Amachiza okwangoku avunyelwe ukunyamezela isisulu somdlavuza kwizigulane zomhlaza anokunceda abanxilisayo ababenzima kakhulu ukunciphisa ukusela kwabo ngokunciphisa ukunqwenela kwabo utywala, kodwa akunakuze kubekho kwiingxaki ezifanelekileyo zokunxiliswa kotywala.
Omnye wamaqela abaniki beengxaki ezinzima ukuba baphathise ngempumelelo abo baziwa njengabanxilisayo bokuqala-abo batywala ukusetyenziswa kwezidakamizwa ngaphambi kokufikelela kwiminyaka eyi-25.
Eli qela likholelwa ukuba linomdla wezinto eziphilayo ngokubhekiselele ekunxilweni, kunye neengxaki zentsapho ezinobunxila.
Ukusela ngokukhawuleza kokusela kotywala ngokuqhelekileyo kunokuxhatshazwa kwimizimba yokuziphatha kuphela, mhlawumbi ngenxa yokuba banokungalingani phakathi kwamakhemikhali amabili "abathunywa" kwingqondo, i-serotonin kunye ne-dopamine. Oku kungalingani kukholwa yizinzululwazi ukudala ukunqwenela kotywala.
Umlinganiselo ophezulu wokubuyela kwixesha lokuqala-usetyenzise utywala
Kukho uphando oluninzi olubonisa ukusetyenziswa kakubi kwe-serotonin phakathi kokusasaza kwezidakwa.
Ukuqala ukuphuza utywala "kunomdla wentsapho enkulu yokwanda kotywala, kwandiswe ukuziphatha okuchasayo, kunye nesifo esizinzileyo kunye nesifo esiqinileyo kunezo ziphuzo zokusela utywala," ngokutsho kweNational Institute of Alcohol Abuse and Alcoholism.
Ukuqala kwangoko kutywala izidyo-mlando akusikuncedwa ngokucebisa, kubonisa ukuziphatha okuchasene nentlalo kunye nezinga eliphezulu lokuphindaphinda xa bezama ukuyeka ukusela.
Ukufuna isisombululo se-Pharmalogical
Ngenxa yokuba eli qela lingaphenduli kakuhle kwipilisi yokuziphatha yedwa, abaphandi baye bafuna imishanguzo yokuphatha ukungalingani kwemichiza.
Omnye wamayeza afunyenwe ngokuphindaphindiweyo ukunciphisa izifiso ezinxilisayo ezidalwa yi-ondansetron, i-ondansetron, imithi evunyiweyo ye-FDA ekusebenziseni ukuphazamisa isicupuchelelo kwizigulane zomhlaza.
Ithengiswa phantsi kwegama lomthi uZofran.
Uphando oluninzi kunye namaqela olwaphulo olusenyongweni lokuqala oluphatha elinye iqela nge-ondansetron kunye neqela elilawulayo elinendawo ye-placebo lifumene ukuba amayeza anceda ukunciphisa izifiso zabo zotywala.
I-Ondansetron iyanciphisa ukukhanga, iintsuku zokusela
Ucwaningo kwiYunivesithi yaseTexas yezeNzululwazi yezeMpilo eSan Antonio malunga nezigulane ezingama-271 ezichongiweyo njengezixhobo zokusela izidakamizwa zifumene ukuba i-dodansetron ngexesha leveki ezili-11 laphumela ekunxilweni okuncinci ngemini kunye neentsuku ezingaphezulu kokusela, xa kuthelekiswa iqela lokulawula.
Olunye uhlolisiso lufanisa ukuba i-ondansetron yanciphisa njani iminqweno ekuqalekeni kotywala kwinto ebizwa ngokuba yi-alcoholic-late those-alcoholics - abo baphuhlise ukusetyenziswa kotywala emva kweminyaka yobudala engama-25. I-Ondansetron yavelisa ukunciphisa okukhulu kwinqweno kwiqela lokuqala, kodwa kungekhona ukusela ngokukhawuleza.
