Back Clinic Oxidative Stress Chiropractic ndi Functional Medicine Team. Kupsinjika kwa okosijeni kumatanthauzidwa ngati kusokonezeka kwapakati pakupanga mpweya wokhazikika (ma free radicals) ndi chitetezo cha antioxidant. Mwa kuyankhula kwina, ndi kusalinganika pakati pa kupanga ma free radicals ndi kuthekera kwa thupi kulimbana kapena kuchotseratu zotsatira zovulaza kudzera mu neutralization ndi antioxidants. Kupsinjika kwa okosijeni kumabweretsa zovuta zambiri zapathophysiological m'thupi. Izi zikuphatikizapo matenda a neurodegenerative, mwachitsanzo, matenda a Parkinson, matenda a Alzheimer's, kusintha kwa majini, khansa, matenda otopa kwambiri, matenda osalimba a X, matenda a mtima ndi mitsempha ya magazi, atherosclerosis, kulephera kwa mtima, matenda a mtima, ndi matenda otupa. Oxidation imachitika nthawi zambiri:
ma cell amagwiritsa ntchito glucose kupanga mphamvu
chitetezo cha mthupi chimalimbana ndi mabakiteriya ndikupanga kutupa
matupi amachotsa zinthu zoipitsa, mankhwala ophera tizilombo, ndi utsi wa ndudu
Pali mamiliyoni azinthu zomwe zimachitika m'matupi athu nthawi iliyonse zomwe zimatha kubweretsa okosijeni. Nazi zizindikiro zingapo:
kutopa
Kuwonongeka kwa kukumbukira kapena chifunga cha ubongo
Kupweteka kwa minofu kapena mafupa
Makwinya pamodzi ndi imvi
Kuchepa kwa maso
Mutu komanso kumva phokoso
Kulandira matenda
Kusankha zakudya zamagulu ndi kupewa poizoni m'dera lanu kumapangitsa kusiyana kwakukulu. Izi, komanso kuchepetsa nkhawa, zitha kukhala zopindulitsa pakuchepetsa okosijeni.
Kwa anthu omwe akufuna kukhala ndi thanzi la mtima, kodi kudya ma prunes kungathandize kuthandizira thanzi la mtima?
Prunes ndi Moyo Wamoyo
Prunes, kapena plums zouma, ndi zipatso zokhala ndi fiber zambiri zomwe zimakhala ndi michere yambiri kuposa ma plums atsopano ndipo zimathandizira chimbudzi ndikuyenda m'matumbo. (Ellen Lever et al., 2019) Kafukufuku watsopano akusonyeza kuti angapereke zambiri kuposa chimbudzi ndi kudzimbidwa, malinga ndi kafukufuku watsopano woperekedwa ku American Society for Nutrition. Kudya prunes tsiku lililonse kumatha kukulitsa kuchuluka kwa cholesterol ndikuchepetsa kupsinjika kwa okosijeni ndi kutupa.
Kudya ma prunes 10 mpaka XNUMX patsiku kumathandizira thanzi la mtima.
Ubwino waumoyo wamtima wogwiritsa ntchito pafupipafupi udawonedwa mwa amuna.
Kwa amayi achikulire, kudya ma prunes nthawi zonse sikunawononge mafuta m'thupi, shuga wamagazi, ndi insulin.
Kafukufuku wina adapeza kuti kudya 50-100 magalamu kapena ma prunes asanu mpaka khumi tsiku lililonse kumalumikizidwa ndi kuchepetsedwa kwa matenda amtima. (Mee Young Hong et al., 2021)
Kutsika kwa cholesterol ndi zolembera zotupa zinali chifukwa cha kusintha kwa ma antioxidant.
Mapeto ake anali akuti prunes amatha kuthandizira thanzi la mtima.
Prunes ndi Plums Mwatsopano
Ngakhale kafukufuku wasonyeza kuti prunes ikhoza kuthandizira thanzi la mtima, izi sizikutanthauza kuti plums kapena madzi a prune angapereke ubwino womwewo. Komabe, palibe maphunziro ambiri okhudza ubwino wa plums watsopano kapena madzi a prune, koma ndizotheka kuti angatero. Komabe, kufufuza kwina n’kofunika. Ma plums atsopano omwe aumitsidwa mumpweya wotentha amapangitsa kuti zipatsozo zikhale ndi thanzi labwino komanso moyo wake wa alumali, zomwe zingakhale chifukwa chake zouma zouma zimakhala ndi zakudya zambiri. (Harjeet Singh Brar et al., 2020)
Anthu angafunike kudya ma plums kuti apindule nawo.
Kudya ma prunes 5-10 kumawoneka ngati kosavuta kuposa kuyesa kufanana ndi ma plums atsopano.
Koma njira iliyonse ndi yabwino m'malo mwa prune juice chifukwa zipatso zonse zimakhala ndi fiber zambiri, zimapangitsa thupi kukhala lodzaza, komanso zopatsa mphamvu zochepa.
Ubwino Kwa Achinyamata Pawokha
Kafukufuku wambiri wachitika kwa amayi ndi abambo omwe ali ndi zaka zopitirira 55, koma anthu ang'onoang'ono amathanso kupindula ndi kudya prunes. Zakudya zomwe zimakhala ndi zipatso ndi ndiwo zamasamba zimaonedwa kuti ndi zathanzi, choncho kuwonjezera ma prunes pazakudya zanu kumawonjezera thanzi. Kwa anthu omwe sakonda prunes, zipatso monga maapulo ndi zipatso zimalimbikitsidwanso pa thanzi la mtima. Komabe, zipatso zimangopanga gawo limodzi lazakudya, ndipo ndikofunikira kuyang'ana pazakudya zopatsa thanzi ndi masamba, nyemba, ndi mafuta opatsa thanzi. Prunes ali ndi ulusi wambiri, kotero anthu akulimbikitsidwa kuti aziwonjezera pang'onopang'ono pazochitika zawo za tsiku ndi tsiku, chifukwa kuwonjezera kwambiri nthawi imodzi kungayambitse kupweteka, kutupa, ndi/kapena. kudzimbidwa.
Kugonjetsa Kulephera kwa Mtima Wam'mimba
Zothandizira
Lever, E., Scott, S. M., Louis, P., Emery, P. W., & Whelan, K. (2019). Zotsatira za prunes pakutulutsa chimbudzi, nthawi yodutsa m'matumbo ndi m'mimba microbiota: kuyesa kosasinthika. Zakudya zachipatala (Edinburgh, Scotland), 38 (1), 165-173. doi.org/10.1016/j.clnu.2018.01.003
Hong, M. Y., Kern, M., Nakamichi-Lee, M., Abbaspour, N., Ahouraei Far, A., & Hooshmand, S. (2021). Kugwiritsa Ntchito Plum Zouma Kumawonjezera Mphamvu ya Cholesterol Yonse ndi Antioxidant ndi Kuchepetsa Kutupa kwa Azimayi Athanzi Omaliza Menopausal. Journal ya zakudya zamankhwala, 24 (11), 1161-1168. doi.org/10.1089/jmf.2020.0142
Harjeet Singh Brar, Prabhjot Kaur, Jayasankar Subramanian, Gopu R. Nair & Ashutosh Singh (2020) Mmene Chemical Pretreatment on Drying Kinetics and Physio-chemical Characteristics of Yellow European Plums, International Journal of Fruit Science, 20:sup2, S252-S , DOI: 279/10.1080
Dr. Alex Jimenez, DC, akuwonetsa momwe kupanikizika kosatha kungakhudzire thupi komanso momwe zimayenderana ndi kutupa mu mndandanda wa 2-part. Part 1 anaunika momwe kupsinjika maganizo kumayenderana ndi zizindikiro zosiyanasiyana zomwe zimakhudza ma jini a thupi. Gawo 2 limayang'ana momwe kutupa ndi kupsinjika kwakanthawi kumayenderana ndi zinthu zosiyanasiyana zomwe zingayambitse kukula kwa thupi. Timatumiza odwala athu kwa akatswiri azachipatala ovomerezeka omwe amapereka chithandizo chamankhwala kwa anthu ambiri omwe akuvutika ndi kupsinjika kwanthawi yayitali komwe kumakhudzana ndi mtima, endocrine, ndi chitetezo chamthupi chomwe chimakhudza thupi ndikupanga kutupa. Timalimbikitsa aliyense wa odwala athu powatchula kwa azachipatala ogwirizana nawo malinga ndi kuwunika kwawo moyenera. Timamvetsetsa kuti maphunziro ndi njira yosangalatsa tikamafunsa opereka athu mafunso malinga ndi zomwe wodwala akufuna komanso kumvetsetsa. Dr. Jimenez, DC, amangogwiritsa ntchito chidziwitsochi ngati ntchito yophunzitsa. chandalama
Kodi Kupsinjika Maganizo Kungatikhudze Bwanji?
Dr. Alex Jimenez, DC, akupereka: Kupsinjika maganizo kumatha kubweretsa malingaliro ambiri omwe angakhudze kwambiri ambiri aife. Kaya ndi mkwiyo, kukhumudwa, kapena chisoni, kupsinjika maganizo kungapangitse aliyense kufika povuta kwambiri ndi kuyambitsa mikhalidwe yomwe ingayambitse matenda a mtima. Chifukwa chake anthu omwe ali ndi ukali wapamwamba kwambiri, mukayang'ana zolemba zamtima, amakhala ndi mwayi wopulumuka. Mkwiyo ndi wosewera woyipa. Mkwiyo umayambitsa arrhythmia. Kafukufukuyu adayang'ana, tsopano popeza tili ndi anthu omwe ali ndi ICDs ndi defibrillators, tikhoza kuyang'anitsitsa zinthu izi. Ndipo tikuwona kuti mkwiyo ukhoza kuyambitsa ma ventricular arrhythmias mwa odwala. Ndipo ndizosavuta kutsatira, ndiukadaulo wathu wina.
