Shingles muaj lwm lub npe - shingles. Tus neeg sawv cev ntawm tus kab mob no kis tau yog tus kab mob herpes. Tus kab mob no cuam tshuam rau ntawm daim tawv nqaij thiab lub paj hlwb, thiab yog li ntawd kev kho mob yog nqa tawm los ntawm ob qho tib si dermatologists thiab neurologists, nyob ntawm seb cov tsos mob tshwm sim tshaj plaws. Herpes zoster thiab kab mob qhua pias muaj ib qho etiology thiab pathogenesis. Qhov no yog ib qho kab mob thib ob ntawm cov keeb kwm endogenous hauv cov neeg uas yav tas los muaj kab mob qhua pias nyob rau hauv daim ntawv latent lossis kho mob. Tom qab mob khaub thuas, kab mob tuaj yeem nyob hauv lub cev mus ntev. Lawv nyob hauv lub ganglia ntawm cov hlab ntsha cranial thiab txha caj qaum ganglia, thiab nyob rau hauv kev cuam tshuam ntawm cov kab mob pathogenic lawv tau rov ua haujlwm, uas feem ntau pom thaum kev tiv thaiv ntawm tes tsis muaj zog.
Varicella-zoster tus kab mob kis tau sai heev los ntawm cov ntshav, cov kua cerebrospinal thiab cov paj hlwb thaum nojtus neeg. Yog tias lawv tau nyob hauv cov paj hlwb ntawm tus txha caj qaum ganglia, lawv yuav nyob mus ib txhis. Txij li thaum lawv muaj tropism rau cov hlwb ntawm lub paj hlwb, cov kab mob varicella-zoster ua rau cov kab mob uas feem ntau tshwm sim los ntawm kev kis kab mob ntawm lub hauv nruab nrab thiab lub paj hlwb peripheral.
Lub neej ntev kev zais cia ntawm varicella zoster muaj nyob hauv kwv yees li 20% ntawm cov neeg nyob hauv peb lub tebchaws uas muaj kab mob pox thaum yau. Asymptomatic carriage ntawm tus kab mob "dormant" tuaj yeem ua neej nyob. Qhov chaw nkaum tseem ceeb rau nws yog cov paj hlwb ntawm lub cev. Raws li kev ua ntawm cov neeg sab hauv thiab / lossis cov neeg ua haujlwm sab nraud, tus kab mob no tau qhib.
Kev raug mob, kev ntxhov siab, hypothermia, kis kab mob thiab somatic tuaj yeem ua rau mob herpes. Lub pathological anatomy ntawm tus kab mob nyob rau hauv nws classical daim ntawv yog ib tug inflammatory txheej txheem nyob rau hauv tus txha caj qaum ganglia thiab nyob rau hauv cov cheeb tsam ntawm daim tawv nqaij nyob ib sab ntawm lawv. Qee lub sij hawm cov txheej txheem tuaj yeem cuam tshuam nrog cov anterior thiab posterior horns ntawm grey teeb meem, cov hauv paus hniav ntawm tus txha caj qaum, cov ntaub so ntswg ntawm lub hlwb.
Tus kab mob no maj mam, nrog cov tsos mob tshwm sim: dyspeptic mob, mob taub hau, kub taub hau, malaise thiab ua daus no. Nyob rau hauv lub neej yav tom ntej, khaus thiab hlawv ntawm daim tawv nqaij, pob khaus koom. Qhov hnyav ntawm cov kev tshwm sim hauv txhua tus neeg mob yuav txawv.
Tom qab lub sijhawm luv luv, muaj qhov kub thiab txias thiab cov tsos mob ntawm kev qaug cawv (tsis qab los noj mov, mob leeg). Nyob rau tib lub sijhawm, qhov mob pob khaus tshwm rau ntawm daim tawv nqaij nyob rau hauv daim ntawv ntawm cov pob liab liab,nrog ib txoj kab uas hla ntawm 2-5 mm. Feem ntau, herpes zoster tshwm sim nyob rau tom qab. Cov menyuam yaus tuaj yeem tsim cov kab mob catarrhal ntawm cov kab mob ua pa (laryngitis, pharyngitis, rhinitis), uas ua rau muaj kev cuam tshuam loj rau cov kab mob.
Tus kab mob herpes zoster txaus ntshai npaum li cas?
Shingles, txawm tias nws muaj ntau, suav hais tias yog ib qho kev phom sij txaus ntshai heev. Ntxiv nrog rau neuralgia, ntau lwm yam teeb meem tuaj yeem ua tau. Nrog rau kev loj hlob ntawm pob khaus, rwj tuaj yeem tsim, uas tawm cov nti thiab nti ntawm daim tawv nqaij. Qhov no yog vim kev puas tsuaj rau daim tawv nqaij.
