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Mankhwala osokoneza bongo

Back Clinic Cannabinoids. Zomera ndi mankhwala, ndipo pamene kafukufuku akupitirira ndi mankhwala ena ochiritsira, chidziwitso chochuluka chilipo pankhani ya zosankha zachipatala za matenda osiyanasiyana, mikhalidwe, matenda, matenda, ndi zina ... Chiropractor Dr. Alex Jimenez amafufuza ndikubweretsa chidziwitso pamankhwala omwe akukula, momwe atha kuthandiza odwala, zomwe angachite, ndi zomwe sangathe kuchita.

Chomera cha chamba ndi momwe ambiri amadziwira za cannabinoids. Ndiwodziwika kwambiri cannabinoid tetrahydrocannabinol (THC), chomwe ndi chinthu chomwe chimayambitsa chisangalalo.

Asayansi adazindikira cannabinoids mu chamba chokha. Komabe, kafukufuku watsopano wapeza makhalidwe omwewo amankhwala muzomera zambiri, kuphatikizapo tsabola wakuda, broccoli, kaloti, clove, echinacea, ndi ginseng.

Zamasamba kapena zokometsera izi sizingakulitseni, koma kumvetsetsa momwe mbewu zosiyanasiyanazi zimakhudzira thupi la munthu zitha kupangitsa kuti pakhale zodziwikiratu.


Kuyang'ana Mozama mu Metabolic Syndrome | El Paso, TX (2021)

Kuyang'ana Mozama mu Metabolic Syndrome | El Paso, TX (2021)

Mu podcast yamasiku ano, Dr. Alex Jimenez, mphunzitsi wa zaumoyo Kenna Vaughn, mkonzi wamkulu Astrid Ornelas amakambirana za matenda a kagayidwe kachakudya kuchokera kumawonedwe osiyana komanso, zakudya zosiyana siyana zolimbana ndi kutupa.

 

