Tilmaamaha AHS / AAN
Ilaalinta xusuus qor madax xanuun waa wax aad u tiro badan oo naga murgayaal ah si aan u aqoonsano kiciyadayada nooceeda ah. Iyagoo si taxadar leh u ilaalineyno oo ka fogaanaya kiciyeyaasheenna, waxaan rajeyneynaa inaan ka hortagno weerarka maskaxda dilaaca. Hase yeeshee, ha niyad jabin, inkastoo ay ka hortagayso, migreeb badan ayaa weli u baahan daaweyn maalin walba ah si looga hortago madax-xanuunka cabsanaya.
Waa maxay Daaweynta Migraine Preventive Treatment?
Daawooyinka ka hortagga ah ayaa la qaataa maalin kasta si loo yareeyo lambarka, darnaanta, iyo mudada weerarada dhanjafka, iyo sidoo kale yareynta naafonimada ay keento madax xanuun badan. Caadi ahaan waxaa loo isticmaalaa kuwa ku xanuunsada hurgunka joogtada ah , laakiin sidoo kale waxaa loo isticmaali karaa migreebka miyir-qabtiga ah.
Tusaalooyinka tilmaamayaasha kartida (marka laga reebo migrejo joogto ah) ee daawooyinka ka hortagga ah waxaa ka mid ah: ka hortagga daaweynta diiqada iyo / ama tayada nolol maalmeedka ama shaqo maalmeedka. Noocyada aan dhicin ee xanuunka dhanjafka ah ee loo yaqaan ' jigraine' iyo 'migraine majesty' ayaa sidoo kale ah calaamad muujinaysa daawo ka hortag ah.
Ururka Aafootiga Ameerikaanka (AHS) iyo Agaasinka Akademiyada Maraykanka ee AAN ayaa aasaasay tilmaamo ku saabsan daawooyinka ay kugula talinayaan ka-hortagga muruqa jilicsan - xannibaadaha aan ba'anayn 15 cisho bishii. Hase yeeshee, qaar badan oo ka mid ah daawooyinkan oo kale ayaa loo isticmaalaa sidii looga hortagi lahaa dadka u dhinta hurgumooyinka daba dheeraaday.
Daweynta cudurada maskaxda ee caadiga ah.
- Antihypertensives (cadaadiska dhiigga cadaadiska dhiigga)
- Dawooyinka lid ku ah diiqadda
- Anticonvulsants
- Petasites (Butterbur)
Cadaadis dhiig oo hoos u dhigaya daawooyinka si looga hortago Migraines
Noocyo daawooyin ah ayaa loo isticmaalaa si looga hortago weerarrada dhanjafka. Cadaadiska dhiigga cadaadiska dhiigga , gaar ahaan beta-blockers, ayaa si caadi ah loo isticmaalaa.
AHS / AAN waxay go'aamisay in metoprolol, propranolol, iyo timolol ay yihiin heer daroogo A. Tani macnaheedu waa inay yihiin kuwo "waxtar leh" oo loogu talagalay ka-hortagga migreentka, halka atenolol yahay daroogada Heerka B ama "laga yaabo inay wax ku ool ah."
Beta-blockers waa in loo isticmaalaa taxadar leh kuwa qaba neefta iyo sokorowga, waxayna u dhigantaa kuwa ka horjeeda kuwa qaba cudurka bradycardia ee calaamadaha (wadnaha hooseeya). Dhibaatooyinka kale ee ka yimaada xannibaadayaasha beta waxaa ka mid ah niyad jab, daal, iyo cillad aan caadi ahayn.
Daawooyinka kale ee cadaadiska dhiigga sida verapamil, calcium-channel blocker , ayaa sidoo kale mararka qaar loo isticmaalaa si looga hortago mareenada, inkastoo caddaynta sayniska ee ka dambeysa aysan ahayn mid xooggan sida kuwa beta-blockers. Nidaamka AHS / AAN 2012 ayaa ku qoran liiska daawooyinka loo yaqaan 'U', taas oo macnaheedu yahay "xog aan ku filneyn oo lagu taageerayo ama lagu dhaleeceynayo isticmaalka cudurka maskaxda ee migreemaxis." Daawooyinka qanjidhada 'antiinfectiveives lisinopril' iyo 'candhutartan' (oo loo yaqaan ACE inhibitor) AHS / AAN, taas oo macnaheedu yahay "waxay suurtogal tahay" ayadoo ku saleysan hal daraasad.
Daawooyinka Niyad-jabka ah si looga hortago Mijo-bararka Miyiriga ah
Dawooyinka antidepressants , gaar ahaan amitriptyline iyo venlafaxin, ayaa loo tixgeliyaa daroogada Heerka B ("laga yaabo inay waxtar leedahay") ka hortagga maskaxda. Venlafaxine (Effexor) waa xakameyn daaweyn serotonin-norepinephrine oo xakameyn ah.
Amitriptyline (Elavil) waa antisepressant tricyclic antidepressant ugu badan ee ka shaqeeya adigoo joojiya soo celinta laba neurotransmitters ee maskaxda, serotonin iyo norepinephrine. Waa daawo saa'id ah oo caadiyan la qaato waqtiga hurdada.
