Ukusebenzisa ukwelashwa njengoba kunqunyiwe kungakhombisa ushintsho olukhulu empilweni yesiguli, esimweni sengqondo nasekuthuthukisweni kwayo lapho umuthi wokwaliwa noma inqubo yokwelashwa isebenza ukulawula izimpawu.

Kunezinhlobo eziningi zemithi yokungezwani komzimba:

Ama-Antihistamine

Ama-antihistamine asebenza ngokuvimba imiphumela yokuvuvukala ye-histamine, enye yamakhemikhali amakhulu akhululwa ngumzimba lapho ihlangana ne-allergen okhuthazwa kuyo. Ama-antihistamine mhlawumbe uhlobo oluhle kakhulu lwemithi yokungezwani komzimba, futhi iningi litholakala kalula ekhemisi ngaphandle kwemithi kadokotela. Bangakwazi ukuzola ukuthimula, ukulunywa, ikhala eligijimayo kanye nesifuba. Ziza ngamaphilisi, uketshezi, amaphilisi ancibilikayo noma izifutho zamakhala. Ama-antihistamine amasha sha, angahlali futhi angahlali phansi aphephe kakhulu kunama-antihistamine amadala, ngoba mancane amathuba okuthi abangele ukozela noma ukuthambisa umzimba.

Abamelene neLeukotriene

Le mishanguzo yokungezwani komzimba ivimbela isenzo seqembu lamakhemikhali, ama-leukotrienes, aqinisa imisipha ezungeze imigwaqo yomoya yamaphaphu. Njenge-histamine, zikhishwa ngesikhathi sokungazwani komzimba ikakhulukazi kusuka kumaseli asemzimbeni, amangqamuzana omzimba, aphakathi kokuvusa ukusabela okweqile.

Ama-Bronchodilators

Zisebenza ngokuxegisa imisipha ebushelelezi yomoya womoya wamaphaphu. Ama-bronchodilators asetshenziselwa ukudambisa ukuqina kwesifuba nokufinyela okuyizimpawu ezisheshayo ze ufuba. Uma uhlushwa ukuvuthwa isifuba noma ukuqina kwesifuba ungasebenzisa ngokuphepha ama-bronchodilators njengokwelapha okukodwa. Uma izimpawu zesifuba zihlala isikhathi eside, ama-bronchodilators kufanele asetshenziswe ngokuhlanganyela ne-corticosteroid inhaler, ezokwelapha ukuvuvukala kwesikhathi eside okubangelwa ukuhlaselwa yisifuba somoya okuphindayo.

Ama-decongestants

Ama-decongestants acinanisa imithambo yegazi emakhaleni futhi anganikezwa njengesifutho samakhala, amaconsi noma njengamaphilisi okuhlinzeka ukukhululeka okusheshayo kokuvaleka kwamakhala. Akufanele zisetshenziselwe izinsuku ezingaphezu kwezingu-7 ngoba zingalimaza izicubu zekhala futhi zidale ukuwohloka kwezimpawu.

Ama-Chromones

Izidakamizwa, i-cromolyn sodium (noma sphiwe) futhi umabhebhana, zivame ukuqoqwa ndawonye njengama-chromones (abizwa nangokuthi ama-cromoglycates). I-Cromoglycate isebenza ngokuvimba izimpendulo zamaseli akhiphe i-histamine ngesikhathi sokuphendula okweqile, futhi ingaba yindlela ewusizo kune-antihistamine ekuvimbeleni ukusabela okweqile. Kodwa-ke, lokhu kwelashwa kusebenza kuphela uma kuthathwe ngaphambi kokuxhumana ne-allergen, futhi kungathatha amasonto ambalwa ukuthi kubonakale imiphumela yokwelashwa. I-Cromoglycate isetshenziswa kakhulu kumaconsi wamehlo, futhi ilusizo kakhulu kulokhu kwelashwa njengoba ama-antihistamine enganikeli ngaso sonke isikhathi ukukhululeka ezimpawu zamehlo zomzimba.

Adrenaline

Adrenaline (i-epinephrine) isetshenziselwa ukwelapha ukushaqeka kwe-anaphylactic, lapho amazinga ngokuzumayo, aphezulu e-histamine nezinye izinto ezikhishwa ngesikhathi sokuphendula okweqile kubangela ukuthi isiguli sibe nenkinga yokuphefumula, futhi futhi kungadala nokulahlekelwa ukwazi. Isebenza ngokulwa nayo yonke imiphumela emzimbeni wokukhishwa okungazelelwe kwegazi le-histamine kanye nama-leukotrienes. Lesi sidakamizwa siyindlela yokwelashwa ephumelela kunazo zonke ye-acute severe generalized allergen reaction eyaziwa nge "anaphylaxis" futhi isindise izimpilo eziningi.