Mkwiyo walumikizidwa ndi magawo a atrial fibrillation. Mukaganizira izi, ndi adrenaline kutsanulidwa m'thupi ndikupangitsa kuti mtima ukhale wolimba. Ikuwonjezera kugunda kwa mtima. Zonsezi zimatha kuyambitsa arrhythmia. Ndipo sichiyenera kukhala AFib. Itha kukhala ma APC ndi ma VPC. Tsopano, kafukufuku wosangalatsa kwambiri watuluka wokhudza telomerase ndi telomeres. Ma telomere ndi zipewa zazing'ono pa ma chromosome, ndipo telomerase ndi puloteni yolumikizidwa ndi mapangidwe a telomere. Ndipo tsopano, tikhoza kumvetsetsa kupyolera mu chinenero cha sayansi, ndipo tikuyamba kugwiritsa ntchito luso lamakono ndi kugwiritsa ntchito sayansi m'njira yomwe sitingathe kuchitapo kale kuti timvetse zotsatira za kupsinjika maganizo pa ma telomeres ndi ma telomerase enzymes.
Zomwe Zimayambitsa Kupsinjika Kwambiri
Dr. Alex Jimenez, DC, akupereka: Chifukwa chake m'modzi mwa anthu ofunikira kuti aphunzire izi ndi wopambana Mphotho ya Nobel, Dr. Elizabeth Blackburn. Ndipo zomwe ananena ndikuti uku ndi kutha, ndipo tibwereranso ku maphunziro ake ena. Amatiuza kuti ma telomeres a makanda ochokera kwa amayi omwe ali m'chiberekero anali ndi nkhawa zambiri kapena anali afupi kwambiri akakula poyerekeza ndi amayi omwe analibe zovuta zofanana. Kupsyinjika kwamaganizo kwa amayi pa nthawi yomwe ali ndi pakati kungapangitse kuti pulogalamu ya telomere biology ipangidwe yomwe imawonekera kale pa kubadwa monga momwe zimakhalira ndi kutalika kwa telemetry ya leukocyte. Choncho ana akhoza kubwera atasindikizidwa, ndipo ngakhale atatero, izi zikhoza kusinthidwa.
Nanga bwanji tsankho laufuko mabokosi awa pano akuwonetsa tsankho lambiri lomwe limatsogolera ku utali wa telomere, womwe ambiri aife timaganizapo. Chifukwa chake, kutalika kwa telomere kumadzetsa chiopsezo chowonjezereka cha khansa komanso kufa kwathunthu. Matenda a khansa ndi 22.5 pa zaka 1000 za munthu mu gulu lalifupi kwambiri la telomere, ndime 14.2 pakati pa gulu, ndi 5.1 mu gulu lalitali kwambiri la telomere. Ma telomere amfupi angayambitse kusakhazikika kwa chromosome ndikupangitsa kuti khansa ipangidwe. Kotero, tsopano tikumvetsa, kupyolera mu chinenero cha sayansi, zotsatira za kupsinjika maganizo pa pulojekiti ya telomerase ndi kutalika kwa telomere. Malinga ndi Dr. Elizabeth Blackburn, 58 akazi premenopausal anali osamalira ana awo odwala matenda vesi akazi amene anali ndi ana athanzi. Amayiwo adafunsidwa momwe amaonera kupsinjika m'miyoyo yawo komanso ngati kumakhudza thanzi lawo pokhudza ukalamba wawo.
Ilo linali funso la kafukufukuyu pamene ankayang'ana kutalika kwa telomere ndi telomerase enzyme, ndipo izi ndi zomwe anapeza. Tsopano, mawu ofunika apa akudziwika. Sitiyenera kuweruzana wina ndi mzake. Kupsyinjika ndi kwaumwini, ndipo mayankho athu ena akhoza kukhala chibadwa. Mwachitsanzo, munthu yemwe ali ndi homozygous comps ndi jini waulesi akhoza kukhala ndi nkhawa zambiri kuposa munthu yemwe alibe chibadwa cha polymorphism. Wina yemwe ali ndi MAOA mu MAOB akhoza kukhala ndi nkhawa zambiri kuposa munthu yemwe alibe chibadwa cha polymorphism. Chifukwa chake pali gawo la majini pamayankhidwe athu, koma zomwe adapeza ndizovuta zamaganizidwe. Ndipo kuchuluka kwa zaka zosamalira ana odwala matenda osachiritsika kumalumikizidwa ndi kutalika kwa telomere ndi kuchepa kwa ntchito ya telomerase, zomwe zimapereka chisonyezero choyamba chakuti kupsinjika maganizo kungakhudze kusamalira telomere ndi moyo wautali.
Dr. Alex Jimenez, DC, akupereka: Izi ndi zamphamvu, ndipo ambiri opereka chithandizo chamankhwala ali pamavuto amtundu wina. Ndipo funso nlakuti, kodi tingatani kuti tisinthe mayankho athu? Framingham anayang'ananso za kuvutika maganizo ndipo adazindikira kuti kuvutika maganizo kwachipatala ndi chiopsezo chachikulu cha zochitika za mtima ndi zotsatira zoipa kusiyana ndi kusuta fodya, shuga, LDL yapamwamba, ndi HDL yochepa, yomwe ndi yopenga chifukwa timathera nthawi yathu yonse pazinthu izi. Komabe, sitithera nthawi yochuluka tikulimbana ndi mbali zamaganizo za matenda a mitsempha. Izi zimakhudzidwa ndi kupsinjika maganizo, kufufuza, kuyesa kosavuta kwa kuvutika maganizo, kuyang'ana anthu omwe ali ndi vuto lalikulu la kuvutika maganizo ndi kuchepa kwa maganizo. Ndipo mukhoza kuona kuti pamene mukuyenda kuchokera pansi kupita kumtunda wapamwamba, pamene mukugwira ntchito, mwayi wopulumuka umakhala wochepa.
Ndipo ambiri aife tili ndi malingaliro athu chifukwa chake izi zimachitika. Ndipo ndi chifukwa chakuti ngati tili opsinjika maganizo, sitinena kuti, “O, ndidya mphukira za ma brussels, ndipo nditenga mavitamini a B amenewo, ndikupita kukachita masewera olimbitsa thupi, ndipo ndichita kusinkhasinkha. " Chifukwa chake post-MI yodziyimira payokha pachiwopsezo cha chochitika ndikukhumudwa. Malingaliro athu okhudzana ndi kupsinjika maganizo amatipangitsa kuti tisamagwire bwino ntchito ndipo amatha kupanga matupi athu kukhala ndi zinthu zomwe zimakhudza ziwalo zathu zofunika, minofu, ndi mfundo. Kotero, kuvutika maganizo ndi wosewera wamkulu, monga 75% ya imfa za pambuyo pa MI zimagwirizana ndi kuvutika maganizo, chabwino? Kotero kuyang'ana odwala, tsopano, muyenera kufunsa funso: Kodi ndi kuvutika maganizo komwe kumayambitsa vutoli, kapena ndi matenda a cytokine omwe atsogolera kale ku matenda a mtima omwe amachititsa kuvutika maganizo? Tiyenera kufotokozera zonsezi.
Ndipo kafukufuku wina adayang'ana anthu opitilira 4,000 omwe alibe matenda a coronary poyambira. Pakuwonjezeka kulikonse kwa mfundo zisanu pa sikelo ya kuvutika maganizo, chiopsezochi chinawonjezeka ndi 15%. Ndipo iwo omwe anali ndi ziwopsezo zapamwamba kwambiri anali ndi 40% kuchuluka kwa matenda amitsempha yamagazi komanso kufa kwa 60%. Chifukwa chake nthawi zambiri aliyense amaganiza kuti ndi matenda a cytokine omwe amatsogolera ku MI, matenda amtima, komanso kukhumudwa. Ndiyeno, ndithudi, mukakhala ndi chochitika, ndipo mutuluka ndi nkhani zambiri zozungulira izo, tikudziwa kuti anthu omwe ali ndi nkhawa amakhala ndi chiwerengero chowirikiza cha imfa, kuwonjezeka kasanu imfa pambuyo pa matenda a mtima, ndipo zotsatira zoipa ndi opaleshoni. Zili chonchi, chinayamba ndi chiyani, nkhuku kapena dzira?
Kodi Kupsinjika Maganizo Kumagwirizana Bwanji ndi Kupsinjika Maganizo Kwanthawi Zonse?
Dr. Alex Jimenez, DC, akupereka: Dokotala aliyense amadziwa izi. Safuna kuchita opaleshoni anthu ovutika maganizo. Amadziwa kuti zotsatira zake sizabwino, ndipo, ndithudi, sangatsatire malangizo athu onse abwino azachipatala. Ndiye ndi njira ziti zomwe zimayenderana ndi vuto la autonomic zomwe zawunikidwa kusinthasintha kwa kugunda kwa mtima komanso kuchepa kwa omega-3s, zomwe zimakhudza kwambiri ubongo, komanso kuchepa kwa vitamini D. tulo tobwezeretsa, ndipo ambiri mwa odwala athu amtima amakhala ndi vuto la kupuma. Ndipo kumbukirani, musamangoganiza kuti ndi odwala mtima olemera omwe ali ndi khosi lalifupi lalifupi; zikhoza kukhala zonyenga kwambiri. Ndipo ndizofunika kwambiri kuyang'ana mawonekedwe a nkhope ndipo, ndithudi, kugwirizana kwa anthu, komwe ndi msuzi wachinsinsi. Ndiye kodi autonomic dysfunction ndi makina? Kafukufuku wina adawona kusiyana kwa kugunda kwa mtima kwa anthu omwe ali ndi MI yaposachedwa, ndipo adayang'ana anthu opitilira 300 omwe ali ndi kupsinjika maganizo komanso omwe alibe kupsinjika. Iwo adapeza kuti zizindikiro zinayi za kugunda kwa mtima zidzatsika mwa anthu omwe ali ndi kuvutika maganizo.