Amitriptyline waxay sidoo kale ka dhigtaa xayawaanka acetylcholine iyo soo-saarka histamine ee maskaxda, taas oo keenaysa saamaynta daawada anticholinergic sida afka qalalan, caloosha, iyo kaadida. Waxay sidoo kale keeni kartaa miisaanka iyo jahawareerka. Ugu dambeyntii, amitriptyline waxay yeelan kartaa saameyno aad u culus sida isdhaafsashada wadnaha, sida waa in laga fogaadaa kuwa qaba cudurada wadnaha ee hoosta ka ah.
Anticonvulsants si looga hortago Migrainy Mellitus
Marka la eego anticonvulsants , Akademiyada Maraykanka ee Nuurolojiga Mareykanka waxay soo gabagabeeyeen in alaabooyinka qiimaha leh, divalproex sodium, iyo sodium valproate, iyo sidoo kale topiramate (topamax) ay yihiin kuwo waxtar leh (daroogada Heerka A) ee ka hortagga uur-jiifka. Dhibaatooyinka kale ee kor ku xusan waxaa ka mid ah
- miisaanka luminta
- daal
- dawakhaad
- walbahaar
- garashada maqnaashaha
- dhadhaminta isbeddelka.
Dhibaatooyinka kale ee daawooyinka valproate waxaa ka mid ah: korodhka miisaanka, lallabbo, tremor, iyo timo lumis.
Butterbur iyo Daawooyin Kale oo Looga Hortagayo Cudurka Migraine
Petasites (Loagobur) waa daroogada Heerka A ee waxtar u leh ka hortagga xanuunka. Tani waa dawo geedeed ama mid kale oo la qaato laba jeer maalintii. Waxyeelada ugu muhiimsan ee daawadu waa qafiifinta GI-du-soke, gaar ahaan ciribtirka.
Daroogooyinka kale ee heerarka B ama daroogada ee "laga yaabo inay waxtar u leeyihiin" ka hortagga maskaxda, sida ay sheegayso Jaamicadda Madaxa Madaxbanaan ee Maraykanku iyo Akademiyada Maraykanka ee Nuurolojiyada Maraykanka waxaa ka mid ah:
- Daaweynta Kale : Feverfew, magnesium, iyo riboflavin
- Qaar ka mid ah NSAIDs (ibuprofen, naproxen)
- Safarrada qaarkood (naratriptan, zolmitriptan): Fadlan ogow , kuwaa waxaa lagu tilmaamay calaamadaha caadada ee caadada ah .
Khadadka hoose
Daawooyinka ka hortaga ayaa mararka qaarkood lagu tilmaamaa in la yareeyo tirada, darnaanta, muddada, iyo naafanimada la xidhiidha hijrada. Sida khabiiradu sheegeen, qaar ka mid ah beta-blockers (metoprolol, timolol, propanolol), anticonvulsants (badeecada valproate, topiramate), iyo kabridda dhirta "butterbur" ayaa lagu aasaasay heerka Heerka A ama "wax ku ool ah" sida daawooyinka ka hortagga uur-jiifka.
Haddii aad ogaato in haajiradaadu ay si xun u saameynayso hawl maalmeedkaaga ama tayada noloshaada, kala hadal dhakhtarkaaga wixii ku saabsan faa'iidooyinka suurtagalka ah iyo halista bilawga daawada ka hortaga xagjirka ah - waxay noqon kartaa wax aad u baahan tahay si ku meel gaar ah ilaa aad ka go'aamin karto xanuunka maskaxda ama raadso hab kale oo aad ku maareyn kartid.
Ilaha:
Bajwa Z, Sabahat A. Daaweynta ka hortagga xanuunka dhanjafka ee dadka waaweyn. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites xididada hybridus (butterbur) waa daaweyn ka hortag ah ee xanuunka dhanjafka. Nuurolojiyada . 2004 Dec 28; 63 (12): 2240-4.
Loder E, Burch R, Rizzoli P. 2012 AHS / AAN tilmaamaha loogu talagalay ka-hortagga jafarka muruqa ah: soo koobid iyo isbarbardhig tilmaan-bixinnada kale ee dhowaan daaweynta. Madax xanuun . 2012; 52: 930-45 .
Podrid P. Dhibaatooyinka ugu weyn ee beta blockers.In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Silberstein SD, Holland S, Freitag F, et al. Cusbooneysiinta tilmaamaha caddaynta ku salaysan: Cilmi-baarista daaweynta fayo-dhawrka daaweynta xanuunka migraine ee dadka qaangaarka ah: warbixinta Heerarka Qiimayaasha Tayada ee Akademiyada Maraykanka ee Nuuroole (American Academy of Neurology). Neurology 2012; 78: 1337.
Diidmada: Macluumaadka ku yaala boggan waa ujeedo waxbarasho kaliya. Waa inaan loo isticmaalin beddelka daryeelka shakhsi ahaaneed ee dhakhtar shati leh. Fadlan u tag dhakhtarkaaga si loo ogaado iyo daaweynta wixii astaamo ah ama xaaladda caafimaad .