twb tau 5 hnub nws yuav luag tsis pom cov kev hloov no.
CT yog qhov zoo rau siv nyob rau theem kawg ntawm tus kab mob, qhov no, cov duab ua tau zoo tau txais, tso cai rau koj los tshuaj xyuas kom meej qhov deformity ntawm cov pob qij txha, txhawm rau txiav txim siab qhov chaw ntawm kev hloov pauv. Thaum ntxov, nws yog ib qho nyuaj rau kev soj ntsuam cov tsos mob ntawm tus kab mob nrog kev pab los ntawm CT, nws yuav pom tau tias tsuas yog cov ntaub so ntswg thickening thaum lub sij hawm exacerbation ntawm tus kab mob.
X-ray tseem muab cov ntaub ntawv me me nyob rau theem pib ntawm tus kabmob. Nws feem ntau yog muab tshuaj rau thawj theem ntawm tus kab mob thaum muaj lwm yam kab mob los yog kab mob ntawm cov pob qij txha. X-rays kuj tseem yuav pab tau ntau dua hauv cov kab mob ntev.
Thaum pib, txoj hauv kev zoo tshaj plaws rau kev kuaj mob thiab tshuaj xyuas gout yog scintigraphy. Thaum lub sij hawm tus txheej txheem, ib tug tshwj xeeb tshuaj yog txhaj rau hauv tus neeg mob cov ntshav, uas, nrog rau ntxivscanning lub cev tso cai rau koj txheeb xyuas tag nrho cov uas twb muaj lawm deposits ntawm urate. Txoj kev no yog qhov zoo nyob rau theem pib ntawm tus kab mob, vim nws tso cai rau koj txheeb xyuas cov kab mob sib kis txawm tias ua ntej cov txheej txheem deformity pib.
Tshawb Fawb Ntxiv
Ntxiv rau, yog tias xav tias muaj kab mob gout, tus kws kho mob yuav muab kev kuaj mob sib txawv ntawm gout. Tus txheej txheem yuav pab kom pom cov duab tseeb ntawm tus kab mob, thiab tseem yuav paub qhov txawv ntawm lwm yam kab mob zoo sib xws. Txhawm rau kuaj mob gout, koj yuav tsum xeem dhau cov kev sim hauv qab no:
- Kev tshuaj ntsuam zis thiab ntshav.
- Biochemical tsom xam ntshav thiab zis.
- Kev kuaj kua dej hauv cov pob qij txha.
- Kev tshawb fawb ntawm tophi thiab lawv cov ntsiab lus.
Txhua txoj hauv kev kuaj kuaj mob gout muaj cov qauv sib txawv, tab sis ua ke lawv yuav pab kom tau txais daim duab tiav ntawm cov kab mob, nrog rau kev kho kom txaus thiab raws sijhawm.
kev kho mob
Kev siv tshuaj tshuaj thaum lub sijhawm exacerbation yog qhov zoo tshaj plaws. Thaum lub sij hawm lub sij hawm ntawm anti-inflammatory kev kho mob rau gouty mob caj dab, Colchicine yog feem ntau sau tseg. Cov tshuaj no yog noj los ntawm qhov ncauj lossis muab tso rau hauv cov hlab ntsha, cov koob tshuaj yog teem los ntawm tus kws kho mob. "Colchicine" tshwj xeeb tshaj yog siv tau yog tias nws pib sai li sai tau thaum cov tsos mob tshwm sim thawj zaug. Ib qho kev txhim kho tseem ceeb ntawm cov neeg mob twb tau pom nyob rau hauvthawj kaum ob teev ntawm kev noj cov tshuaj no hauv 75% ntawm cov neeg mob. Tab sis tej zaum yuav muaj kev phiv, piv txwv li, nyob rau hauv daim ntawv ntawm cov kab mob ntawm lub plab zom mov.
Tsis tas li ntawd, lwm cov tshuaj tiv thaiv kab mob tau muab rau kev ua kom lub cev hnyav ntxiv, suav nrog Indomethacin, Phenylbutazone, Naproxen, Etoricoxib thiab lwm yam.