Tab sis qhov phom sij tseem ceeb ntawm herpes zoster yog kev txhim kho ntawm meningoencephalitis, uas ua rau mob taub hau, ntuav, photophobia, thiab ua rau tsis nco qab. Cov kab mob no feem ntau ua rau tus neeg mob tsis taus. Herpes zoster yog qhov txaus ntshai tshwj xeeb rau cov neeg laus.
Nrog rau qhov txhab ntawm lub qhov muag thiab cov hlab ntsha ntawm lub ntsej muag, tus neeg mob tuaj yeem tsim qhov tshwm sim loj hauv daim ntawv ntawm qhov muag tsis pom lossis glaucoma. Hauv qee kis, tus kab mob herpes zoster tuaj yeem ua rau muaj kab mob siab thiab mob ntsws.
Kev muaj tus kab mob hauv lub cev poj niam feem ntau ua rau lub ncauj tsev menyuam yaig, teeb meem nrog cev xeeb tub, xeeb tub thiab mob qog noj ntshav.
Tus kab mob herpes rov tshwm sim hauv lub cev ntawm tus txiv neej ua rau lub cev tsis muaj zog, uas tsim cov xwm txheej zoo rau kev loj hlob ntawm ntau yam kab mob. Hauv cov txiv neej, prostatitis, vesiculitis, epididymo-orchitis thiabCov kab mob urethritis.
Neonatal herpes tuaj yeem ua rau muaj kab mob loj hauv paj hlwb thiab txawm tuag. Feem ntau qhov tshwm sim ntawm qhov kis kab mob hauv cov menyuam yaus yog meningoencephalitis thiab hydrocephalus, cuam tshuam rau lub hlwb. Yog li, cia saib seb yuav kho herpes zoster li cas.
Kev kho mob
Etiotropic kho ntawm cov txheej txheem pathological yog raws li kev siv cov tshuaj tiv thaiv kab mob DNA ntau lawm, piv txwv li, acyclovir. Cov kev kho mob zoo li no tau zoo nyob rau hauv thawj theem ntawm tus kab mob. Cov tshuaj "Acyclovir" tau muab tso rau hauv cov hlab ntsha, hauv ib hnub ntawm 15-30 mg / kg, uas tau muab faib ua peb qhov kev txhaj tshuaj nrog lub sijhawm 8 teev. Ib koob tshuaj yog diluted hauv isotonic kua. Thaum sau cov ntsiav tshuaj ntawm cov tshuaj no, ib koob tshuaj yog 800 mg 5 zaug hauv ib hnub, rau 5 hnub.
Nws tsis yog ib txwm ua tau sai sai kho herpes zoster nrog tshuaj. Pathogenetic therapy yog raws li kev noj cov dipyridamole, uas ua rau cov txheej txheem ntawm platelet aggregation. Kev kho mob nrog cov tshuaj no yuav tsum yog tsawg kawg 5-7 hnub. Furosemide yog tshuaj rau lub cev qhuav dej. Txhawm rau qhib cov tshuaj tiv thaiv kab mob, kev siv homologous ntawm immunoglobulin (ntawm kev txhaj tshuaj intramuscular) raug pom zoo.
Kev kho mob rau tus kab mob no tau muab tshuaj rau tus kheej, thiab nws nyob ntawm qhov hnyav ntawm nws cov chav kawm. Txhawm rau ua qhov no, siv tshuaj tua kab mob, kho kom zoo thiab tshuaj tua kab mob, rau kev pw tsaug zog tsis zoo - hypnotics thiab sedatives, hauv qee qhov.mob, antidepressants. Yog hais tias cov tsos mob ntawm intoxication yog pronounced, detoxification kho nrog yuam diuresis yog nqa tawm.
Hauv ib cheeb tsam, cov pob khaus tau kho nrog cov tshuaj ntsuab ci ntsa iab, thiab thaum lub sij hawm tawg - nrog dermatol ointment. Thaum tus kab mob thib ob txuas nrog, cov txheej txheem ntawm kev kho tshuaj tua kab mob raug sau tseg. Kev kho mob herpes zoster yog dab tsi, tus kws kho mob yuav qhia.
Tshuaj Ntsuam Xyuas
Cov tshuaj tseem ceeb rau herpes zoster yog:
- "Aciclovir";
- "Famciclovir teva";
- "Amixin";
- "Viferon" (txhais tau tias txhim khu kev tiv thaiv kab mob).