Kutupa M'matumbo & Kupsinjika Kwambiri
Dr. Alex Jimenez, DC, akupereka: Kotero apa pali magulu awiri a anthu omwe ali ndi vuto la mtima ndi kusinthasintha kwa mtima, akukwera pamwamba ngati etiology yotheka. Chimodzi mwazinthu zambiri zomwe zingakhudzenso kupsinjika kwakanthawi m'thupi ndi momwe matumbo a microbiome amachitira gawo lake pakupsinjika kwa okosijeni. M'matumbo ndi chilichonse, ndipo odwala ambiri amtima amaseka chifukwa amafunsa akatswiri awo amtima kuti, "N'chifukwa chiyani mumasamala za microbiome yanga? Chifukwa chiyani izi zingakhudze mtima wanga?" Chabwino, kutupa konseko m'matumbo kumayambitsa matenda a cytokine. Ndipo zomwe ambiri aife tayiwala kuyambira kusukulu ya zamankhwala ndikuti ambiri mwa ma neurotransmitters athu amachokera m'matumbo. Chifukwa chake kutupa kosatha komanso kuwonekera kwa ma cytokines otupa kumawoneka kuti kumayambitsa kusintha kwa dopamine ntchito ndi basal ganglia, zowonetsedwa ndi kukhumudwa, kutopa, komanso kuchepa kwa psychomotor. Chifukwa chake sitingatsimikize gawo la kutupa ndi kukhumudwa kokwanira ngati tiyang'ana pachimake matenda a coronary ndi kukhumudwa, komwe kumalumikizidwa ndi zolembera zapamwamba za kutupa, CRP yokwera kwambiri, kuchepa kwa HS, kutsika kwa kugunda kwa mtima, ndi china chake chomwe sichinachitikepo. amakapimidwa m'chipatala, ndiko kuperewera kwa zakudya m'thupi.
Ndipo pamenepa, adayang'ana ma omega-3s ndi ma vitamini D, kotero kuti osachepera, kufufuza kwa omega-3 ndi mlingo wa vitamini D ndizovomerezeka mwa odwala athu onse. Ndipo ndithudi, ngati mungathe kupeza matenda athunthu chifukwa cha kutupa koyambitsa nkhawa. Vuto lina lomwe muyenera kuyang'ana pokhudzana ndi kutupa komwe kumayambitsa kupsinjika ndi kufooka kwa mafupa m'malo olumikizirana mafupa. Anthu ambiri omwe ali ndi matenda osteoporosis adzakhala ndi kutayika kwa minofu, kuwonongeka kwa chitetezo cha mthupi, mafuta ozungulira pakati, ndi shuga wambiri wamagazi amagwirizanitsidwa ndi ukalamba, ndipo amatha kubwera kuchokera kumagulu okwera a cortisol m'thupi.
Chiwopsezo chachikulu cha matenda a mtima a cortisol ndi okwera kawiri mwa anthu omwe amamwa kwambiri ma steroid. Ma steroid ang'onoang'ono alibe chiwopsezo chofanana, chifukwa chake sichinthu chachikulu. Inde, timayesetsa kuchotsa odwala athu ku steroids. Koma mfundo apa ndi yakuti cortisol ndi hormone yopanikizika ndipo ndi hormone yopanikizika yomwe imayambitsa kuthamanga kwa magazi ndikuyika kulemera kwapakati, imatipangitsa kukhala odwala matenda a shuga, imayambitsa insulini kukana, ndipo mndandanda ulibe malire. Chifukwa chake, cortisol ndiwosewerera kwambiri, ndipo zikafika pazamankhwala ogwira ntchito, tiyenera kuyang'ana mayeso osiyanasiyana okhudzana ndi kuchuluka kwa cortisol monga kumva kwa chakudya, valavu yamasiku atatu, valavu ya nutra, komanso kupsinjika kwa adrenal. kuyesa kwa index kuti muwone zomwe zikuchitika ndi odwala. Pakakhala dongosolo lamanjenje lachifundo komanso kuchuluka kwa cortisol, tidakambirana chilichonse kuyambira coagulopathy mpaka kuchepa kwa kugunda kwa mtima, kunenepa kwambiri, matenda a shuga, ndi matenda oopsa.
Ubale Wamakolo & Kupsinjika Kwanthawi Zonse
Dr. Alex Jimenez, DC, akupereka: Ndipo kuyatsa dongosolo la renin-angiotensin zonse zimalumikizidwa ndi kupsinjika. Tiyeni tiwone kafukufukuyu yemwe adayang'ana ophunzira 126 a Harvard Medical, ndipo adatsatiridwa kwa zaka 35, kafukufuku wautali. Ndipo iwo anati, matenda aakulu, matenda a mtima, khansa, matenda oopsa ndi chiyani? Ndipo anafunsa ophunzirawa mafunso ophweka kwambiri, kodi ubale wanu ndi amayi anu ndi abambo anu unali wotani? Kodi chinali pafupi kwambiri? Kodi kunali kwaubwenzi ndi kwaubwenzi? Kodi zinali zololera? Kodi chinali chovuta komanso chozizira? Izi ndi zomwe adapeza. Iwo adapeza kuti ngati ophunzirawo atazindikira ubale wawo ndi makolo awo kuti wasokonekera 100% pachiwopsezo chachikulu chaumoyo. Zaka makumi atatu ndi zisanu pambuyo pake, ngati adanena kuti kunali kotentha ndi kotseka, zotsatirazo zidadula gawolo pakati. Ndipo zingathandize ngati mungaganizire za zomwe zili ndi zomwe zingafotokoze izi, ndipo muwona momwe zokumana nazo zaubwana zimatipangitsa kudwala m'mphindi zochepa ndi momwe timaphunzirira luso lathu lolimbana ndi vutoli kuchokera kwa makolo athu.
Kutsiliza
Dr. Alex Jimenez, DC, akupereka: Mwambo wathu wauzimu umachokera kwa makolo athu nthawi zambiri. Makolo athu ndi amene amatiphunzitsa kaŵirikaŵiri mmene tingakwiyire kapena kuthetsa mikangano. Choncho makolo athu atikhudza kwambiri. Ndipo mukaganizira za izi, kulumikizana kwathu nakonso sikodabwitsa kwambiri. Ili ndi kafukufuku wotsatira wazaka 35.
Kupsinjika kwakanthawi kumatha kuyambitsa zovuta zingapo zomwe zingagwirizane ndi matenda komanso kusagwira bwino ntchito kwa minofu ndi mafupa. Zingakhudze dongosolo la m'matumbo ndikuyambitsa kutupa ngati sizikusamalidwa nthawi yomweyo. Chifukwa chake zikafika pazovuta za kupsinjika komwe kumakhudza moyo wathu watsiku ndi tsiku, zitha kukhala zinthu zambiri, kuyambira pazovuta mpaka mbiri yabanja. Kudya zakudya zopatsa thanzi zomwe zimakhala ndi antioxidants, kuchita masewera olimbitsa thupi, kuchita masewera olimbitsa thupi, komanso kupita kuchipatala cha tsiku ndi tsiku kungathe kuchepetsa zotsatira za kupsinjika maganizo kosatha ndi kuchepetsa zizindikiro zomwe zimagwirizanitsa zomwe zimagwirizanitsa ndi kupweteketsa thupi. Titha kupitiliza ndiulendo wathu wathanzi komanso wathanzi wopanda zowawa pogwiritsa ntchito njira zosiyanasiyana zochepetsera kupsinjika kwakanthawi m'matupi athu.
Dr. Alex Jimenez, DC, akuwonetsa momwe kupanikizika kungakhudzire anthu ambiri ndikugwirizanitsa ndi mikhalidwe yambiri m'thupi mu mndandanda wa 2-part. Timatumiza odwala athu kwa madokotala ovomerezeka omwe amapereka chithandizo chochuluka kwa anthu ambiri omwe ali ndi matenda oopsa omwe amakhudzana ndi mtima, endocrine, ndi chitetezo cha mthupi chomwe chimakhudza thupi. Timalimbikitsa aliyense wa odwala athu powatchula kwa azachipatala ogwirizana nawo malinga ndi kuwunika kwawo moyenera. Timamvetsetsa kuti maphunziro ndi njira yosangalatsa tikamafunsa opereka athu mafunso malinga ndi zomwe wodwala akufuna komanso kumvetsetsa. Dr. Jimenez, DC, amangogwiritsa ntchito chidziwitsochi ngati ntchito yophunzitsa. chandalama
Momwe Kupsinjika Maganizo Kumakhudzira Thupi
Dr. Alex Jimenez, DC, akupereka: Tsopano aliyense amayankha kusintha kwa chilengedwe mosiyana. Pankhani ya anthu ambiri amene amachita zinthu za tsiku ndi tsiku kuyambira ku ntchito yawo, kutsegula Loweruka ndi Lamlungu, kuchulukana kwa magalimoto pamsewu, kulemba mayeso, kapena kukonzekera mawu aakulu, thupi limapitirizabe kuchita zinthu mopitirira muyeso mpaka kufika potopa kwambiri. zimene zimachititsa kuti munthuyo atope komanso kuti azivutika maganizo. Ndipo chofunikira ndikuzindikira izi zisanachitike, pamene tikuwona zotsatira za kupsinjika maganizo kwa odwala athu ndi ife eni. Ndipo chinthu choyamba kuzindikira ndi chomwe chochitika choyambirira chikuyambitsa izi.