Ukushaqeka kwe-Anaphylactic kungenzeka ngokushesha ngemuva kokuthintana ne-allergen, noma kuze kufike emahoreni ambalwa kamuva. I-Adrenaline yihomoni ekhiqizwa ngumzimba eyehlisa ukuvuvukala okuhambisana nokusabela okweqile, ikhulule izimpawu ze-asthma, inciphisa ukuphefumula, iqinisa imithambo yegazi futhi ivuselele inhliziyo. Ucwaningo lukhombisile ukuthi i-adrenaline esheshayo inikezwa uma ukuphendula kwe-anaphylactic sekuqalile, kuba ngcono imiphumela yezempilo yesiguli. Ngalesi sizathu, abantu abasengozini ye-anaphylaxis bavame ukunikezwa iyunithi elilodwa lokuzilawula ngomjovo noma ngedivayisi yokujova okuzenzakalelayo (ngokwesibonelo i-Epipen, iJext noma i-Anapen) edalwa lapho icindezelwa ngokuqinile esikhunjeni. Isiza esikhethwayo somjovo singene emisipheni engaphandle kwethanga. Kubalulekile ukuthi lokhu kuhlale kuthwalwa nomuntu ongezwani nakho futhi kuyatholakala ukuze kusetshenziswe. Ama-adrenaline auto-injectors abukeka njengezibaya futhi anqunywa ngokwesisindo sesiguli. Iningi lezingane lizonikezwa ngomjovo omncane, kepha izingane ezinkudlwana nentsha zizonikezwa uhlobo lwabantu abadala.

Lapho nje umthamo we-adrenaline usunikiwe, i-ambulensi idinga ukubizwa futhi isiguli kufanele siye esibhedlela ukuze kutholakale okunye ukwelashwa.

Corticosteroids

Ama-Corticosteroids avame ukubizwa nge- “steroids”. I-steroids esetshenziselwa ukwelashwa kokungezwani komzimba icishe ifane ne-hormone yemvelo, i-cortisol, ekhiqizwa yizinhlayiya zomzimba ezi-adrenal. Ama-corticosteroids okwelapha asebenza ngokuvimbela umzimba ekwenzeni izithunywa zamakhemikhali (ezibizwa ngama-cytokines) ezibhekene nokwandisa ukuvuvukala kwezicubu ngokushesha okwenzeka ngemuva kokuvezwa yi-allergen. Ama-Corticosteroids asetshenziselwa ukwelapha ukuvuvukala okuhlala isikhathi eside okutholakala ezimeni ezingalapheki ezifana nesifuba somoya, izimo zesikhumba ezingezwani, i-hay fever kanye ne-perennial rhinitis.

Zinganikezwa nge-nasal spray ye-hay fever kanye ne-perennial allergen rhinitis. Zinciphisa ukuvuvukala. Ukuvuvukala kubangela ikhala eligudlanayo, eligijimayo nelilumayo. Futhi zingathathwa yi-inhalation, ye-asthma, futhi njengokhilimu noma amafutha okugcoba izimo zesikhumba ezingezwani. Ukugwema imiphumela engemihle, la ma-inhaler kanye nezifafazi zenzelwe ukusebenza ebusweni bekhala noma amaphaphu, futhi zingangeni kahle egazini. Ezinye izimpendulo zomzimba zibandakanya isikhathi sesibili, sekwephuzile ukusabela kwesigaba ngemuva kokuphendula kokuqala kokungezwani komzimba. Lesi sigaba sesibili se-allergen reaction sibangelwa amasosha omzimba abiza amanye amaseli omzimba ukuthi avikele umzimba. Lawa maseli akhipha amakhemikhali aqhubekisa phambili ingxenye yomzimba esivele icasuliwe ukusabela kokuqala kokungezwani komzimba, futhi angadala nezimpawu ezingeziwe kwezinye izingxenye zomzimba. ICorticosteroids, ngokungafani nama-antihistamine, inganciphisa izimpawu zalokhu kusabela kwesigaba sekwephuzile, ngokunciphisa ukusebenza kwamaseli abhekele ukukhipha amanye amakhemikhali emzimbeni. Ngale ndlela ama-steroids awagcini nje ngokunciphisa ukuvuvukala, kepha futhi angamisa ukuvuvukala okungalapheki okwenzeka okungapheli.