Cov tshuaj hauv qab no yog siv hauv txoj haujlwm:
- antiherpetic;
- painkillers;
- antiviral;
- immunomodulating;
- anti-inflammatory;
- relieves khaus.
Aciclovir
Cov tshuaj no yog ib qho tshuaj tiv thaiv kab mob rau parenteral, sab hauv, sab nrauv thiab siv tshuaj pleev ib ce. Hauv kev kho mob ntawm hom herpes no, feem ntau yog siv rau hauv daim ntawv ntawm cov ntsiav tshuaj "Acyclovir 200 mg". Nws yog ib qho hluavtaws analog ntawm acyclic purine nucleoside. Cov tshuaj tau nce qhov tshwj xeeb tiv thaiv kab mob Herpes simplex (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV) thiab Varicella zoster virus (VZV). Kev ua haujlwm loj tshaj plaws ntawm cov khoom tseem ceeb yog pom muaj feem xyuam rau HSV-1.
Lub tshuab ua haujlwm ntawm "Acyclovir" hauv herpes zoster yog vim li casKev nkag mus ntawm cov khoom nquag ncaj qha rau hauv cov hlwb uas kis tus kab mob thiab tsim cov kab mob thymidine kinase, vim nws yog phosphorylated rau acyclovir monophosphate. Kev ua haujlwm ntawm thymidine kinase ntawm tus kab mob cuam tshuam nrog acyclovir ntau dua li cov nyhuv ntawm cov enzymes intracellular ntawm nws (qhov ntim ntawm acyclovir monophosphate hauv hlwb yog 40-100 npaug siab dua). Tom qab ntawd, qhov tsim ntawm acyclovir triphosphate tshwm sim, uas yog ib qho kev xaiv thiab tsis tshua muaj zog inhibitor ntawm tus kab mob DNA polymerase.
Raws li cov lus qhia, parenterally thiab qhov ncauj "Acyclovir 200 mg" yog muab rau kev kho mob ntawm cov kab mob hauv qab no: rov tshwm sim thiab thawj qhov chaw mos herpes ntawm cov ntaub ntawv hnyav, herpes zoster (Varicella zoster), herpes simplex nrog cov kab mob ntawm cov kab mob. daim tawv nqaij thiab mucous daim nyias nyias (Herpes simplex 1 virus thiab 2 hom), herpes zoster nrog qhov muag koom tes.
YContraindications
Kev kho mob herpes zoster yog dab tsi, nws yog qhov zoo dua kom paub ua ntej, vim tias cov tshuaj muaj ob peb contraindications. Cov tshuaj "Acyclovir" tsis raug sau tseg, yog tias muaj:
- hypersensitivity rau cov khoom xyaw;
- lactase deficiency, qabzib-galactose malabsorption;
- hnub nyoog qis dua 3 xyoos;
- lub sijhawm lactation.
Famciclovir teva
Qhov no yog ib yam tshuaj uas tsim los ntawm cov tshuaj ntawm tib lub npe famciclovir. Nws yog ib qho tshuaj tiv thaiv kab mob. Tom qab kev tswj hwm qhov ncauj, famciclovir tau hloov pauv sai sai rau penciclovir, uas muaj kev tawm tsamCov kab mob herpes tib neeg, nrog rau cytomegalovirus thiab Epstein-Barr virus.
Penciclovir nkag mus rau hauv cov kab mob, qhov twg, nyob rau hauv kev cuam tshuam ntawm tus kab mob thymidine kinase, nws tau hloov mus rau monophosphate, uas, nrog kev koom tes ntawm cellular enzymes, hloov mus rau triphosphate. Penciclovir triphosphate nyob hauv cov kab mob kis tau ntev dua 12 teev, inhibiting kev tsim cov kab mob DNA hauv lawv. Qhov concentration ntawm cov tshuaj no nyob rau hauv cov hlwb tsis muaj kab mob tsis siab tshaj qhov tsawg tshaj plaws uas kuaj tau, yog li ntawd, hauv cov koob tshuaj kho mob, penciclovir tsis cuam tshuam rau cov hlwb tsis muaj kab mob.
Cov tshuaj Famciclovir txo qis lub sijhawm thiab kev siv ntawm postherpetic neuralgia hauv cov neeg mob herpes zoster.
Rau kev kho mob herpes zoster, nws raug nquahu kom noj cov tshuaj no ntawm koob tshuaj 250-500 mg. Lub sijhawm thiab zaus ntawm kev tswj hwm yog nyob ntawm qhov qhia tau, lub raum ua haujlwm, lub cev tiv thaiv kab mob, thiab kev kho tau zoo.