Yog tias muaj kev txwv tsis pub noj cov tshuaj saum toj no, tom qab ntawd kev tswj hwm qhov ncauj lossis kev tswj hwm hauv lub cev ntawm glucocorticoids, piv txwv li, cov tshuaj nrog triamcinolone hexacetonide tuaj yeem siv tau thaum lub sijhawm ua rau mob gouty mob caj dab.
Lwm txoj kev yog kev siv sab nraud ntawm cov tshuaj nplaum thiab cov gels, uas suav nrog cov tshuaj uas tsis yog tshuaj steroidal. Cov tshuaj nrov tshaj plaws hauv pawg no yog Diclofenac, Ketoprofen, Nimesulide. Thaum lub sijhawm tshem tawm ntawm tus kab mob, cov tshuaj tau sau tseg uas normalize cov concentration ntawm uric acid hauv lub cev. Cov no yog cov tshuaj raws li benzbromarone, allopurinol. Piv txwv li, "Avisan" thiab lwm yam. Thov nrog tus kws kho mob tham ua ntej siv.
Physiotherapy
Raws li ib feem ntawm kev kho mob nyuaj, kev kho lub cev rau gout yog qhov zoo heev. Nws txhim kho cov mob ntawm cov pob txha mos thiab tiv thaiv lawv txoj kev lwj. Cia peb tsom xam cov hom kev kho lub cev uas nrov tshaj plaws, uas feem ntau tau sau tseg rau lub sijhawm ntawm kev tawm tsam:
- Electrophoresis yog txheej txheem thaum lub sijhawm hluav taws xob ruaj khov ua rau lub cev. Qhov no muab cov txiaj ntsig kho hauv zos. Tsis tas li ntawd, electrophoresistxhim khu kev nkag mus ntawm cov tshuaj los ntawm daim tawv nqaij. Rau gout, Analgin thiab Novocain yog siv rau lub hom phiaj ntawm qhov mob nyem, thiab zinc, sulfur thiab lithium yog siv los txhawb cov pob txha mos.
- Kev kho av nkos suav hais tias yog ib txoj hauv kev los txhim kho cov neeg mob gout. Cov txheej txheem no feem ntau raug sau tseg thaum lub sijhawm kho spa.
- Kev kho cua sov txhawb nqa kev nqus ntawm uric acid deposits. Rau lub hom phiaj no, cov ntawv thov paraffin thiab ozocerite yog tsim rau cov neeg mob.
- Balneotherapy yog ib qho kev lom zem tshaj plaws ntawm kev kho lub cev. Kev cuam tshuam ntawm cov pob qij txha yog tsim thaum lub sij hawm da dej. Rau cov kab mob gout, raws li txoj cai, lub voj voog ntawm radon, hydrogen sulfide lossis sodium chloride da dej tau raug sau tseg.
- Bishofite yog cov ntxhia ntuj. Magnesium ntsev yog tau los ntawm nws, los ntawm cov tshuaj kho tau npaj. Compresses nrog bischofite zoo txo qhov mob thiab tshuaj loog rau thaj tsam cuam tshuam.
Nrog rau lwm yam, gout tau kho zoo nrog UVT, suab thiab magnetotherapy, qoj ib ce kho mob thiab zaws. Txoj kev twg yuav zoo tshaj yog qhov nyuaj rau kev txiav txim. Txoj kev kho mob, suav nrog cov txheej txheem physiotherapy, yog kws kho mob tau sau tseg, suav nrog cov yam ntxwv ntawm txhua kis tshwj xeeb. Feem ntau cov kev kho mob physiotherapy feem ntau yog yooj yim nyob rau hauv chav kawm ntawm kev kho mob spa.
kev kho neeg zoo
tshuaj ntsuab rau gout tuaj yeem ua tau zoo heev. Qhov tseem ceeb tshaj plaws yog tham nrog koj tus kws kho mob tshwj xeeb thiab tsis yogtsis kam ua ib txoj kev kho mob ntawm lawv tus kheej. Yog li, cov tshuaj zoo tshaj plaws rau kev tawm tsam gout:
- Kho decoction ntawm chamomile paj yog zoo meej rau kev txhim kho tus mob ntawm cov ceg. Txhawm rau npaj qhov decoction, koj yuav xav tau paj (100 g) thiab dej (10 l). Tom qab ntawd, koj yuav tsum tau ntxiv ntsev (200 g) thiab sib tov kom huv si. Siv cov tshuaj thaum npaj da dej rau ob txhais tes thiab ko taw cuam tshuam los ntawm gout.