Kaya chochitika choyamba chikhale chotani, chofunikira kwambiri ndi momwe timaonera chochitikacho. Kodi zikutanthauza chiyani kwa ife? Ndi malingaliro athu? Pamene thupi likudutsa muzochitika zoyambira izi, zingayambitse malingaliro kuti atsogolere kuyankha ndi zotsatira za thupi lathu. Chifukwa chake malingaliro ndi chilichonse tikamalankhula za kupsinjika ndi kuyankha kwapakatikati. Tsopano, tili ndi zinthu zopitilira 1400 zomwe zimachitika mthupi. Chifukwa chake pacholinga chankhani iyi, tikambirana zitatu zazikuluzikulu: adrenaline ndi neuro-adrenaline, aldosterone, komanso, cortisol.
Ndipo n’cifukwa ciani zimenezi n’zofunika? Chifukwa chilichonse mwa izi chimakhudza kwambiri matenda amtima. Tsopano, m’zaka za m’ma 1990, madokotala ambiri anayamba kumvetsa mmene kupsinjika maganizo kumakhudzira thupi. Ndipo chimachitika ndi chiyani kwa anthu pamene HPA-axis yawo ikuwonetsa kuti ali pachiwopsezo ndikuyamba kusefukira matupi awo ndi mahomoni opsinjika? Chabwino, tikuwona kuwonjezeka kwa coagulation. Timawona kusintha kwa renin ndi angiotensin system. Zimatsitsimutsa. Timawona kulemera kwa anthu ndi kukana insulini. Zomwe anthu ambiri sadziwa ndikuti lipids imakhala yachilendo ndi kupsinjika. Pafupifupi aliyense wa odwala athu amadziwa kuti tachycardia ndi arrhythmia zimachitika pamene adrenaline yathu ikuyenda, ndipo kuthamanga kwa magazi kumawonjezeka. Tsopano, ganizirani za izi kupyolera mu chinenero cha mankhwala.
Cha m'ma 1990, madokotala anali kupatsa aspirin ndi Plavix panthawiyo kuti asokonezeke. Tikupitiriza kupereka ma ACE ndi ma ARB kwa odwala athu. Zotsatira za cortisol zimayambitsa kunenepa komanso kukana insulini. Timapereka ma statins; timapereka metformin. Timapereka ma beta blockers a izi, tachycardia, ndi calcium blockers pa kuthamanga kwa magazi. Chifukwa chake timadzi tating'onoting'ono tomwe timayatsidwa ndi kupsinjika, tili ndi mankhwala omwe timagwiritsa ntchito kuti tichite bwino. Ndipo moona mtima, kwa zaka zambiri, tinkakambirana za momwe ma beta blockers anali abwino pamtima. Chabwino, mukaganizira za izi, ma beta blockers amaletsa adrenaline. Kotero pamene madokotala ayang'ana pa izi, amayamba kuganiza, "Chabwino, mwinamwake tiyenera kusinkhasinkha ndi kusinkhasinkha, chabwino? Tikugwiritsa ntchito mankhwalawa, koma tingafunike kuyang'ana njira zina zosinthira kupsinjika maganizo. "
Kodi Vasoconstriction ndi chiyani?
Dr. Alex Jimenez, DC, akupereka: Sitidzawerenga zizindikiro zonsezi chifukwa zilipo zambiri, koma zonse zimabwera ku chinthu chomwecho. Kupsinjika maganizo. Tiyenera kuganizira za munthu yemwe wachita ngozi ya galimoto, mwachitsanzo, ndipo munthuyo akutuluka magazi. Choncho thupi ndi lokongola chifukwa limaika pamodzi njira yolepheretsa munthu kutuluka magazi kapena vasoconstriction. Vasoconstriction ikupanga mitsempha yamagazi iyi ndikupanga mapulateleti kumamatira kuti apange magazi, ndipo magazi amatha kuyima. Izi zimawonjezera kutulutsa kwa mtima mwa kukweza kugunda kwa mtima ndikuwonjezera aldosterone, zomwe zimapangitsa kuti mchere ndi madzi azisungirako kukweza kuthamanga kwa magazi. Chifukwa chake kwa wina yemwe ali pachiwopsezo chachipatala, monga ngozi, kutuluka magazi, kapena kutsika mphamvu, uku ndiye kukongola kwa thupi la munthu. Koma mwatsoka, tikuwona anthu akukhala motere, kwenikweni 24/7. Chifukwa chake timadziwa vasoconstriction ndi kukhazikika kwa mapulateleti, ndipo tikuwona kuwonjezeka kwa zolembera za kutupa, homocysteine, CRP, ndi fibrinogen, zonse zomwe zimawonjezera chiopsezo cha mtima.
Timawona zotsatira za cortisol, osati kungowonjezera kuthamanga kwa magazi, osati kungoyambitsa matenda a shuga ndi insulini kukana, komanso kuika mafuta a m'mimba mozungulira pakati. Ndiyeno, monga muwona mumphindi zochepa, pali maulalo pakati pa zochitika zodetsa nkhawa ndi arrhythmias monga atrial fibrillation komanso ventricular fibrillation. Kwa nthawi yoyamba mu zamankhwala, m’maganizo, tili ndi matenda otchedwa takosubo cardiomyopathy, omwe mwachikondi amatchedwa matenda a mtima wosweka. Ndipo ichi ndi matenda omwe myocardium imagwedezeka kwambiri mpaka kupangitsa kuti minyewa yamanzere igwire bwino ntchito kapena kusagwira bwino ntchito. Ndipo kawirikawiri, izi zimayambitsidwa ndi nkhani zoipa ndi chochitika chodetsa nkhawa. Zikuoneka kuti wina akufunika kumuika mtima. Ndiye tikamaganizira za ngozi zakale za Framingham, timati, ndi ziti mwa izi zomwe zimakhudzidwa ndi kupsinjika?
Zizindikiro za Kupsinjika Maganizo
Dr. Alex Jimenez, DC, akupereka: Anthu ali ndi mitundu yonse ya makhalidwe oipa kupsinjika maganizo, kaya abwenzi a 20 mu paketi ya ndudu, kudya Cinnabon iyi chifukwa zimandipangitsa kumva bwino pakalipano, kapena cortisol yonse idzandipangitsa ine kunenepa komanso matenda a shuga. Ma lipids amakwera chifukwa cha kupsinjika; kuthamanga kwa magazi kumakwera pansi pa kupsinjika maganizo. Chifukwa chake chilichonse mwazinthu zowopsa izi chimakhudzidwa ndi mahomoni opsinjika. Ndipo, ndithudi, tikudziwa kuti ndi kutembenuka kwa RAS dongosolo kapena renin-angiotensin dongosolo, nthawi zonse timawona kuwonjezereka kwa mtima kulephera. Ndipo izi zafotokozedwa kwambiri m'mabuku. Ndipo, kwa inu omwe mungagwire ntchito m'chipinda chodzidzimutsa, funsani odwala anu zomwe anali kuchita asanabwere ndi gawo lawo la kulephera kwa mtima kapena kupweteka pachifuwa. Ndipo mudzamva nkhani ngati, ndinali kuwonera kanema woyipa, kapena ndimawonera kanema wankhondo, kapena ndimakhumudwa ndi masewera a mpira, kapena china chonga icho.
Tikambirana za kugunda kwa mtima, komwe kumakhudzidwa ndi kupsinjika. Ndipo, ndithudi, kupsinjika maganizo kumakhudza mphamvu yathu yolimbana ndi matenda. Ndipo tikudziwa kuti anthu amakhala ndi nkhawa akalandira katemera. Mwachitsanzo, ma laser a Cleco amagwira ntchito koma satulutsa ma antibodies ku katemera akakhala ndi nkhawa. Ndipo, ndithudi, monga muwona mu miniti, kupsinjika kwakukulu kungayambitse imfa yadzidzidzi ya mtima, MI, ndi zina zotero. Chifukwa chake ndi wosewera woyipa yemwe amanyalanyazidwa. Ndipo kwa odwala athu ambiri, kupsinjika kumayendetsa sitima. Kotero pamene tikukamba za kudya masamba a brussels ndi kolifulawa ndipo, mukudziwa, masamba ambiri obiriwira, ndipo wina ali ndi nkhawa kwambiri moti amayesa kulingalira, "Kodi ndidutsa bwanji tsikuli? ” Sakumva zina mwazinthu zina zomwe timalimbikitsa.