Cov tshuaj yuav tsum tau noj sai li sai tau tom qab pib cov tsos mob ntawm tus kab mob, vim qhov no txoj kev kho yuav zoo dua.
Amiksin
Cov tshuaj no rau kev kho mob herpes zoster hauv cov neeg laus thiab menyuam yaus yog cov tshuaj tiv thaiv kab mob. Nws yog ib qho zoo siv hluavtaws inductor uas txhawb lub cev lub cev ntuj tsim ntawm interferons teej tug mus rau alpha, beta thiab gamma hom. Lub ntsiab tseem ceeb ntawm cov tshuaj "Amiksina" yog tiporon. Hepatocytes (hepatichlwb), granulocytes (cov qe ntshav dawb), T-lymphocytes (thymus cells), thiab plab hnyuv epithelial cells.
Thaum cov tshuaj nkag mus rau hauv lub cev, lawv pib nquag tsim cov tshuaj interferons, qhov siab tshaj plaws ntawm cov khoom tsim tawm hauv 24 teev. Cov tshuaj muaj immunomodulatory thiab antiviral zog. Nws siv tau zoo tiv thaiv keeb kwm yav dhau los ntawm kev kho mob ntawm ntau yam kab mob ntawm tus kab mob, suav nrog herpes, influenza, kab mob ua pa, thiab kab mob siab. Cov tshuaj tiv thaiv kab mob yog vim nws lub peev xwm los tiv thaiv kev tsim cov kab mob los ntawm inhibiting kev txhais cov kab mob proteins hauv cov kab mob.
Amixin tshuaj rau herpes zoster yog tshuaj raws li cov txheej txheem hauv qab no: thawj 2 hnub - 1 ntsiav tshuaj, tom qab ntawd - 1 ntsiav tshuaj ib zaug txhua ob hnub. Nyob rau hauv tag nrho, tus neeg mob yuav tsum noj 10-20 ntsiav tshuaj rau kev kho mob, nyob ntawm seb qhov hnyav ntawm cov txheej txheem pathological.
Viferon
Txij li thaum herpes zoster tshwm nrog kev tiv thaiv tsis muaj zog, "Viferon" pab kom rov zoo los ntawm tus kab mob hauv lub sijhawm luv luv. Cov tshuaj no raug tso cai siv rau hauv cov menyuam yaus, thaum cev xeeb tub. Txawm li cas los xij, txawm tias muaj txiaj ntsig zoo ntawm kev kho mob, kev kho tus kheej yog contraindicated rau lawv.
Lub ntsiab tseem ceeb hauv cov tshuaj muaj pes tsawg leeg yog interferon - cov hlwb protein uas tsis tso cai rau cov kab mob sib kis. Ntxiv nrog rau interferon, ascorbic acid thiab tocopherol-alpha muaj nyob rau hauv cov tshuaj. "Viferon" yog tsimnyob rau hauv daim ntawv ntawm cov tshuaj pleev, gels thiab qhov quav suppositories.
Feem ntau, yuav ua li cas smear herpes zoster, thiab cov txheej txheem ntawm kev kho mob yuav tsum tau pom zoo nrog tus kws kho mob. Cov tswm ciab suav hais tias zoo dua li cov tshuaj pleev thiab gel. Lawv siv rectally, qhov ntau npaum li cas nyob ntawm qhov hnyav thiab hnub nyoog ntawm tus neeg mob. Rau cov neeg laus, cov tshuaj tau sau thaum sawv ntxov thiab yav tsaus ntuj, ib koob tshuaj ntawm 500 txhiab IU. Nws yog ib qho tseem ceeb heev uas yuav tau siv cov tshuaj no hauv 5 hnub. Sab nrauv siv tshuaj pleev "Viferon", nws raug pom zoo kom lubricate pob khaus ntawm daim tawv nqaij.
Txhawm rau ua kom cov kev kho mob ntawm cov kab mob no ua tau zoo li qhov ua tau, nws raug nquahu kom pib noj nws sai li sai tau. Tsis tas li ntawd, txoj kev kho nyuaj yog qhov tseem ceeb - kev sib xyaw ntawm "Viferon" thiab cov tshuaj tiv thaiv kab mob.
Cov tshuaj no tau xyaum tsis muaj contraindications thiab tsis muaj kev phiv. Muaj tsawg zaus, kev hnov mob me ntsis tuaj yeem tshwm sim ntawm qhov chaw siv tshuaj pleev.
painkillers
Qhia seb vim li cas peb thiaj xav tau cov tshuaj tua kab mob herpes zoster. Ntxiv nrog rau cov tshuaj uas tshem tawm tus kab mob ncaj qha, cov tshuaj feem ntau tau sau tseg uas txo qhov mob. Lawv feem ntau raug xaiv raws li:
- "Analgin";
- Y"Paracetamol";
- "Nurofen";
- "Indomethacin";
- Butadion.
Yog tias qhov mob hnyav dhau thiab ua rau ntev, qee cov tshuaj tiv thaiv kab mob xws li Gabapentin lossis Diazepam tuaj yeem siv. Ua ke nrog cov ntsiav tshuajsiv cov tshuaj pleev raws li capsation thiab lidocaine gels.
Thaum mob hnyav, tus kws kho mob tuaj yeem pom zoo siv tshuaj kho mob hnyav los ntawm qeb tshuaj yeeb lossis tshuaj tiv thaiv kev ntxhov siab. Lawv yog "Promedol", "Fortral", "Tramal", thiab lwm yam. Cov tshuaj no yuav tsum tau siv nruj me ntsis raws li kev saib xyuas ntawm tus kws kho mob tshwj xeeb thiab tsuas yog muaj cov tsos mob tsim nyog. Puas muaj lwm yam tshuaj siv los kho tus mob herpes zoster hauv cov neeg laus?
Immunomodulatory tshuaj
Herpes zoster yuav tsum tau kho nrog cov tshuaj tiv thaiv kab mob. Lawv raug muab tshuaj ntxiv rau kev kho tshuaj tiv thaiv kab mob, thiab lawv qhov kev ua yog txhawm rau txhawm rau txhawm rau ua haujlwm ntawm tus kab mob zos.
Vim tias txoj haujlwm ntawm cov tshuaj no yog kev txhawb nqa ntawm tus neeg mob lub cev tiv thaiv kab mob, lawv yuav tsum tau muab tshuaj tsuas yog raws li cov lus qhia, thiab siv raws li cov txheej txheem qhia.
Kev npaj ntawm pab pawg no tuaj yeem yog ntuj thiab hluavtaws. Ob leeg thiab lwm tus nquag siv herpes zoster hauv tus kab mob. Hauv kev kho mob pathologies provoked los ntawm tus kab mob herpes, lawv muaj txiaj ntsig zoo:
- "Lavomax" yog cov tshuaj raws li cov khoom nquag ntawm tilorone, uas tau txais los ntawm kev sib txuas ntawm interferon. Cov tshuaj yog tsim nyob rau hauv daim ntawv ntsiav tshuaj, nws yog contraindicated nyob rau hauv lactation, cev xeeb tub thiab nyob rau hauv lub hnub nyoog ntawm 18 xyoo. Cov xwm txheej tsis zoo uas tshwm sim thaum lub sij hawm txais tos yog qhov tsis tseem ceeb. Cov no yog cov kab mob dyspeptic, ua xua thiab ua rau lub sijhawm luv luv.
- "Proteflazid" yog cov tshuaj hauv daim ntawv tee, raws lidag flavonoids ntawm cov nplej qus uas tuaj yeem cuam tshuam DNA ntawm cov kab mob. Cov tshuaj tsis yog tsuas yog txhim kho kev tiv thaiv hauv zos, tab sis kuj muaj cov khoom antioxidant, pab tshem tawm cov khoom lipid oxidation. Nrog ceev faj, cov tshuaj yog siv thaum cev xeeb tub. Contraindications rau nws yog peptic rwj ntawm lub plab zom mov thaum lub sij hawm exacerbation thiab rhiab heev rau cov khoom.
Tshuaj rau tshuaj pleev ib ce
Yuav ua li cas lwm tus mob herpes zoster kho? Cov neeg feem ntau raug kev txom nyem tsis yog los ntawm qhov mob xwb, tab sis kuj los ntawm qhov khaus hnyav uas tshwm sim hauv thaj tsam pob liab liab. Kev kho mob ntawm cov kab mob no yuav tsum tau siv cov tshuaj tsim nyog.
Raws li txoj cai, lawv yog cov gels, tshuaj pleev thiab tshuaj pleev raws li acyclovir:
- Zovirax;
- Gerpevir;
- Virolex;
- Gerperax thiab lwm tus
Cov tshuaj tiv thaiv khaus khaus rau herpes zoster kuj suav nrog cov tshuaj uas muaj lwm yam tshuaj nquag. Cov no yog, piv txwv li, "Viru-Merz Serol", uas yog raws li tromantadine hydrochloride, "Panavir" nrog cov nroj tsuag rho tawm, "Fenistil Pencivir" raws li penciclovir thiab lwm yam.