- Ordinary spruce cones yog ib qho tshuaj zoo heev rau kev kho pob qij txha. Txhawm rau npaj lub decoction, nws yog ib qhov tsim nyog los ncuav lub khob ntim nrog cov noob (5-6 pieces) nrog dej kub (1.5 tablespoons) thiab tawm mus rau brew thaum hmo ntuj. Lub resulting decoction yuav tsum tau muab faib ua peb koob, noj ib nrab ib teev ua ntej noj mov. Infusion yog qaug dej qaug cawv kom txog thaum rov ua tiav.
- Bay leaf yog ib qho tshuaj txawv txawv thiab siv tau zoo. Nws yog tsim nyog los ncuav 5 grams ntawm nplooj nplooj nrog dej (1.5 tablespoons) thiab ua noj nyob rau hauv ib da dej rau tsib feeb, ces npog thiab cia sawv ntsug rau peb teev. Tom qab no, lub decoction yuav tsum haus dej haus txhua hnub hauv ib feem me me.
- Boiled mov yog lwm txoj kev kho mob rau pob qij txha. Nws yog ib qho tsim nyog los yaug 2 tablespoons nplej nrog dej kom txog thaum dej huv, ces ncuav 1.5-liter hub thiab ncuav dej rau hauv nws, tawm hauv ib hmos. Thaum sawv ntxov, tshem tawm cov mov, yaug, ntxiv dej thiab coj mus rau boil. Tom qab nws boils nws yog tsim nyog los yaug nws dua thiab coj mus rau boil dua. Ua kom tiav cov txheej txheem plaub zaug hauv tag nrho. Tom qab ntawd nws yuav tsum tau noj yam tsis muaj ntsev thiab roj.
Khoom noj
Gout yog ib yam kab mob tsis kaj siab heev, yog vim li cas nws tseem ceeb heev uas yuav tsum ua raws li kev noj zaub mov kom raug thaum lub sijhawm kho. Cov zaub mov noj qab haus huv thiab zaub mov noj thaum lub sijhawm mob gout:
- Txiv. Lawv tseem ceeb heev, vim tias lawv muaj ntau yam tseem ceeb, yuav tsum tau saib xyuas tshwj xeeb rau cov txiv hmab txiv ntoo citrus.
- zaub. nquag haus beets, qos yaj ywm, dib, txiv lws suav, dos, carrots.
- Ntau yam txiv hmab txiv ntoo yuav tsum muaj nyob rau hauv tus neeg mob noj.
- Nws pom zoo kom siv cov kua txiv hmab txiv ntoo tshiab los ntawm cov txiv hmab txiv ntoo thiab txiv hmab txiv ntoo.
- Cov khoom qab zib (tsev cheese, cheese thiab mis nyuj, kefir, thiab lwm yam) yuav tsum nyob hauv kev noj haus.
- Seafood li cws thiab squid zoo heev rau gout.
- Cov khoom lag luam thiab cov khoom lag luam yuav tsum muaj nyob hauv cov khoom noj, tab sis koj yuav tsum tsis txhob tsim txom lawv ntau dhau.
- Nuts muaj txiaj ntsig zoo rau gout. Nws raug nquahu kom noj ib qho me me ntawm cov txiv ntoo ntoo, almonds, hazelnuts, avocados lossis pistachios.
- Boscht, pickles, zaub mov noj, beetroot - cov kua zaub mov tsis tuaj yeem tsis lees paub, lawv yuav tsum nyob hauv cov ntawv qhia zaub mov.
- YGreens (dill, cilantro, parsley, thiab lwm yam).
Raws li cov khoom tsim kev puas tsuaj rau gout, cov no suav nrog ntsev, cov hnyuv ntxwm, cov khoom haus luam yeeb, nceb, pickles. Spinach, sorrel, cauliflower, radish, celery yuav tsum tau siv ceev faj.
Nws tseem pom zoo kom tshem tawm cov khoom noj (lub hlwb, lub siab, lub raum, lub ntsws). Cov kws kho mobNws raug nquahu kom tso cov ntses haus luam yeeb, ntsim tais diav, tsis suav nrog cocoa, chocolate, tshuaj yej muaj zog thiab kas fes los ntawm cov ntawv qhia zaub mov. Cawv thaum muaj mob no feem ntau txwv tsis pub, tshwj xeeb tshaj yog cawv thiab npias. Tag nrho cov txuj lom thiab kua ntses tseem raug txwv, vim lawv ua rau khaus thiab muaj kev cuam tshuam tsis zoo rau kev noj qab haus huv.
Kev Tiv Thaiv Kab Mob
Rau kev tiv thaiv kab mob gout, nws yog qhov tsim nyog, ua ntej, ua raws li qee yam kev noj haus. Nws cov cai tseem ceeb yog:
- noj zaub mov tsis muaj calorie ntau, ntau yogurt, tsev cheese, zaub thiab txiv hmab txiv ntoo, noj ib citrus txhua hnub;
- khob cij wholemeal;
- cov dej haus yuav tsum tsawg kawg yog 2.5 litres ib hnub twg, yog li lub raum yuav ntxuav tau zoo dua thiab cov uric acid hauv cov ntshav yuav txo qis;
- cawv yuav tsum raug tshem tawm ntawm koj lub neej, vim nws txhawb nqa cov crystallization ntawm uric acid;
- ntsev tsawg kawg;
- tsis txhob hnov qab txog hnub yoo mov yam tsis muaj nqaij thiab ntses.
Txawm tias tsis muaj qhov mob thiab cov tsos mob tshwm sim, koj yuav tsum tsis txhob tso tseg kev noj haus. Thib ob, gymnastics, caij tsheb kauj vab, taug kev nrawm, tab sis tsis muaj qhov hnyav, yuav yog tus pab zoo hauv kev tiv thaiv kab mob gout. Yog tias qhov mob hnyav zuj zus, ces kev ua si yuav tsum tau tso tseg. Nws tseem yog qhov tsim nyog kom txo qis kev ua haujlwm ntawm lub cev hnyav. Nws tsim nyog them nyiaj tshwj xeeb rau koj nkawm khau thiab sim xaiv qhov nyiam tshaj plaws. Nyob hauv tsev, nws yog qhov zoo tshaj los taug kev taw. Nws raug nquahu kom mus ntsib kws kho mob ob zaug hauv ib xyoos (tus kws phais mob, kws kho mob, kws kho mob neuropathologist) thiab kuaj.
Nyob rau hauv tsab xov xwm pebsuav tias yog cov yam ntxwv ntawm kev faib tawm, chaw kho mob, kev kuaj mob thiab kev kho mob ntawm gout. Yog tias peb tig mus rau kev tshuaj xyuas cov neeg uas muaj tus kab mob no, peb tuaj yeem txiav txim siab tias nws nyuaj heev los kho tus kab mob, tshwj xeeb tshaj yog tias nws twb nyob rau theem siab heev. Ua ntej tshaj plaws, zoo li kws kho mob, hauv kev tshuaj xyuas tib neeg tau qhia kom pib noj txoj cai thiab txav mus - qhov no yog qhov kev tiv thaiv zoo thiab kev ntsuas kev kho mob. Nws tsis yog qhov tsim nyog, raws li lawv, sau tawm cov tshuaj ib txwm siv, nrog rau kev kho spa, uas, nrog rau kev kho tshuaj, muab cov txiaj ntsig zoo.