I-Corticosteroids ingathathwa ifomu lethebulethi ukwelapha ukubonakaliswa okuningi kwesifo somzimba, ngokwesibonelo esigulini esine-asthma, i-allergen rhinitis ne-eczema. Ukuqokwa kwama-corticosteroids efomini yethebhulethi kugcinelwe izimo ezinzima zomzimba.

Isiguli esisebenzisa i-steroids kufanele sibhekwe ngokucophelela futhi sithole ukuhlolwa okujwayelekile.

Ukwelashwa Kwe-anti-IgE

Ukubaluleka kwe-immunoglobulin E (IgE) ezinkingeni ze-atopic ezifana ne-asthma, i-rhinitis ye-allergen, i-allergies yokudla, ne-atopic dermatitis kusungulwe kahle. Ukuphakama kwe-serum ephelele ye-IgE kutholakala kakhulu ezigulini eziningi ze-atopic, nakubantu ababekiwe, i-IgE eqondene ne-allergen iyakhiqizwa. Ama-antibody e-IgE ayimbangela ejwayelekile kakhulu yamasosha omzimba asabela ku-allergen futhi aqale impendulo yokungezwani komzimba. Imithi elwa ne-IgE yenzelwe ukunciphisa ukuzwela kuma-allergen ahogelwayo noma afuthwayo, ikakhulukazi ekulawuleni i-asthma elinganiselayo, engaphenduli emithamo ephezulu ye-corticosteroids. Bakhipha amasosha omzimba e-IgE ngaphandle kwegazi. Imithi elwa ne-IgE ingavumela abanye abantu ukuthi banciphise, futhi bayeke, ukwelashwa kwabo kwe-steroid okuhogelwayo. I-Omalizumab yayiyi-anti-monoclonal antibody yokuqala eyenziwe ngabantu elwa ne-IgE eyethulwe ngo-2005. Okwamanje kunolwazi oluningi ngalo muthi osebenzayo futhi osebenza kahle kakhulu ku-urticaria engapheli eyenzeka njalo.

I-Allergen Immunotherapy

I-Allergen immunotherapy, eyaziwa nangokuthi ukungafuni ukuzwela noma ukuzwela ngokweqile, yindlela yokwelashwa yezinhlobo ezithile zokungezwani komzimba. Kutholwe nguLeonard Noon noJohn Freeman ngo-1911, i-allergen immunotherapy iwukuphela komuthi owaziwayo ukubhekana hhayi kuphela nezimpawu kodwa nezimbangela zokungezwani komzimba nokuphefumula. Ukuphela kokwelapha okuyimbangela okuguqula amasosha omzimba. Kuyasiza ekulweni nokungezwani kwemvelo, ukungezwani komzimba nokulunywa yizinambuzane, nesifuba somoya. Inzuzo yayo yokungezwani komzimba nokudla ayicaci ngakho-ke akunconywa. I-Immunotherapy iyaphikiswa ezigulini ezine-asthma enamandla, engazinzile noma engalawulwa.

