Daaweynta Calaamadaha Cudurka Dabeesha ee Polycystic Ovary Syndrome
Xanuunkan ugxan-sidaha ah (PCOS) waa xaalad qatar ah oo saameysa qiyaastii boqolkiiba 10 dumarka da'da dhalashada. Haweenka qaba PCOS waxay la kulmi karaan calaamado kala duwan oo kala duwan isbeddelada niyadda iyo xaaladaha maqaarka (finan, timo badan oo waji leh) ilaa xilliyo aan caadi ahayn iyo dhibaatooyinka bacriminta.
Daawooyinka loo isticmaalo PCOS waxay ujeedadoodu tahay in la yareeyo calaamadaha cudurka.
Inkasta oo aysan jirin wax daawo ah ee loo yaqaan PCOS, waxaad yareyn kartaa saameynta cudurkan adigoo sii wadaya hab nololeed caafimaad leh iyo maareynta calaamadaha leh isticmaalka daroogada.
Daawooyinka loo Isticmaalo Inay Xakameyaan Cirbad-Xumada
PCOS waxaa lagu gartaa astaamo hoormooni ah oo keeni kara xilliyo aan caadi ahayn ( oligomenorrhea ) ama mudada maqnayd ( amenorrhea ). Kuwani iyo habdhaqanka kale ee hormoon la'aanta ah ayaa wiiqi kara awooda dumarka inay uur yeelato. Daaweynta maandooriyaha waxaa loogu talagalay in lagu hagaajiyo hormoonnada si loo fiicnaado wareegga caadada caadiga ah.
Labada xulasho ayaa sida caadiga ah loo isticmaalaa kaniiniyada xakameynta dhalmada iyo Provera, labaduba waxay xakameynayaan wareegga caadadaada adoo siinaya hormoonkii jirkaagu u baahnaa. Marka la eego heerarka hoormoonka, xuubka ilmagaleenka ayaa si joogto ah u daadin kara, si looga hortago dhuubnaanta unugyada ay sababaan waqtiyo maqan ama aan joogto ahayn.
Glucophage (metformin), daroogada sonkorowga, waxay bixisaa faa'iidada labad ee hoos u dhigista caabbinta insulin sida badanaa lagu arko haweenka qaba PCOS halka kor u qaadista caadada.
Daawooyinka loo isticmaalo in lagu daaweeyo Kansarka
Qalitaanka hormoon la'aanta hormoonka PCOS waxay sababi kartaa in qulqulatooyin aan caadi ahayn ama maqnaansho ah (anovulation). Daawooyin kala duwan ayaa loo isticmaali karaa si loo daaweeyo tan, kor u qaadidda tayada labada ukun (oocyte) iyo daaweynta ugxan-darrada ah. Habka daaweynta koowaad ee dawada, waxaa ka mid ah daawooyinka kobcinta (clomiphene citrate) iyo Femara (letrozole).
In kasta oo Clomid loo isticmaalo si loo xoojiyo ugxanta, Femara ayaa laga yaabaa inay si fiican uga shaqeyso haweenka PCOS maadaama aysan kor u qaadin heerarka estrogen ama aysan kordhin halista ilmo badan oo kala duwan sida Clomid.
Daaweynta hoormoonka ee kala duwan ayaa sidoo kale loo isticmaali karaa in lagu kiciyo ugxanta, oo ay ka mid yihiin:
- Hoos u kicinta hormoonka (FSH) , taasoo kicinaysa koritaanka ukunta
- Lungining hormone (LH), oo kiciya xayiraadda ukunta ee ugxansidaha
- Gonadotropin (HCG) ee sheybaarka dadka , kaas oo xaqiijinaya koriinka ukunta
- Estrace (estrogen) , kaas oo u diyaariya ilmo-galeenka si uu u helo ukunta
- Provera (Progesterone) , kaas oo u diyaariya ilmo galeenka ilmagaleenka
- Menopur (menotropins), oo keena FSH iyo LH by cirbadeynta
- Bravelle (urofollitropin), kaas oo keena FSH cirbadeynta
Dhanka kale, dheecaan aan hormoon ahayn, inositol , ayaa lagu muujiyay in la hagaajiyo oocyte iyo tayada embriyaha iyada oo kor loo qaado heerka uurka ee haweenka qaba PCOS.
Daawooyinka lagu Daaweynayo Cadaadiska Insulinta
Qiyaastii 50 boqolkiiba haweenka qaba PCOS waxay horumarin doonaan sonkorowga ama kahor-sonkorowga da'doodu tahay 40 jir. Waxaa intaa dheer, waxay halis weyn ugu jiraan inay yeeshaan sonkorowga uurka, xaalad ay sababtay awoodda daciifinta ee lagu garto sonkorta (sonkorta) xilliga uurka.
Daawooyinka sonkorowga ayaa si joogto ah loo isticmaalaa si loo yareeyo heerarka gulukooska iyo insulin ee haweenka leh insulin-resistenta PCOS.
Waxaa intaa dheer, isbedelka doorashooyinka qaab nololeedka, oo ay ku jiraan jimicsi iyo cuntooyin ay ku yar yihiin dufanka iyo sonkorta sonkorta leh, ayaa loo tixgeliyaa habka daaweynta.
Fursadaha daaweynta waxaa ka mid ah:
- Glucophage (metformin) , oo xakameyn kara cudurka macaanka iyo caawinta miisaanka luminta
- Victoza (liraglutide) , daroogada laysku duro ayaa loo isticmaalaa in lagu xakameeyo insulin iyo glucose
- Actos (pioglitazone), oo ah nooc ka mid ah daroogada laysku duro ayaa loo isticmaalaa si loo yareeyo sonkorta dhiigga oo sareysa
- Avandia (rosiglitazone), daroogada la isku duro ee isla fasalka sida pioglitazone
- Avandamet, isku-dar ah rosiglitazone iyo metformin.
Daawooyinka lagu Caawinayo Miisaanka Culayska
Qiyaas ahaan kala badh haweenka qaba PCOS waa cayil ama cayil.
Ma aha oo keliya PCOS-ga oo ku kordhinaysa miisaanka, taasina waxay ka dhigeysaa mid aad u adag haweenka in ay miisaanka lumiyaan . Marka lagu daro jimicsiga iyo cuntada, daaweynta dawooyinka waxaa mararka qaarkood loo isticmaalaa caawinta miisaan lumis, inkastoo ay u muuqdaan inay la yimaadaan waxyeelo muhiim ah.
Fursadaha hadda jira waxaa ka mid ah:
- Xinical (orlistat), oo ah daroogo ka hortagi kara nuugista dufanka
- Qsymia (phentermine / topiramate), xakameyn cunto yari
- Belviq (lorcaserin), xakameyn cunto kale
- Contrave (Naltrexone / bupropion), oo xakamayn karta cuntada
- Saxenda (liraglutide) , oo loo isticmaalo daawaynta insulin-ta iyo cayilka
- Inositol , dabiiciyan dabiiciga ah oo lala xiriirinayo miisaanka lumista haweenka qaba PCOS
Daawooyinka loo Isticmaaley daaweynta timaha iyo timaha
Haweenka haysta PCOS waxay inta badan leeyihiin heerar sare oo hormoon ah oo lab ah (androgens), oo ay ku jiraan testosterone. Daawooyinka ka hortaga iyo ka hortaga xitaa waxay shaqeeyaan xannibaad ku sameynta hormoonnada kuwaas oo yareynaya sifooyinka labka ah ee labka ah, oo ay ka mid yihiin hirsutism (timaha iyo jidhka oo xad dhaaf ah) ama timo lumis.
Fursadaha daaweynta waxaa ka mid ah:
- Aldactone (spironolactone) , daawo lagu durayo oo leh saameyn liddi ku ah is-galka
- Vaniqa (eflornithine hydrochloride) , kareemka jirka ah ee loo isticmaalo in lagu xannibo koritaanka timaha
- Propecia (finasteride) , waxay isticmaashaa calaamad muujinaysa in lagu daaweeyo timaha lumista haweenka qaba PCOS
Marka laga soo tago isbeddelka koritaanka timaha, korriimada korriinka iyo korriinshaha waxay keeni kartaa horumarinta finanka. Tan waxaa badanaa lagu daaweeyaa kiriimyada miisaanka oo ay ka mid yihiin benzoyl peroxide , salicylic acid , retinoids , ama antibiotics .
Ereyga
Marka aad la qabsanaysid calaamadahaaga PCOS, waxaad u baahan doontaa inaad la shaqeyso dhakhtarkaaga. Waxaa jiri kara qaar ka mid ah daawooyinka aan kugu habbooneyn sababo caafimaad darro, isdhexgal daawo, iyo waxyaabo kale. U hubso inaad fahamto daaweynta lagu taliyey iyo sida loo qaato daawada takhaatirta si habboon.
Xigasho:
> Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison Mabaadii'da Daaweynta Gudaha . New York: Waxbarashada McGraw-Hill, 2015.