Chifukwa chake, kupsinjika kwanthawi yayitali ndi zovuta zamagulu, kaya kukhumudwa, nkhawa, kapena mantha, timayika phazi lathu pa accelerator ndikutsitsimutsa dongosolo lamanjenje lachifundo. Tikudziwa kuti zomwezo zomwe timawona ndi ukalamba, monga muwona mumphindi imodzi, zimalumikizidwa ndi kuchuluka kwa mahomoni opsinjika, makamaka cortisol. Kotero kaya ndi kufooka kwa mafupa, kuchepa kwa mafupa, kuchepa kwa endothelial, kutsegula kwa mapulateleti, kuthamanga kwa magazi, kunenepa kwambiri, kapena insulin kukana, izi zimachokera ku kupsinjika maganizo. Ndipo tiyenera kukhala ndi ndondomeko kwa odwala athu momwe tingachitire izi. American Institute of Stress ikuti 75 mpaka 90% ya maulendo onse azachipatala amabwera chifukwa cha zovuta zokhudzana ndi kupsinjika. Ndipo ndizokwera kwambiri, koma poyang'ana odwala komanso komwe amalowera, amafotokozera madotolo awo nkhani zawo. Zotsatira zake ndi zofanana; zilibe kanthu kaya ndi mutu, kupsinjika kwa minofu, angina, arrhythmia, kapena matumbo okwiya; pafupifupi nthawi zonse zinkayambitsa kupsinjika maganizo.
Kupsinjika Kwambiri & Kusakhazikika
Dr. Alex Jimenez, DC, akupereka: Pali kusiyana pakati pa kupsinjika kwamphamvu ndi kosatha ndi momwe timaonera komanso kulumikizana kwathu. Ngakhale timapeza mphamvu kuchokera ku mphamvu zapamwamba, kupsinjika maganizo kumakhudza aliyense, ndipo ambiri aife sitingathe kupirira bwino. Chotero kufufuza kwakukulu kunachitidwa zaka zambiri zapitazo ndi Dr. Ray ndi Holmes amene ananena, zaka 50 zapitazo, anasonkhanitsa pamodzi njira yoŵerengera zochitika zosintha moyo. Choncho tiyeni tione mbali zina, monga kusintha kwa moyo. Kodi zochitika zosintha moyo zimasintha bwanji ndipo zimakhala bwanji? Kodi zazikulu ndi ziti, ndipo zazing'ono ndi ziti?
Ndipo kodi kusankhidwa kumeneku kumabweretsa bwanji mavuto aakulu azachipatala monga khansa, matenda a mtima, ndi imfa yadzidzidzi m'tsogolomu? Chifukwa chake adayang'ana zochitika 43 zosintha moyo, adaziyika poyambirira, ndikuziyikanso m'ma 1990s. Ndipo ena a iwo adakhalabe momwemo. Anapereka ziwerengero zosinthira pamwambowo, kenako adayang'ana manambala omwe angagwirizane ndi matenda akulu. Kotero, mwachitsanzo, chochitika chosintha moyo. Nambala wani, magawo 100 osintha moyo, ndi imfa ya mnzako. Aliyense akhoza kugwirizana nazo. Chisudzulo chinali chachiwiri, kulekanitsa nambala yachitatu, ndi mapeto a wachibale wapamtima. Koma ndawonanso kuti zinthu zina zidayikidwa pagulu zomwe, mwina simungafanane nazo, kukhala chochitika chachikulu chosintha moyo chomwe chingakhudze kuyankha kwamavuto monga ukwati kapena kupuma pantchito.
Kutsiliza
Dr. Alex Jimenez, DC, akupereka: Choncho sichinali chochitika chimodzi chenicheni chimene chinasintha. Kunali kuphatikizika kwa zochitika. Ndipo zomwe adapeza atayang'ana madotolo 67 zinali ngati mutakhala ndi gawo losintha moyo penapake pakati pa ziro ndi 50, osati vuto lalikulu, mulibe matenda enieni, koma mukangogunda 300, panali 50% mwayi wa matenda aakulu. Choncho ndondomeko yanthawi imeneyi ya zochitika m'moyo wa wodwalayo. Tikufuna kudziwa zomwe zinali kuchitika m'miyoyo yawo pomwe zizindikiro zawo zidayamba ndikuzibweretsanso kale kuti timvetsetse malo omwe munthuyu amakhala. Zotsatira za kupsinjika maganizo zingapangitse anthu ambiri kukhala ndi matenda aakulu ndikubisa zizindikiro zina zomwe zingayambitse kupweteka kwa minofu ndi mafupa. Mu gawo 2, tizama mwatsatanetsatane momwe kupsinjika kumakhudzira thupi ndi thanzi la munthu.
Dr. Alex Jimenez, DC, akuwonetsa momwe kuthamanga kwa magazi kumakhudzira thupi la munthu ndi zifukwa zina zomwe zingayambitse matenda oopsa kwa anthu ambiri muzotsatira za 2. Timatumiza odwala athu kwa akatswiri azachipatala ovomerezeka omwe amapereka chithandizo chambiri chopezeka kwa anthu ambiri omwe akudwala matenda oopsa omwe amakhudzana ndi mtima komanso chitetezo chamthupi chomwe chimakhudza thupi. Timalimbikitsa aliyense wa odwala athu powatchula kwa azachipatala ogwirizana nawo malinga ndi kuwunika kwawo moyenera. Timamvetsetsa kuti maphunziro ndi njira yosangalatsa tikamafunsa opereka athu mafunso malinga ndi zomwe wodwala akufuna komanso kumvetsetsa. Dr. Jimenez, DC, amangogwiritsa ntchito chidziwitsochi ngati ntchito yophunzitsa. chandalama
Momwe Mungayang'anire Matenda Othamanga Kwambiri
Dr. Alex Jimenez, DC, akupereka: Tiyeni tibwererenso ku mtengo wachigamulo kuti muthe kuganizira momwe mungagwiritsire ntchito njira yopititsira patsogolo pamankhwala ochizira matenda oopsa komanso momwe mungayambitsire kuyeza munthu yemwe ali ndi vuto la kuthamanga kwa magazi m'malo mowauza kuti kuthamanga kwa magazi kwawo kwakwera. . Kodi thupi limakhudzidwa ndi kutupa, kupsinjika kwa okosijeni, kapena chitetezo chamthupi? Kodi zimakhudza endothelial ntchito kapena minofu yosalala ya mitsempha kuchokera m'magulu atatuwa, kutupa, kupsinjika kwa okosijeni, kapena kuyankha kwa chitetezo chamthupi? Kodi timasankha diuretic calcium channel blocker kapena ACE inhibitor? Ndipo kuti tichite izi, ndikofunikira kwambiri m'gawo lathu lamagulu. Kutengera mbiri yachipatala ndi nthawi ya matenda awo oopsa, mumapeza chidziwitso cha kuwonongeka kwa chiwalo pamafunso. Mukuyang'ana ma anthropometric awo.
Izi zikuphatikizapo mafunso otsatirawa:
Kodi zizindikiro zotupa ndi chiyani?
Kodi ma biomarkers ndi zizindikiro zachipatala ndi ziti?
Izi zikufotokozedwa mumtengo wa chisankho chachipatala. Ndipo mukungochita izi, mukulitsa ndikusintha mandala anu pazomwe mungawone mwa wodwala wanu wa hypertension. Tiyeni tiwonjeze pa nthawi yomwe matenda oopsa amayamba liti? Nthawi ya matenda oopsa kwambiri imayamba panthawi yoyembekezera. Ndikofunikira kufunsa wodwala wanu ngati anali wamkulu kapena wamkulu wamaphunziro. Kodi amayi awo anali ndi nkhawa? Kodi anabadwa msanga kapena nthawi isanakwane? Kodi panali nkhawa ya zakudya m'mimba mwawo? Ngati akudziwa zimenezo, mutha kukhala ndi anthu awiri omwe ali ndi kukula kwa impso zofanana, koma munthu amene analibe mapuloteni okwanira pa nthawi ya mimba akhoza kukhala ndi glomeruli yocheperapo ndi 40%. Kudziwa izi kudzasintha momwe mungasinthire mankhwalawa patapita zaka zambiri ngati mukudziwa kuti ali ndi 40% yocheperako glomeruli.
Nthawi ya Kuthamanga kwa Magazi
Dr. Alex Jimenez, DC, akupereka: Choncho ndikofunikira kutenga nthawi ya kuthamanga kwa magazi awo. Ndiye ndikofunikanso kuzindikira zomwe zikuchitika tikayamba kukonza ndi kusonkhanitsa deta kudzera m'ma biomarkers; ma biomarkers oyambira adzakupatsani zidziwitso ngati ali ndi vuto ndi insulin lipids, kaya ali ndi vuto la vascular reactivity, autonomic nerve system balance, kusalinganika, coagulation, kapena zotsatira za poizoni wa chitetezo chamthupi. Chifukwa chake ichi ndi chinthu chomveka kusindikiza chifukwa, mwa wodwala wanu wothamanga kwambiri, izi ndi kudzera mwa ma biomarkers omwe mungayambe kudziwa kuti ndi zinthu ziti zomwe zimakhudzidwa ndi kutupa, kupsinjika kwa okosijeni, komanso kuyankha kwa chitetezo chamthupi komanso momwe ma biomarker awa amawonetsera izi. zambiri kwa inu. Izi ndizomveka kukhala ndi patsogolo panu kuti muthe kusintha malingaliro anu okhudza kuthamanga kwa magazi komanso kukuthandizani kuti musinthe zina mwazochita za munthu yemwe ali kumbali ina ya stethoscope yanu m'njira yokhazikika, yolondola.