Ukujova i-Allergen Immunotherapy - SCIT

I-Allergen immunotherapy ifaka umjovo wenani elikhulayo le-allergen ngaphansi kwesikhumba kuze kwehle ukuzwela kwe-allergen. Ukujova kuqala kunikezwa masonto onke noma kabili ngesonto bese kuba njalo ngenyanga esikhathini esiyiminyaka emi-3-5. Izimpawu zokungezwani komzimba ngeke zime ubusuku bonke. Imvamisa ziyathuthuka phakathi nonyaka wokuqala wokwelashwa, kepha ukuthuthuka okubonakala kakhulu kuvame ukwenzeka ngonyaka wesibili. Ngonyaka wesithathu, iningi labantu selingasenaso isisindo semizimba yokungezwani komzimba equkethwe amashothi - futhi asisenakho ukungezwani okubalulekile kokungezwani komzimba nalezo zinto. Ngemuva kweminyaka embalwa yokwelashwa okuphumelelayo, abanye abantu abanazinkinga ezinkulu zokungezwani komzimba noma ngabe kumiswe isibhamu sokwaliwa. Abanye abantu badinga isibhamu esiqhubekayo ukugcina izimpawu zilawulwa. Le ndlela yokwelashwa isebenza kahle kakhulu kwizinyosi, umnyovu, ijakhethi ephuzi, i-hornet ne-ant venom allergy kanye nokwaliwa yizifo ezithile ezingadonswa umoya ezifana notshani, ukhula nempova yezihlahla. Ukujova i-immunotherapy nakho kungaba lusizo ekuphathweni kwekati, inja, uthuli nezikhunta zokungezwani komzimba. Lolu hlobo lwemithi yokungezwani komzimba yilona kuphela uhlobo lokwelashwa kwesifo esingezwani nomzimba esinganciphisa kakhulu izimpawu noma lungaholela ekuxazululeni izimpawu ngokuphelele ngaphandle kwemithi futhi, lapho lunikezwa izingane, lungavimbela ukuthuthukiswa kwesifo esingezwani nokungezwani. Ngoba kunengozi yokuphendula okweqile okwenzeka ngokushesha noma ngemuva nje kokujova, i-allergen immunotherapy kumele inikezwe ehhovisi lezokwelapha lapho kunemithi efanelekile nemishini etholakalayo. Iziguli kufanele zihlale ziqashelwe okwelashwa imizuzu engama-20 - 30 ngemuva komjovo we-immunotherapy uma kwenzeka kwenzeka ukungezwani komzimba. Imiphumela emibi ngesikhathi sokwelashwa imvamisa yendawo futhi imnene futhi imvamisa ingaqedwa ngokulungisa umthamo. Izinzuzo zingahlala iminyaka ngemuva kokumiswa kokwelashwa.

I-Sub-Lingual (Oral) Allergen Immunotherapy - ISITITI

I-Sublingual immunotherapy (i-SLIT) iyindlela entsha ye-immunotherapy. Esikhundleni sokujova i-allergen ngaphansi kwesikhumba, amanani amancane afakwa ngaphansi kolimi imizuzu emibili bese egwinywa. Kunezinhlobo ezimbili ze-SLIT - amaphilisi namaconsi - ngesikhathi esitholakalayo sempova yotshani, uthuli lwasendlini kanye ne-ragweed. Amaphilisi we-allergen angaphansi (i-SLIT-tablet) - I-Allergen yenziwa ithebhulethi eqedwa ngokushesha ebanjwa ngaphansi kolimi ize ichitheke ngokuphelele. Amaphilisi ayazenzela, kanye ngosuku. Izicashunwa ezingaphansi kwe-liquid allergen (SLIT-drops) - Isikhombi samanzi noma oketshezi se-allergen, esilawulwa njengamaconsi, naso sibanjwa ngaphansi kolimi okwemizuzu embalwa bese sigwinywa. I-allergen ithathwa ngomlomo womlomo. Ukubamba okukhishwe ngaphansi kolimi kubonakala kusebenza kakhulu ekulethweni kwesidakamizwa esisebenzayo. I-Sublingual immunotherapy (SLIT) -tablet therapy iqalwa ngomthamo wokuqala onikezwe ngaphansi kweso lezokwelapha, bese ukuphathwa kuqhubeka kanye ngosuku futhi kuzenzela isiguli noma umnakekeli ekhaya.

Abantu abanenkinga yokungezwani komzimba nomzimba bavame ukungezwani nezinto ezingaphezu kwesisodwa. Ama-Shots anganikeza ukukhululeka kwe-allergen engaphezu kweyodwa, ngenkathi ukwelashwa kwe-SLIT kukhawulelwe ku-allergen eyodwa.

Kunobuhle nobubi balezi zinhlobo ezahlukene zemithi yokwaliwa komzimba

  • I-SLIT iphephe kakhudlwana, inokusabela okweqile kokungezwani komzimba nokwasendaweni kune-SCIT.
  • I-SLIT inethezeke kakhulu ezigulini, ayikho inaliti.
  • I-SLIT ilula kakhulu ezigulini nasemitholampilo ngoba imishanguzo iyazenzela isiguli noma umnakekeli ekhaya.
  • Ukunamathela ekwelashweni kwesiguli kubalulekile. Iziguli ezilahlekelwa yimithamo njalo kungenzeka zingabi nemiphumela egculisayo.
  • Imfundo yesineke izodingeka ukuqinisekisa ukuthi ukwelashwa kwenziwa ngokuphepha nangempumelelo. Iziguli zizodinga imfundo yokuthi ungayisebenzisa kanjani kabusha imishanguzo ngemuva kwezilinganiso ezingekho.

Buza udokotela wakho okhuluma ngokungezwani nomzimba noma ukungezwani komzimba nezinto ezithile, angakusiza wenze izinqumo ezinhle zesikhashana nezesikhathi eside.