Dr. Alex Jimenez DC*: Takulandirani, anyamata, talandiridwa ku podcast ya Dr. Jimenez ndi ogwira nawo ntchito. Tikukambirana za metabolic syndrome yamasiku ano, ndipo tikhala tikukambirana mwanjira ina. Tikupatsirani malangizo abwino kwambiri, othandiza omwe angakhale omveka komanso osavuta kuchita kunyumba. Metabolic syndrome ndi lingaliro lalikulu kwambiri. Lili ndi mfundo zazikulu zisanu. Ili ndi shuga wambiri m'magazi, imakhala ndi mafuta am'mimba, imakhala ndi triglycerides, imakhala ndi zovuta za HDL, ndipo imakhala ndi mikangano yambiri yomwe imayenera kuyesedwa pachifukwa chonse chomwe timakambirana za metabolic syndrome chifukwa imakhudza kwambiri dera lathu. zambiri. Choncho, tikambirana nkhani zimenezi ndi mmene tingathetsere. Ndipo zimakupatsani mwayi wosintha moyo wanu kuti musakhale nazo. Ndi imodzi mwazovuta kwambiri zomwe zimakhudza mankhwala amakono, osasiyapo tikamvetsetsa. Kulikonse komwe mungapite, muwona anthu ambiri omwe ali ndi metabolic syndrome. Ndipo ndi gawo la anthu, ndipo ndi zomwe mukuwona ku Europe mochuluka. Koma ku America, chifukwa tili ndi zakudya zambiri ndipo mbale zathu nthawi zambiri zimakhala zazikulu, timatha kusintha matupi athu mosiyana ndi zomwe timadya. Palibe vuto lomwe lidzasinthe mwachangu komanso mwachangu ngati njira yabwino komanso njira yabwino yothanirana ndi vuto la metabolic komanso metabolic syndrome. Chifukwa chake titanena izi, lero, tili ndi gulu la anthu. Tili ndi Astrid Ornelas ndi Kenna Vaughn, omwe akambirana ndikuwonjezera zambiri kuti atithandize pakuchita izi. Tsopano, Kenna Vaughn ndi mphunzitsi wathu wazaumoyo. Iye ndi amene amagwira ntchito mu ofesi yathu; Ndikakhala dokotala wodziwa zachipatala komanso ndikugwira ntchito ndi anthu mmodzimmodzi, timakhala ndi anthu ena omwe amagwira ntchito ndi zakudya komanso zosowa za zakudya. Gulu langa pano ndilabwino kwambiri. Tilinso ndi wofufuza wathu wamkulu wazachipatala komanso munthu yemwe amasamalira ukadaulo wathu wambiri ndipo ali pachiwopsezo cha zomwe timachita ndi sayansi yathu. Ndi Akazi. Ornelas. Mai. Ornelas kapena Astrid, momwe timamutchulira, ndi ghetto ndi chidziwitso. Amakhala woyipa ndi sayansi. Ndipo ziri kwenikweni, kwenikweni pamene ife tiri. Masiku ano, tikukhala m'dziko limene kafukufuku akubwera ndikulavulira kuchokera ku NCBI, yomwe ndi malo osungiramo zinthu kapena PubMed, omwe anthu amatha kuwona timagwiritsa ntchito chidziwitsochi ndipo timagwiritsa ntchito zomwe zimagwira ntchito ndi zomwe zimachita. Sizidziwitso zonse zomwe zili zolondola mu PubMed chifukwa muli ndi malingaliro osiyanasiyana, koma zimakhala ngati chala pamphuno tikakhala ndi chala chathu. Timatha kuona zinthu zomwe zimakhudza. Ndi mawu osakira ndi zidziwitso zina, timadziwitsidwa zakusintha, tinene, zovuta za shuga m'zakudya kapena zovuta za triglyceride ndi mafuta, chilichonse chokhudza kusokonezeka kwa metabolic. Titha kukhala ndi njira yachipatala yomwe imasinthidwa kuchokera kwa madokotala ndi ofufuza ndi ma PhD padziko lonse lapansi pafupifupi nthawi yomweyo, ngakhale asanasindikizidwe. Mwachitsanzo, lero ndi February 1st. Sichoncho, koma tidzakhala tikupeza zotsatira ndi maphunziro operekedwa ndi National Journal of Cardiology omwe adzatuluka mu March ngati izo ziri zomveka. Chifukwa chake chidziwitsocho chimakhala chotentha kwambiri, ndipo Astrid amatithandiza kuzindikira zinthu izi ndikuwona, "Hei, mukudziwa, tapeza china chake chotentha komanso china chothandizira odwala athu" ndikubweretsa N yofanana ndi imodzi, yomwe ili yoleza mtima- dokotala ndi mmodzi. Wodwala ndi wochiritsa wofanana yemwe sitipanga ndondomeko za aliyense. Timapanga ma protocol apadera kwa munthu aliyense pamene tikuyenda. Chifukwa chake tikamachita izi, ulendo womvetsetsa metabolic syndrome ndi wamphamvu komanso wozama kwambiri. Titha kuyambira kungoyang'ana munthu kupita kumagazi, mpaka kukusintha kwazakudya, kusintha kwa kagayidwe kachakudya, mpaka kuzinthu zama cell zomwe zikugwira ntchito mwachangu. Timayesa nkhani ndi ma BIA ndi BMI, zomwe tidachita ndi ma podcasts am'mbuyomu. Koma tingathenso kulowa mu mlingo, ma genomics ndi kusintha kwa ma chromosome ndi ma telomere mu chromosomes, zomwe tingakhudze ndi zakudya zathu. CHABWINO. Njira zonse zimatengera zakudya. Ndipo zomwe ndikunena mwanjira ina yodabwitsa, misewu yonse imatsogolera ku smoothies, OK, smoothies. Chifukwa tikayang'ana pa smoothies, timayang'ana zigawo za smoothies ndikubwera ndi mphamvu zomwe zimatha kusintha tsopano. Chimene ndimayang’ana ndi pamene ndimayang’ana chithandizo chamankhwala, ndimayang’ana zinthu zimene zimapangitsa moyo wa anthu kukhala wabwinoko, ndipo tingachite bwanji zimenezi? Ndipo kwa amayi onsewa, amamvetsetsa kuti sangazindikire kuti amachita izi, koma amayi samadzuka kuti, ndipatsa mwana wanga chakudya. Ayi, ali ngati akusokoneza maganizo kuti abweretse khitchini yonse chifukwa akufuna kuti apatse mwana wawo zakudya zabwino kwambiri ndikupereka njira zabwino zomwe mwana wawo angasankhe kuti apite kudziko lonse kapena kusukulu ya pulayimale, kusukulu ya pulayimale, kudzera kusukulu ya sekondale kuti mwanayo akule bwino. Palibe amene amapita poganiza kuti ndipatsa mwana wanga zinthu zopanda pake. Ndipo ngati ndi choncho, ndiye kuti mwina si makolo abwino. Koma ife sitiyankhula za izo bwino; tikambirana za zakudya zabwino ndikusintha zinthuzo. Chifukwa chake ndikufuna ndikudziwitse Kenna pompano. Ndipo akhala akukambirana pang'ono pazomwe timachita tikawona munthu yemwe ali ndi vuto la metabolic komanso momwe timachitira. Chifukwa chake akamadutsa izi, azitha kumvetsetsa momwe timawerengera ndikuwunika wodwala ndikumubweretsa kuti tiyambe kuwongolera pang'ono kwa munthuyo.

 

Kenna Vaughn: Chabwino. Kotero choyamba, ine ndikungofuna kulankhula za smoothies pang'ono. Ndine mayi, ndiye m'mawa, zinthu zimapenga. Simumakhala ndi nthawi yochuluka monga momwe mukuganizira, koma mumafunikira zakudya zopatsa thanzi komanso ana anu. Chifukwa chake ndimakonda ma smoothies. Iwo ali othamanga kwambiri. Mumapeza zonse zomwe mukufuna. Ndipo anthu ambiri amaganiza kuti pamene mukudya, mukudya kuti mukhutitse mimba yanu, koma mukudya kuti mukhudze maselo anu. Maselo anu ndi amene amafunikira zakudya zimenezo. Ndizomwe zimakupititsani patsogolo ndi mphamvu, metabolism, zonsezo. Chifukwa chake ma smoothies amenewo ndi njira yabwino kwambiri, yomwe timapatsa odwala athu. Tili ndi bukhu lomwe lili ndi maphikidwe a smoothie okwana 150 omwe ali abwino kwambiri oletsa kukalamba, kuthandiza matenda a shuga, kutsitsa mafuta m'thupi, kuletsa kutupa, ndi zina zotero. Kotero ndi chinthu chimodzi chomwe timapereka kwa odwala athu. Koma tili ndi zosankha zina zingapo kwa odwala omwe amabwera ndi matenda a metabolic.

 

Dr. Alex Jimenez DC*:  Musanalowe mmenemo, Kenna. Ndiloleni ndingowonjezera kuti zomwe ndaphunzira ndikuti tiyenera kuzipanga zosavuta. Tiyenera kupita kunyumba kapena zotengerako. Ndipo zomwe tikuyesera kuchita ndikuti tikuyesera kukupatsani zida zomwe zingakuthandizeni kuchita izi. Ndipo tikutengerani kukhitchini. Tikugwirani khutu, titero kunena kwake, ndipo tikuwonetsani madera omwe tiyenera kuyang'ana. Chifukwa chake Kenna watsala pang'ono kutipatsa chidziwitso chokhudza ma smoothies omwe angatithandize ndi kusintha kwa zakudya zomwe titha kupatsa mabanja athu ndikusintha tsoka lake la metabolic lomwe limakhudza anthu ambiri otchedwa metabolic syndrome. Chitani zomwezo.

 

Kenna Vaughn: Chabwino, monga momwe amanenera ndi ma smoothies amenewo. Chinthu chimodzi chomwe muyenera kuwonjezera pa smoothie yanu ndi, chomwe ndimakonda kuwonjezera pa ine ndi sipinachi. Sipinachi ndi chisankho chabwino kwambiri chifukwa chimapatsa thupi lanu michere yambiri. Mukupeza masamba owonjezera, koma simungalawe, makamaka ngati ataphimbidwa ndi kukoma kwachilengedwe komwe mumapeza mu zipatso. Chifukwa chake ndiye njira yabwino ikafika ku ma smoothies. Koma chinthu china chimene Dr. Jiménez anali kunena ndi zinthu zina za kukhitchini. Chifukwa chake pali zinthu zina zomwe tikufuna kuti odwala athu azigwiritsa ntchito ndikuzigwiritsa ntchito. Mutha kuyamba pang'ono, ndipo zipanga kusiyana kwakukulu pongosintha mafuta omwe mukuphika nawo. Ndipo mudzayamba kuwona kusintha kwamalumikizidwe anu, ana anu, ndipo aliyense azingochita bwino kwambiri. Kotero chinthu chimodzi chomwe tikufuna kuti odwala athu agwiritse ntchito ndi mafuta amenewo, monga mafuta a avocado, mafuta a kokonati, ndi ... Mafuta a azitona? Mafuta a azitona. Inde, zikomo, Astrid.

 

Dr. Alex Jimenez DC*: Amenewo anali mafuta a azitona. Ameneyo anali Astrid kumbuyo. Tikupeza zowona bwino kwambiri ndikupitilira.

 

Kenna Vaughn: Mukachotsa izi, thupi lanu limaphwanya zinthu mosiyana ndi mafuta osatha. Ndiye iyi ndi njira ina yomwe muli nayo kukhitchini komweko kuphatikiza kupanga ma smoothies. Koma monga ndidanenera kale, ndine wofulumira, wosavuta, wosavuta. Ndikosavuta kusintha moyo wanu mukakhala ndi gulu lonse lozungulira inu. Ndipo pamene kuli kophweka, simutero. Simukufuna kutuluka ndikupanga chilichonse kukhala chovuta kwambiri chifukwa mwayi woti mumamatire siwokwera kwambiri. Chifukwa chake chinthu chimodzi chomwe tikufuna kuchita ndikuwonetsetsa kuti chilichonse chomwe timapereka kwa odwala athu ndichosavuta kuchita komanso kuti chizitheka tsiku lililonse.

 

Dr. Alex Jimenez DC*: Ndine wowoneka bwino. Ndiye ndikapita kukhitchini, ndimakonda kupanga khitchini yanga kuti iwoneke ngati cocina kapena chilichonse chomwe amachitcha ku Italy, cucina ndi ine ndili ndi mabotolo atatu pamenepo, ndipo ndili ndi mafuta a avocado. Ndili ndi mafuta a kokonati, ndipo ndili ndi mafuta a azitona pomwepo. Pali mabotolo akuluakulu pamenepo. Amawapangitsa kukhala okongola, ndipo amawoneka a Tuscan. Ndipo, inu mukudziwa, ine sindisamala ngati liri dzira, ine sindikusamala. Nthawi zina, ngakhale ndikamwa khofi wanga, ndimagwira mafuta a kokonati, ndikutsanulira ilo ndikudzipangira java yokhala ndi mafuta a kokonati. Kotero, eya, pitirirani.

 

Kenna Vaughn: Ine ndikuti ndinene kuti ndi njira yabwino kwambiri. Chifukwa chake ndimamwa tiyi wobiriwira, ndikuwonjezeranso mafuta a kokonati mu tiyi wobiriwira kuti athandizire kulimbikitsa chilichonse ndikupatsa thupi langa mlingo wina wamafuta acid omwe tikufuna.

 

Dr. Alex Jimenez DC*: Ine ndiri ndi funso kwa inu mukakhala ndi khofi wanu monga choncho; mafuta mukakhala nawo, amapaka milomo yanu.

 

Kenna Vaughn: Imachita pang'ono. Kotero zilinso ngati chapstick.

 

Dr. Alex Jimenez DC*: Eya, zimatero. Ziri ngati, O, ndimakonda. Chabwino, pitirirani.

 

Kenna Vaughn: Inde, ndiyeneranso kusuntha pang'ono kuti nditsimikizire kuti zonse zikuyenda bwino. Inde. Ndiyeno chinthu china kungolankhula za chinachake chimene odwala athu angachite pankhani kunyumba, pali matani osiyanasiyana options ndi kudya nsomba. Kuchulukitsa kadyedwe kanu kabwino ka nsomba sabata yonse, kukuthandizaninso. Ndipo chifukwa nsomba imapereka zinthu zambiri zazikulu ngati ma omegas, ndikudziwa kuti Astrid ilinso ndi zambiri za omega.

 

Dr. Alex Jimenez DC*: Ndinali ndi funso Astrid asanalowe mmenemo. Mukudziwa, tawonani, tikamakamba za chakudya, anthu, kodi ndi chomwe chimagawitsa? O, anthu amati apulo, nthochi, maswiti, ndi mitundu yonse ya zinthu zomwe anthu amatha kuwononga chakudya kapena mapuloteni. Nkhuku, ng'ombe, chirichonse chimene iwo angakhoze kuchiwononga. Koma chimodzi mwazinthu zomwe ndapeza kuti anthu amavutika nazo ndikuti mafuta abwino ndi ati? Ndikufuna zisanu. Ndipatseni mafuta khumi abwino a madola miliyoni. Ndipatseni mafuta khumi abwino ngati mafuta anyama, ngati nyama. Ayi, izi ndi zomwe tikukamba. Chifukwa chosavuta chomwe timagwiritsa ntchito ndipo tikuwonjezerapo zoyipa ndikukhala mafuta avocado. Mafuta a azitona. Kodi mafuta a kokonati? Titha kugwiritsa ntchito zinthu monga mafuta a batala, mitundu yosiyanasiyana ya m'mphepete, osati m'mphepete, koma mitundu ya batala yomwe imachokera, mukudziwa, ng'ombe zodyetsedwa ndi udzu. Titha kutha zopaka mafuta, mukudziwa, mafuta opaka osakhala a nondairy, opaka mafuta enieni, omwe timawathera, sichoncho? Kuthamanga kwenikweni. Ndiye zili ngati, mafuta ndi chiyani, chabwino? Ndiyeno ife timazifufuza izo. Chifukwa chake njira imodzi yabwino kwambiri yochitira izi ndikuti nthawi zonse sitidzayika zonona pamwamba kapena batala pamwamba, zomwe, mwa njira, khofi wina amakhala, amathira batala ndikusakaniza, ndipo amapanga. kugunda kwakung'ono kwa java. Ndipo aliyense amabwera ndi ginger wawo waung'ono ndi mafuta ndi khofi wawo ndikupanga espresso kuchokera kumwamba, sichoncho? Ndiye tingachitenso chiyani?

 

Kenna Vaughn: Titha, monga ndidanenera, kuwonjezera nsombazo, zomwe zitithandiza kupatsa matupi athu omega ochulukirapo. Kenako titha kuchitanso masamba ofiirira, ndipo izi zipatsa thupi lanu ma antioxidants ambiri. Ndiye kuti ndi njira yabwino ikafika ku golosale. Lamulo lomwe ndimakonda komanso kumva kalekale ndikuti musagule m'mipata ndikuyesa kugula m'mphepete chifukwa m'mphepete ndi komwe mungapeze zokolola zatsopano ndi nyama zonse zowonda. Ndipamene mumayamba kulowa mumipata imeneyo, ndipo ndipamene mudzayambire kupeza, mukudziwa, phala, ma carbohydrate oyipa, zakudya zosavuta zomwe zakudya zaku America zayamba kuzikonda koma sizikusowa. Oreos?

 

Kenna Vaughn: Inde.

 

Dr. Alex Jimenez DC*: Njira ya maswiti yomwe mwana aliyense amadziwa. Chabwino, inde. 

 

Kenna Vaughn: Kotero ndiyo chabe mfundo ina yaikulu pamenepo. Chifukwa chake mukabwera muofesi yathu, ngati mukudwala metabolic syndrome kapena china chilichonse, timapanga mapulani anu kukhala okonda makonda ndikukupatsani malangizo ambiri. Timamvera moyo wanu chifukwa zomwe zimagwira ntchito kwa munthu m'modzi sizingagwire ntchito kwa wina. Chifukwa chake tikuwonetsetsa kuti tikukupatsani chidziwitso chomwe tikudziwa kuti muchita bwino ndikukupatsani maphunziro chifukwa ndi gawo lina lalikulu la izi.

 

Dr. Alex Jimenez DC*: Misewu yonse imapita kukhitchini, huh? Kulondola? Inde, amatero. Chabwino, ndiye tiyeni tiwone bwino zamafuta ndi ma nutraceuticals. Ndikufuna ndikupatseni lingaliro la mtundu wanji wa zakudya zopatsa thanzi zomwe zili zoyenera kwa ife chifukwa tikufuna kuthana ndi zovuta zisanu izi zokhudzana ndi metabolic syndrome zomwe tidakambirana. Kodi anyamata asanuwo ndi chiyani? Tiyeni tipite patsogolo ndikuwayambitsa. Ndi shuga wokwera, chabwino?

 

Kenna Vaughn: Glucose wamagazi, HDL yotsika, yomwe idzakhala cholesterol yabwino yomwe aliyense amafunikira. Inde. Ndipo kudzakhala kuthamanga kwa magazi, komwe sikumaganiziridwa kuti ndipamwamba kwambiri kuchokera kwa dokotala, koma kumaonedwa kuti ndi kokwezeka. Kotero ndicho chinthu china; tikufuna kuwonetsetsa kuti ichi ndi metabolic syndrome, osati matenda a metabolic. Kotero ngati mupita kwa dokotala ndipo kuthamanga kwa magazi kwanu ndi 130 kupitirira makumi asanu ndi atatu mphambu zisanu, ndicho chizindikiro. Komabe dokotala wanu sanganene kwenikweni kuti kuthamanga kwa magazi kwanu ndi kokwera kwambiri. 

 

Dr. Alex Jimenez DC*: Palibe matenda awa pano mwa iwo okha omwe ali azachipatala, ndipo, payekhapayekha, ndi zinthu chabe. Koma mukaphatikiza zisanu zonsezi, muli ndi metabolic syndrome ndikumva ngati sizabwino kwambiri, sichoncho?

 

Astrid Ornelas: Inde inde.

 

Kenna Vaughn: Chinanso chidzakhala kulemera kochulukirapo kuzungulira mimba ndi triglycerides yapamwamba.

 

Dr. Alex Jimenez DC*: Zosavuta kuwona. Umatha kuona munthu ali ndi mimba yolendewera ngati kasupe eti? Kotero tikutha kuona kuti mukhoza kupitako nthawi zina odyera ku Italy ndikuwona wophika wamkulu. Ndipo nthawizina ndimayenera kukuuzani, nthawizina zimangokhala, mukudziwa, tidayankhulana ndi Chef Boyardee sanali munthu woonda. Ndikuganiza kuti Chef Boyardee uja, mukudziwa chiyani? Ndipo mnyamata wa Pillsbury, sichoncho? Chabwino, sizinali zathanzi, sichoncho? Onsewa amadwala metabolic syndrome kuyambira pachiyambi. Kotero ndicho chosavuta kuwona. Ndiye izi ndi zomwe tikhala tikuzilingalira. Astrid apendanso zakudya zina zopatsa thanzi, mavitamini, ndi zakudya zina zomwe titha kusintha zinthu. Ndiye nayi Astrid, ndipo nayi wosamalira sayansi yathu. Koma nayi Astrid, pitirirani.

 

Astrid Ornelas: Eya, ndikuganiza tisanalowe muzakudya zopatsa thanzi, ndikufuna ndifotokoze momveka bwino. Monga timalankhula za metabolic syndrome. Metabolic syndrome si a, ndipo ndikuganiza kuti, matenda kapena vuto lokha. Metabolic syndrome ndi gulu lazinthu zomwe zitha kukulitsa chiwopsezo chokhala ndi zovuta zina monga matenda a shuga, sitiroko, ndi matenda amtima. Chifukwa metabolic syndrome si, mukudziwa, vuto lenileni la thanzi, makamaka gulu ili, mndandanda wazinthu zina, zamavuto ena omwe amatha kukhala ovuta kwambiri azaumoyo. Chifukwa chake, metabolic syndrome ilibe zizindikiro zake zokha. Koma ndithudi, monga momwe timalankhulira, zifukwa zisanu zowopsa ndizo zomwe tinakambirana: mafuta ochulukirapo m'chiuno, kuthamanga kwa magazi, shuga wambiri, triglycerides, otsika HDL, komanso malinga ndi akatswiri a zaumoyo. Kwa madotolo ndi ofufuza, mukudziwa kuti muli ndi metabolic syndrome ngati muli ndi zinthu zitatu mwa zisanu zomwe zingawopseze.

 

Dr. Alex Jimenez DC*: Inde. Atatu. Tsopano, izo sizikutanthauza kuti ngati muli nacho, muli ndi zizindikiro. Monga ndikuwona zinali zowonekera pa. Koma ine ndiyenera kuti ndikuuzeni inu mu chondichitikira changa pamene wina ali ndi oposa atatu kapena atatu. Iwo akuyamba kumva kuwawa. Sakumva bwino. Amangoona ngati, mukudziwa, moyo si wabwino. Ali ndi ovololo basi. Sakuwoneka bwino. Kotero ndipo ine sindikuwadziwa iwo, mwinamwake. Koma banja lawo likudziwa kuti saoneka bwino. Monga amayi sakuwoneka bwino. Abambo akuwoneka bwino.

 

Astrid Ornelas: Inde inde. Ndipo metabolic syndrome, monga ndidanenera, ilibe zizindikiro zowonekera. Koma mukudziwa, ndinali ngati ndikupita ndi chimodzi mwazowopsa zomwe zimakhala ndi mafuta m'chiuno, ndipo apa ndipamene mudzawona anthu omwe mumawatcha apulo kapena thupi looneka ngati peyala, kotero amakhala ndi mafuta ochulukirapo pamimba. