Litaelo tse tsoang ho AHS / AAN
Ho boloka boitsebiso ba hlooho ea hlooho ke ntho e ngata ho rona ba nang le migraine ba etsa e le hore re tsebe hore na migraine ea rona e bakoa ke eng. Ka ho boloka lipampiri tsa rona le ho li qoba, re na le tšepo ea ho thibela tlhaselo ea migraine e fokolisang. Leha ho le joalo, a re be re tiile, ho sa tsotellehe ho qoba ho itšireletsa, ba bangata ba hlokang meriana ba ntse ba hloka meriana ea letsatsi le letsatsi ho thibela lihlooho tsena tse tšosang.
Meriana ea Thibelo ea Migraine ke eng?
Meriana e thibelang e nooa letsatsi le leng le le leng ho fokotsa palo, matla, le nako ea tlhaselo ea migraine, hammoho le ho fokotsa bokooa bo tlisoang ke hlooho ea makhetlo khafetsa. Li sebelisoa hangata bakeng sa ba nang le mafu a sa foleng , empa le tsona li ka sebelisoa bakeng sa li-migraineurs.
Mehlala ea lintho tse ka hlahang (ho fapana le migraine e sa foleng) bakeng sa meriana ea thibelo e kenyelletsa: ho hanyetsana le ho phekola kalafo le / kapa boleng bo sa sebetseng ba bophelo kapa ts'ebetsong ea letsatsi le leng le le leng. Mefuta e mengata ea migraine joaloka hemiplegic migraine kapa basilar migraine e ka boela ea e-ba pontšo bakeng sa meriana ea thibelo.
Mokhatlo oa American Headache (AHS) le American Academy of Neurology (AAN) e thehile melaetsa ea meriana eo ba e khothalletsang ho thibela migraine ea episodic - migraine e se nang letho ebe matsatsi a 15 ka khoeli. Leha ho le joalo, tse ngata tsa meriana e tšoanang li sebelisoa e le thibelo ho ba nang le mafu a sa foleng a migraine.
Mefuta e tloaelehileng ea phekolo ea migraine e thibelang.
- Antihypertensives (khatello ea mali e theolelang)
- Ho tepella maikutlo
- Anticonvulsants
- Petasites (Butterbur)
Khatello ea Mali Meriana e Fokotsang ho Thibela Migraines
Mefuta e mengata ea meriana e sebelisoa ho thibela litlhaselo tsa migraine. Li-agent tse fokolang khatello ea mali , haholo-holo beta-blockers, li sebelisoa ka tloaelo.
AHS / AAN e entse qeto ea hore metoprolol, propranolol, le timolol ke litekanyetso tsa A lithethefatsi. Sena se bolela hore li nkoa li "atlehile" bakeng sa thibelo ea migraine, athe atenolol ke lithethefatsi tsa Level B kapa "mohlomong e sebetsa."
Li-beta-blockers li lokela ho sebelisoa ka tlhokomelo ho ba nang le lefu la tsoekere le lefu la tsoekere 'me ba batla ba sa lumellane le ba nang le matšoao a tšoaetso ea pelo. Litla-morao tse ling tsa beta blockers li kenyeletsa maikutlo a fokolang, mokhathala le ho se sebetse ha erectile.
Mathata a mang a khatello ea mali a kang verapamil, calcium-channel , ka linako tse ling a sebelisoa ho thibela migraine, le hoja bopaki ba saense bo ka morao bo sa matla joaloka ba beta-blockers. Melao-motheo ea AHS / AAN 2012 e thathamisitse verapamil e le "m" lithethefatsi, ho bolelang hore ho na le "boitsebiso bo sa lekaneng ba ho tšehetsa kapa ho hanyetsa tšebeliso ea migraine prophylaxis." Li-antiinpertensives lisinopril le candesartan (tse tsejoang e le li-inhibitor tsa ACE) li arotsoe e le lithethefatsi tsa boemo ba C AHS / AAN, e bolelang hore "e ka sebetsa hantle" e thehiloe thuputsong e le 'ngoe feela.
Ho tepella maikutlo ho thibela Migraine ea Majoe
Li-anti-depressants , haholo-holo amitriptyline le venlafaxine, li nkoa e le lithethefatsi tsa Level B ("mohlomong li sebetsa") bakeng sa thibelo ea migraine. Venlafaxine (Effexor) ke serotonin-norepinephrine reuptake inhibitor e khethollang.
Amitriptyline (Elavil) ke motho ea tloaelehileng ka ho fetisisa oa tricyclic e sebetsang ka ho thibela phetoho ea li-neurotransmitter tse peli bokong, serotonin le norepinephrine. Ke meriana ea ho sithabela 'me hangata e nkoa ka nako ea ho robala.