Iziyobisi ezenza i-Dopamine System
Izidakamizwa ezenza umlinganiselo wenkqubo ye-dopamine yengqondo ngokuchaphazela iindlela zendlela ye-neural ziye zaboniswa kwizifundo zangaphambili ukuguqula indlela yokusela. Ezi zi yobisi ziquka i-ondansetron, i- naltrexone , i- topiramate , ne-baclofen.
Olunye uvavanyo lweveki ezisibhozo lufumene ukuba ukudibanisa i-ondansetron kunye ne-naltrexone kunciphisa kakhulu ukusetyenziswa kotywala kwiqela elixutywayo, xa kuthelekiswa nokulawulwa kwe-placebo.
Zimbalwa Zempembelelo Zecala Nge-Ondansetron
Zonke iziphumo ze-ondansetron zifumene ukuba nayiphina imiphumo emibi yonyango ifumanekile. Iimiphumo ezibi zidlalwa ngokugqithiseleyo, ukuxilongwa, iintloko kunye nokudityaniswa.
Nangona kunjalo, enye yeengxaki zokuphatha utywala kunye ne-ondansetron kukuba inani leziyobisi ezisetyenziselwa kuzo zonke izifundo zeklinikhi zazingaphantsi kweli-dosage esetyenziselwa ukunyanga isicupunu kwizilwanyana zomhlaza.
Akunakucandelo Olwenziwe Ngonyango Lokunxiliswa koTywala
Amachiza awafumanekanga kwi-dose yokwelapha yonyango yokusela utywala, kodwa ikhona kuphela, ngaphandle kweendlela zokucandwa ngophando, kumlinganiselo ophezulu wokuphatha i-nudea eyenziwa yi-chemotherapy.
Olunye uphando lwazama ukujonga ukuba i-dosage esetyenziselwa ukunyanga isicupucu yayiza kusebenza ekuphatheni utywala kodwa ayiphumelelanga. Abaphandi baphetha ngelithi: "Kubonakala ngathi iqondo elifanelekileyo lokunyanga utywala alikafuneka lizimisele."
Okwangoku, i-FDA iyavuma iCampral
Nangona uphando lubonisa ukuba i-ondansetron yonyango oluchanekileyo lokunwa kweengxwaba ezidlulileyo kwabikwa iminyaka, kusenako imvume ye-FDA yokuvunyelwa kwesi sibonakaliso. Okwangoku, i- Campral yonyango ivunyiwe yi-FDA ukunyanga utywala ngokunciphisa izifiso.
Xa i-ondansetron sele isetyenziswe kwimarike ixesha elide ukwenzela ukuba lifumaneke kwifomu yobudala, mhlawumbi bekungeke kube yimali eyenzekayo kumenzi ukuba afune imvume yenguqulo ephantsi yezokwelapha ukusetyenziswa kwezidakamizwa zokusetyenziswa kotywala.
Ait-Daaoud, N. et al. "Ukudibanisa i-ondansetron kunye ne-naltrexone kunciphisa ukukhanga phakathi kwezidakwa ezidalwa yizinto eziphilayo: izibonakaliso zokuqala zonyango." Psychopharmacology ngoFebruwari 2001
Bankle, AJ, et al "Ukwelashwa kweMithi yeeNdidi ezahlukeneyo zoTywala." I-American Journal of Psychiatry ngoJuni 2010
I-Caorrea Filho, JM, et al "Uphononongo lwe-dod full-todansetron ukuphatha abantu abaphuza kakhulu ukuphuza utshwala eBrazil." Ukuziphatha ngokutsha kwe- Epreli 2013
Johnson, BA, et al. "I-Ondansetron iyanciphisa ukufunwa kwezilwanyana ezinxilisayo." Psychopharmacology NgoAprili 2002