Koma tiyeni tiyambire pachiyambi. Kodi wodwala wanu ali ndi kuthamanga kwa magazi? Tikudziwa kuti kutengera zotsatira za chiwalo cha ma comorbidities, mutha kuyendetsa munthu kuthamanga kwa magazi pang'ono ngati muli ndi vuto lalikulu muubongo ndi impso kapena mtima, koma malangizo ena alipo. Malangizo athu a 2017 American Heart Association pamagulu a kuthamanga kwa magazi alembedwa apa. Iwo akhala akuphwa ndi kufota m'zaka makumi angapo zapitazi, koma izi ndi zomveka bwino. Popeza kuthamanga kwa magazi kukukwera, chilichonse choposa 120, chasintha anthu angati omwe timayamba kuwawona kapena kuganizira zomwe zimayambitsa kuthamanga kwa magazi. Chifukwa chake tibwereranso ku izi, makamaka pankhani yotithandiza kuyang'ana momwe timagawira anthu omwe ali ndi vuto la kuthamanga kwa magazi.
Zoyenera Kuyeza Kuthamanga kwa Magazi
Dr. Alex Jimenez, DC, akupereka: Kodi sitepe yoyamba ndi iti? Ndimotani mmene magazi amakutengerani wodwala wanu? Kodi amaziwunika kunyumba? Amabweretsa manambala amenewo kwa inu? Kodi mumawunika bwanji kuthamanga kwa magazi m'chipatala chanu? Kodi mumapeza bwanji zowerengera zolondola kuchipatala chanu? Nazi njira zoyezera molondola kuthamanga kwa magazi ndi mafunso oti muganizire ngati mukuchita zonsezi.
Kodi mumamufunsa wodwala wanu ngati ali ndi caffeine mu ola lapitalo?
Kaya anasutapo ola lapitalo?
Kodi adakumana ndi utsi mu ola lapitalo?
Kodi malo omwe mumayeza kuthamanga kwa magazi ndi ofunda komanso opanda phokoso?
Kodi akukhala ndi nsana wawo atachirikizidwa pampando ndi mapazi awo pansi?
Mutha kukhala ndi kuthamanga kwa magazi kwa systolic ngati zonse zili m'njira. Apa pali vuto. Pali mamilimita 10 mpaka 15 a mercury okwera pankhani yokhala ndi kuthamanga kwa magazi. Nanga kukula kwa khafu? Tikudziwa zaka zana zapitazi; akuluakulu ambiri anali ndi circumference kumtunda kwa mikono yosakwana 33 centimita. Anthu opitilira 61 pa 33 aliwonse tsopano ali ndi kumtunda kwa mkono wozungulira kuposa ma centimita 60. Chifukwa chake kukula kwa khafu ndi kosiyana kwa pafupifupi XNUMX% ya odwala anu akulu, kutengera kuchuluka kwanu. Ndiye muyenera kugwiritsa ntchito cuff lalikulu. Choncho yang'anani momwe kuthamanga kwa magazi kumasonkhanitsira muofesi yanu. Tinene kuti kuthamanga kwa magazi kwakwera mwa odwala anu; ndiye tifunse kuti, ndi zabwinobwino? Zabwino.
Mitundu Yosiyanasiyana ya Hypertension
Dr. Alex Jimenez, DC, akupereka: Kodi ndizokwera chifukwa cha kuthamanga kwa magazi koyera? Kodi ali ndi kuthamanga kwa magazi, kukwezedwa kunja kwa chipatala, kapena kuthamanga kwa magazi kobisika? Kapena amangokhala ndi matenda oopsa omwe ndi ovuta? Tikambirana za izo. Chifukwa chake mukamatanthauzira, ndikofunikiranso kuganizira zowunikira kuthamanga kwa magazi. Ndiye ngati muli ndi munthu yemwe ali ndi vuto la kuthamanga kwa magazi ndipo osadziwa ngati kuthamanga kwa magazi kumatsika ndipo mukuyesera kudziwa ngati ali ndi matenda oopsa, mutha kugwiritsa ntchito maola 24 kuti muwone kuthamanga kwa magazi. Kuthamanga kwa magazi masana kupitirira 130 kupitirira 80 ndi kuthamanga kwa magazi usiku kupitirira 110 kuposa 65 ndi kuthamanga kwa magazi. Nanga n’cifukwa ciani zimenezi n’zofunika? Kuthamanga kwa magazi kumatsika mpaka 15% usiku chifukwa cha vuto la kuthamanga kwa magazi. Kulephera kuchepetsa kuthamanga kwa magazi pamene mukugona usiku kungayambitse mavuto omwe angakhudze munthu tsiku lonse.
Ngati wodwala wanu akugona usiku, ayenera kutsika pafupifupi 15% akagona. Ngati ali ndi kuthamanga kwa magazi kosasunthika, kumalumikizidwa ndi comorbidities. Ndi zina ziti zomwe zimayenderana ndi kuthamanga kwa magazi kosadukiza? Zina mwazinthu zomwe zimayenderana ndi kuthamanga kwa magazi kosadukiza ndi monga:
Congestive Heart Disease
Matenda a Mtima
Matenda a Cerebrovascular
Congestive Mtima Kulephera
Kulephera Kwakanthawi kwamanja
Silent Cerebral Infractions
Co-morbidities Zogwirizana ndi Kuthamanga Kopanda Magazi
Dr. Alex Jimenez, DC, akupereka: Izi ndizovuta zomwe zimagwirizanitsidwa ndi kusakhala kwa magazi. Tonsefe timavomereza kuti kuthamanga kwa magazi kokwezeka sikwabwino kwenikweni m’mikhalidwe yonseyo. Chifukwa chake mukayang'ana magulu a anthu osiyanasiyana kapena zovuta zina, kuthamanga kwa magazi kosasunthika nthawi zambiri kumalumikizidwa ndi anthu omwe ali ndi vuto la sodium, anthu omwe ali ndi vuto laimpso, omwe ali ndi matenda a shuga, omwe asiya ventricular hypertrophy, anthu omwe ali ndi matenda oopsa. kapena autonomic mantha dongosolo kukanika ndipo potsiriza, kugona tulo. Chifukwa chake, kusathamanga kwa magazi kumawonjezera kuyanjana kwanu ndi kuwonongeka kwa mtima wa subclinical. Chabwino, kumiza m'mbuyo kumatanthauza kuti mumakhala ndi matenda oopsa kwambiri usiku ndipo kukwera kumayenderana ndi masana kumakhudzana kwambiri ndi sitiroko yotaya magazi. Ndipo ngati muli ndi munthu yemwe ali ndi matenda oopsa a usiku, muyenera kuyamba kuganiza za zinthu monga mitsempha ya carotid ndi kuchuluka kwa carotid, makulidwe amkati amkati. Mumayamba kuganiza za kumanzere kwa ventricular hypertrophy ndipo mutha kuziwona pa EKG. Izi ndi zomwe tikudziwa za nocturnal hypertension. Nocturnal hypertension ndi kuthamanga kwa magazi usiku kuposa 120 kupitirira 70. Zimagwirizanitsidwa ndi kulosera kwakukulu kwa matenda a mtima ndi imfa.
Ngati muli ndi matenda oopsa a usiku, zimawonjezera chiopsezo chanu chokhala ndi matenda amtima ndi 29 mpaka 38%. Tiyenera kudziwa zomwe zimachitika usiku tikagona, sichoncho? Chabwino, kukonzanso kwina ndi chiyani? Kukonzanso kwina ndikuzindikira kuti kupuma kwa magazi kumayendetsedwa ndi dongosolo lanu la renin-angiotensin. Kuthamanga kwa magazi kumayendetsedwa ndi dongosolo lanu lamanjenje lachifundo. Ndiye tiyeni tikambirane za momwe aimpso angiotensin system imayendetsa kuthamanga kwa magazi usiku, ndipo mukuganiza za mankhwala omwe akumwa. Mukhoza kusintha mlingo wa mankhwala kukhala usiku. Kafukufuku wasonyeza kuti ngati muli ndi matenda oopsa kwambiri usiku ndipo simunadye, ndibwino kuti mutenge ma ACE inhibitors, ARBs, calcium channel blockers, ndi beta blockers usiku musanagone. Koma ndizomveka kuti simungasunthe ma diuretics anu usiku, kapena mudzakhala ndi tulo tosokoneza.
Kuthana ndi Kuthamanga kwa Magazi Masana & Usiku
Dr. Alex Jimenez, DC, akupereka: Choncho ngati sitilimbana ndi kuthamanga kwa magazi usana ndi usiku, tiyenera kuganizira zotsatira za kuthamanga kwa magazi. Kodi kuthamanga kwanu kwa magazi tsiku ndi tsiku ndi kotani komanso kuthamanga kwa magazi komwe mukugona. Tikudziwa kuti kuthamanga kwa magazi mwa achinyamata akuluakulu kumakhala ndi kuthamanga kwa magazi pafupifupi 9% ya nthawiyo. Chifukwa chake kutanthauza kuti systolic katundu ndi pafupifupi 9% motsutsana ndi okalamba, pafupifupi 80% ya kuthamanga kwa magazi ndi systolic. Ndipo kotero mukakhala ndi kuchuluka kwa systolic, mumakhala ndi zovuta zambiri komanso kuwonongeka kwa ziwalo zomaliza. Choncho zimene tikukamba ndi kuthandiza kudziwa wodwala matenda oopsa; nthawi yawo ndi yotani? Kodi phenotype yawo ndi chiyani? Kodi amangothamanga kwambiri masana, kapena amadwala kwambiri usiku? Tiyenera kuyang'ana zomwe zimathandiza kulinganiza izi.
Nayi mfundo ina, pafupifupi 3.5% ya anthu omwe ali ndi matenda oopsa omwe amakhala ndi chifukwa cha majini. Ndi 3.5% yokha ya anthu omwe majini awo amayambitsa matenda oopsa. Mphamvu ili pansi pa matrix ndikuzindikira mawonekedwe awa, sichoncho? Kotero mumayang'ana masewera olimbitsa thupi, kugona, zakudya, nkhawa, ndi maubwenzi. Chifukwa chake tikudziwa kuti miyeso inayi yodziyimira payokha imathandizira kudziwa kuthamanga kwa magazi. Tiwonanso aimpso angiotensin system, voliyumu ya plasma pomwe amasunga madzi ochulukirapo, kuchuluka kwa mchere wamchere, komanso kusagwira bwino ntchito kwa endothelial. Kusakhazikika mu chilichonse mwa izi kungayambitse matenda oopsa. Takhala tikulankhula za china chomwe chingayambitse matenda oopsa: kulumikizana pakati pa insulin kukana ndi kuthamanga kwa magazi.
Izi mojambulidwa zimakupatsirani lingaliro la kuyanjana kwa thupi pakati pa insulin kukana ndi kuthamanga kwa magazi. Zimakhudza kuchuluka kwa kamvekedwe kachifundo ndikuwonjezera kukhazikika kwa aimpso-angiotensin. Kotero tiyeni titenge mphindi zochepa pa renin-angiotensin system pathway angiotensinogen mpaka angiotensin two. Timagwiritsa ntchito ma enzymes awa popereka zoletsa ku angiotensin-converting enzymes mwa odwala athu omwe ali ndi vuto la hypertensive. Kukwera kwa angiotensin XNUMX kumabweretsa kumtima kwamtima hypertrophy, kumabweretsa kutsika kwa gawo lachifundo, kuchuluka kwa magazi, madzi a sodium, kusungidwa, ndi kutulutsidwa kwa aldosterone. Kodi mungafunse za ma biomarker anu odwala? Kodi mungafunse ngati ali ndi ma renin okwera?
Yang'anani Zizindikiro
Dr. Alex Jimenez, DC, akupereka: Chabwino, mungathe. Mutha kuyang'ana ntchito ya plasma renin ndi milingo ya aldosterone. Ndikofunika kuchita izi ngati wodwala wanu ali ndi kuthamanga kwa magazi ndipo sanayambe kumwa mankhwala chifukwa apa ndi pamene nitrous oxide ndi yofunika kwambiri. Apa ndipamene endothelial nitric oxide synthase yanu ilipo. Apa ndipamene mumakhala ndi nkhawa komanso hemodynamic. Apa ndipamene kudya zakudya za arginine kapena chilengedwe chomwe chimakhudza nitric oxide chimakhala ndi thanzi la endothelia. Mukayika zonse palimodzi mwanjira ina, mozizwitsa, kapena m'maso mwanu, zidzaphimba makhothi asanu ndi limodzi a tennis mwa munthu wamkulu. Ndi malo aakulu pamwamba. Ndipo zinthu zomwe zimayambitsa kusokonekera kwa endothelial si nkhani zatsopano kwa anthu omwe amagwira ntchito zamankhwala. Kuchuluka kwa oxidative kupsinjika ndi kutupa ndi zinthu ziwiri zomwe tanena zomwe zimakhudza.
Kenako, yang'anani zina mwa zigawo zina, ADMA yanu ikukwezedwa ndikulumikizana ndi kukana insulini. Zonse zimayamba kupanga pamodzi mu matrix omwe amalumikizana. Chifukwa chake mumayang'ana comorbidity imodzi mu cardiometabolic syndrome, ndipo imakhudzanso comorbidity ina. Mwadzidzidzi mumawona kulumikizana pakati pawo kapena hyperhomocysteinemia, yomwe ndi chizindikiro cha kagayidwe ka kaboni kamodzi, kutanthauza kuti mukuyang'ana kukwanira kwa folate, b12, b6, riboflavin, ndi zomwe zimachitika mu carbon-one metabolism. Chifukwa chake tiyeni tiwone zina mwazomwe zikuwonetsa chiopsezo kuti ziwongolere ndikutsata odwala omwe ali ndi matenda oopsa. Tiyeni tiwunikenso ADMA. ADMA imayimira asymmetric dimethyl arginine. Asymmetric, dimethyl arginine ndi biomarker ya endothelial kukanika. Molekyuyi imalepheretsa nitric oxide synthase pomwe imasokoneza ntchito ya endothelial, ndipo m'matenda onse okhudzana ndi matenda a cardiometabolic syndrome, ADMA ikhoza kukwezedwa.
Kutsiliza
Chifukwa chake, monga kuwunika mwachangu, L-arginine imasinthidwa kukhala nitric oxide kudzera mu nitric oxide synthase, ndipo kukwanira kwa nitric oxide kumabweretsa vasodilation. ADMA imaletsa kutembenukaku. Ndipo ngati milingo yanu ya ADMA ili yokwezeka ndipo nitric oxide yanu ili yotsika, ndiye kuti mwachepetsa nitric oxide platelet aggregation ikuwonjezeka mu LDL oxidation. Zinthu zambiri zimachepetsa nitric oxide kapena zimagwirizanitsidwa ndi kuchepa kwa nitric oxide, kugona tulo, kutsika kwa arginine, mapuloteni, kusowa kwa zinc, ndi kusuta.
Ponseponse, kupsinjika kapena cortisol ndi mahomoni omwe thupi limafunikira kuti ligwire ntchito moyenera. Kupsyinjika kosatha m'thupi kuchokera ku zovuta zosiyanasiyana kumatha kuyambitsa zovuta zambiri za kagayidwe kachakudya monga hypothyroidism, kunenepa kwambiri, insulin kukana, ndi metabolic syndrome, kungotchula ochepa. Kupsyinjika kosatha kungayambitsenso vuto la kugona chifukwa HPA axis ili ndi waya ndipo imatha kuwoneka ngati bata pang'ono. Anthu akayamba kupeza njira zothanirana ndi zovuta zosiyanasiyanazi, amatha kuchepetsa nkhawa zawo kuti zibwerere mwakale komanso kukhala opanda nkhawa.
Zothandizira
Jones, Carol, ndi Christopher Gwenin. "Cortisol Level Dysregulation ndi Kuchuluka Kwake - Kodi Ndi Alamu Yowongoka Yachilengedwe?" Malipoti Amatsenga, John Wiley and Sons Inc., Jan. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC7749606/.
McEwen, Bruce S. "Zotsatira Zapakatikati za Ma Hormone A Kupsinjika Maganizo pa Thanzi ndi Matenda: Kumvetsetsa Kuteteza ndi Kuwononga Zotsatira za Kupsinjika Maganizo ndi Oyimira Kupsinjika." European Journal of Pharmacology, US National Library of Medicine, 7 Apr. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2474765/.
McEwen, Bruce S. "Kupsinjika Kapena Kupsinjika: Kodi Kusiyanako Ndi Chiyani?" Journal of Psychiatry & Neuroscience: JPN, US National Library of Medicine, Sept. 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC1197275/.
Rodriquez, Erik J, et al. "Allostatic Load: Kufunika, Zolemba, ndi Kutsimikiza kwa Magulu Pa Anthu Ochepa ndi Osiyana." Journal of Urban Health: Bulletin ya New York Academy of Medicine, Springer US, Marichi 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6430278/.
Wachichepere, Simon N. "L-Tyrosine Kuti Muchepetse Kupsinjika Maganizo?" Journal of Psychiatry & Neuroscience: JPN, US National Library of Medicine, May 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC1863555/.
Cortisol imathandizira kuthamangitsa shuga wambiri m'chiwindi, zomwe zimapangitsa kuti kaphatikizidwe ka mapuloteni kakankhire ma amino acid kukhala shuga m'thupi. Izi zimadziwika kuti mafuta acid liberation biotransformed kukhala glucose. Izi zikachitika, zimathandiza kulimbikitsa kusungidwa kwamafuta a visceral ngati glucose wochulukirapo sagwiritsidwa ntchito, motero kumapangitsa kulemera. Kafukufuku wasonyeza kuti kusowa kwa cortisol kungayambitse kuchepa kwa shuga m'chiwindi m'thupi. Izi zitha kuyambitsa hypoglycemia, pomwe thupi lilibe shuga wokwanira m'dongosolo lake. Kafukufuku wowonjezera akuwonetsa kuti cortisol imayankha kupsinjika kwamtundu uliwonse komwe kumakhudza munthu yemwe ali ndi milingo yocheperako ya glucose komanso amatha kukhala abwino pambuyo ponyamula shuga. Kuwongolera kuchuluka kwa glucose ndi cortisol m'thupi kungathandize kupititsa patsogolo chitukuko cha matenda a shuga.
Momwe Cortisol Imagwirizanirana Ndi Type 2 Diabetes- Video
Kodi mudakumanapo ndi zovuta zomwe zimakupangitsani kuti minofu yanu ikhale yolimba? Nanga bwanji kumva shuga m'magazi anu akukwera kapena kutsika? Kodi mukumva zotupa mthupi lanu lonse zomwe zimawawawa? Kupsinjika maganizo kumatha kuwononga thupi, kuyambitsa kutupa, kukulitsa kamvekedwe kachifundo, ndikuchepetsa kuyankha kwa glucocorticoid. Kupsinjika maganizo kumathanso kulumikizidwa ndi matenda a shuga, popeza vidiyo yomwe ili pamwambapa ikuwonetsa momwe timadzi timene timatulutsa timadzi ta cortisol timalumikizidwa ndi matenda amtundu wa 2. Kafukufuku wofufuza watchulapo kuti cortisol imatha kulumikizidwa molakwika ndi zimango za insulin kukana, kukulitsa magwiridwe antchito a cell ya beta ndikuwonjezera insulin yotulutsidwa m'thupi. Izi zitha kukhala zowopsa kwa anthu ambiri omwe ali ndi matenda a shuga omwe adakhalapo kale ndipo akhala akulimbana ndi nkhawa nthawi zonse.
Kulumikizana Kwapakati Pakati pa Kupsinjika ndi Matenda a Shuga
Kulumikizana kolumikizana pakati pa kupsinjika ndi matenda a shuga kumawonetsedwa ngati kafukufuku wapeza kuti pathophysiology ya nkhawa ndi shuga yawonjezera chiwopsezo cha insulin kukana kwa thupi. Pamene munthu akulimbana ndi kupsinjika maganizo kosatha, kungayambitse mavuto ambiri monga:
Kusalolera kozizira
Kuchepa kwa chidziwitso ndi malingaliro
Kukhudzidwa kwa chakudya
Mphamvu zochepa tsiku lonse
Izi zikachitika, thupi limakhala pachiwopsezo chachikulu chokhala ndi insulin kukana komanso mtundu wa 2 shuga. Kafukufuku wofufuza watchulapo Type 2 shuga mellitus imadziwika ndi kukana insulini komanso kusagwira bwino ntchito kwa ma cell a beta. Glucocorticoid m'thupi imatha kuchulukirachulukira kuti ikhudze ma cell, zomwe zimayambitsa kusagwira bwino ntchito. Kafukufuku wowonjezera wasonyeza kuti kupsinjika kulikonse komwe kungaganizidwe kumatha kukhala chiwopsezo chofunikira chomwe sichimangokhudza thupi, monga kuthamanga kwa magazi, BMI (body mass index), kapena kadyedwe kabwino koma kungayambitse kukwera kwa matenda amtundu wa 2. Anthu akapeza njira zochepetsera kupsinjika kwawo kosatha, zitha kuthandiza kuwongolera milingo yawo ya glucose kuti isafike pamlingo wovuta.
Kutsiliza
Kupsyinjika kosatha kwa thupi kungayambitse kukana kwa insulini ndikupangitsa matenda a shuga kuti akhalepo kale. Thupi limafunikira cortisol ndi glucose kuti lipitirize kugwira ntchito komanso kukhala ndi mphamvu zoyenda. Anthu akayamba kudwala matenda ovutika maganizo komanso matenda a shuga, zimakhala zovuta kuwasamalira; komabe, kupanga masinthidwe ang'onoang'ono m'thupi monga kupeza njira zochepetsera nkhawa, kudya zakudya zopatsa thanzi, komanso kuyang'anira kuchuluka kwa shuga kungathandize thupi kukhazikitsanso milingo ya glucose ndi cortisol kukhala yabwinobwino. Kuchita izi kungathandize anthu ambiri omwe akufuna kupitiriza ulendo wawo wathanzi kukhala opanda nkhawa.
Zothandizira
Adam, Tanja C, et al. "Cortisol Imalumikizidwa Molakwika ndi Kukhudzidwa kwa Insulin mu Achinyamata Olemera Kwambiri a Latino." The Journal of Clinical Endocrinology ndi Metabolism, The Endocrine Society, Oct. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3050109/.
De Feo, P, et al. "Kuthandizira kwa Cortisol ku Glucose Counterregulation mwa Anthu." The American Journal of Physiology, US National Library of Medicine, July 1989, anayankha.
Hucklebridge, FH, et al. "Mayankho Odzutsa a Cortisol ndi Magazi a Glucose." Sciences Life, US National Library of Medicine, 1999, anayankha.
Joseph, Joshua J, ndi Sherita H Golden. "Cortisol Dysregulation: The Bidirectional Link between Stress, Depression, and Type 2 Diabetes Mellitus." Annals wa New York Academy of Sciences, US National Library of Medicine, Mar. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5334212/.
Kamba, Aya, et al. "Kuyanjana pakati pa Milingo Yapamwamba ya Serum Cortisol ndi Kuchepetsa Kutulutsa kwa Insulin Pagulu Lonse." PloS One, Public Library of Science, 18 Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5115704/.
Lee, Do Yup, et al. "Zakatswiri ndi Zachipatala za Cortisol Monga Chizindikiro cha Biochemical cha Kupsinjika Kwambiri." Malipoti a BMB, Korean Society for Biochemistry and Molecular Biology, Apr. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4436856/.
Thau, Lauren, et al. "Physiology, Cortisol." Mu: StatPearls [Intaneti]. Chilumba cha Treasure (FL), StatPearls Publishing, 6 Sept. 2021, www.ncbi.nlm.nih.gov/books/NBK538239.
Thupi ndi makina ogwira ntchito bwino omwe amatha kupirira chilichonse chomwe chaponyedwa m'njira yake. Komabe, pamene chivulazidwa, machiritso achilengedwe a thupi amaonetsetsa kuti thupi likhoza kubwerera kuntchito zake za tsiku ndi tsiku. Kuchira kwa minofu yovulala kumasiyanasiyana m'thupi lonse. Kutengera ndi momwe kuwonongekako kukukulira komanso kuti kuchira kumatenga nthawi yayitali bwanji, thupi limatha kuchira kwa masiku ochepa kapena miyezi ingapo. Imodzi mwa njira zochiritsira zopweteka kwambiri zomwe thupi limayenera kupirira ndi kuphulika kwa tendon ya calcaneal.
Tendon ya Calcaneal
Mphuno ya calcaneal kapena Achilles tendon ndi tendon wandiweyani yomwe ili kumbuyo kwa mwendo. Minofu-tendon iyi ndi yomwe imapangitsa kuti thupi liziyenda poyenda, kuthamanga, ngakhale kudumpha. Osati kokha, tendon ya calcaneal ndi tendon yamphamvu kwambiri m'thupi, ndipo imagwirizanitsa gastrocnemius ndi minofu yokhayo pa chidendene fupa. Pamene tendon ya calcaneal ikuphwanyidwa, machiritso amatha kuyambira masabata mpaka miyezi mpaka atachira.
Machiritso a Low Laser Therapy
Imodzi mwa njira zomwe zingathandize kuti machiritso a calcaneal tendons ndi otsika laser therapy. Kafukufuku wasonyeza kuti mankhwala otsika a laser amatha kufulumizitsa kukonzanso kwa tendon komwe kunawonongeka pambuyo pa zilonda zina. Osati izo zokha koma chisaKupangidwa kwa ultrasound ndi low laser therapy kwaphunziridwa kukhala othandizira pochiza kuvulala kwa tendon. Maphunziro adawonetsa kuti kuphatikiza otsika laser mankhwala ndi ultrasound ali ndi katundu wopindulitsa pa kuchira ndondomeko kuchiza calcaneal tendon kuvulala.
Kafukufukuyu adapeza kuti odwala akamathandizidwa chifukwa cha minyewa yawo ya calcaneal, milingo yawo ya hydroxyproline kuzungulira malo omwe amathandizidwa imachulukitsidwa kwambiri ndi ultrasound ndi low laser t.mankhwala. Mapangidwe achilengedwe a thupi la biochemical ndi biomechanical pa tendon yovulala amawonjezeka, motero zimakhudza machiritso. Kafukufuku wina wasonyeza kuti chithandizo chochepa cha laser chingathandize kuchepetsa fibrosis ndikupewa kupsinjika kwa okosijeni mu tendon yopwetekedwa mtima ya calcaneal. Kafukufukuyu adawonetsanso kuti pambuyo povulala kwa calcaneal tendon, kutupa, angiogenesis, vasodilation, ndi matrix a extracellular amapangidwa m'dera lomwe lakhudzidwa. Kotero pamene odwala akuchiritsidwa ndi mankhwala otsika a laser kwa masiku khumi ndi anayi mpaka makumi awiri ndi limodzi, zovuta zawo za histological zimachepetsedwa, kuchepetsa ndende ya collagen ndi fibrosis; kuletsa kupsinjika kwa okosijeni kuti isachuluke m'thupi.
Kutsiliza
Ponseponse, akuti zotsatira za kutsika kwa laser therapy zingathandize kufulumizitsa machiritso a kukonzanso calcaneal tendon. Zotsatira zoyembekeza zatsimikiziridwa popeza kutsika kwa laser therapy kungathandize kukonza tendon yowonongeka, kuchepetsa kupsinjika kwa okosijeni ndi kuteteza fibrosis kuti isakule, zomwe zimayambitsa mavuto ambiri pa tendon yovulala. Ndipo kuphatikiza kwa ultrasound, tendon ya calcaneal imatha kuchira mwachangu kotero kuti thupi limatha kupitiriza ntchito zake za tsiku ndi tsiku popanda kuvulala kwanthawi yayitali.
Zothandizira:
Demir, Huseyin, et al. "Kuyerekeza kwa Zotsatira za Laser, Ultrasound, ndi Combined Laser + Ultrasound Treatments in Experimental Tendon Healing." Laser mu Opaleshoni ndi Mankhwala, US National Library of Medicine, 2004, anayankha.
Filippin, Lidiane Isabel, et al. "Low-Level Laser Therapy (LLLT) Imalepheretsa Kupsinjika kwa Oxidative ndi Kuchepetsa Fibrosis mu Makoswe Ovulala Achilles Tendon." Laser mu Opaleshoni ndi Mankhwala, US National Library of Medicine, Oct. 2005, anayankha.
Wood, Viviane T, et al. "Kusintha kwa Collagen ndi Kukonzanso Kumapangidwa ndi Low-Level Laser Therapy ndi Low-Intensity Ultrasound mu Calcaneal Tendon." Laser mu Opaleshoni ndi Mankhwala, US National Library of Medicine, 2010, anayankha.