Amitriptyline e boetse e thibela methapo ea acetylcholine le li -receptor tsa histamine bokong, e leng ho bakang litla-morao tsa anticholinergic joaloka molomo o omeletseng, ho pata, le ho boloka moriana. E boetse e ka etsa hore motho a be le boima ba 'mele le pherekano. Qetellong, amitriptyline e ka ba le litla-morao tse tebileng joaloka ho khanna ha pelo, ka hona ho lokela ho qojoa ho ba nang le lefu la pelo.
Anticonvulsants ho Thibela Li-Migraine tsa Episodic
Mabapi le li-anticonvulsants , American Academy of Neurology e ile ea etsa qeto ea hore lihlahisoa tsa valproate, divalproex sodium, le valproate ea sodium, hammoho le topiramate (topamax) li atleha (Thibelo A lithethefatsi) ho thibela migraine. Litla-morao tsa topiramate li kenyeletsa
- ho lahleheloa ke boima
- mokhathala
- botsoa
- paresthesias
- ho se sebetse hantle
- ho fetola tatso.
Litla-morao tsa meriana ea valproate e kenyelletsa: ho fumana boima ba 'mele, ho nyeheloa ke pelo, ho thothomela le ho lahleheloa ke moriri.
Butterbur le Meriana e Meng ea ho Thibela Migraine ea Likokoana-hloko
Petasites (butterbur) ke e 'ngoe ea litekanyetso tsa lithethefatsi tse atlehang ho thibela migraine. Ena ke meriana ea litlama kapa e meng e nkiloeng habeli ka letsatsi. Sepheo se ka sehloohong se hlahisa maikutlo a bonolo a GI a halefile, haholo-holo a mabe.
Mefuta e meng ea lithethefatsi B kapa lithethefatsi tse "nang le katleho" bakeng sa thibelo ea migraine, joalokaha ho boletsoe ke American Headache Society le American Academy of Neurology li kenyelletsa:
- Mefuta e meng ea phekolo : feverfew, magnesium le riboflavin
- Li-NSAID tse ling (ibuprofen, naproxen)
- Litlhapi tse ling tsa triptans (naratriptan, zolmitriptan): Ka kopo hlokomela , tsena li bonts'oa bakeng sa ho ilela khoeli ea migraine .
The Bottom Line
Ka linako tse ling meriana e thibelang e bontšoa ho fokotsa palo, matla, nako, le bokooa bo amanang le migraines. Ho ea ka litsebi, ba bang ba beta-blockers (metoprolol, timolol, propanolol), anticonvulsants (valproate dihlahisoa, topiramate), le herbal supplement butterbur e thehiloe e le Level A kapa "e sebetsang" e le meriana ea thibelo ea li-episodic migraines.
Haeba u fumana hore migraine ea hau e ama bophelo ba hau ba letsatsi le letsatsi kapa boleng ba bophelo, buisana le ngaka ea hao ka melemo le likotsi tsa ho qala meriana ea thibelo ea migraine - e ka 'na ea e-ba ntho eo ue hlokang nakoana ho fihlela u ka tseba hore na migraine e qala kapa fumana tsela e 'ngoe ea ho sebetsana le boemo.
Lisebelisoa:
Bajwa Z, Sabahat A. Ho thibela phekolo ea migraine ho batho ba baholo. Ka: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A. Petasites hybridus motso (butterbur) ke pheko e sebetsang ea ho thibela migraine. Neurology . 2004 Qetellong ea 28; 63 (12): 2240-4.
Loder E, Burch R, Rizzoli P. Ts'ebetso ea 2012 AHS / AAN bakeng sa thibelo ea migraine ea li-episodic: kakaretso le ho bapisoa le lihlahisoa tse ling tsa morao-rao tsa ts'ebetso ea bongaka. Hlooho ea hlooho . 2012; 52: 930-45 .
Podrid P. Litholoana tse kholo tsa beta blockers.In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2013.
Silberstein SD, Holland S, Freitag F, et al. Tlhaloso e thehiloeng ho tataiso: phekolo ea pharmacologic bakeng sa thibelo ea migraine ho batho ba baholo: tlaleho ea Quality Standards Subcommittee ea American Academy of Neurology le Mokhatlo oa Hlooho ea Amerika. Neurology 2012; 78: 1337.
LITLHAHISO: Boitsebiso bo sethaleng sena ke merero ea thuto feela. Ha ea lokela ho sebelisoa e le sebaka sa tlhokomelo ea botho ke ngaka e nang le tumello. Ke kopa o bone ngaka ea hau bakeng sa ho hlahlojoa le ho phekoloa leha e le efe mabapi le matšoao kapa boemo ba bongaka .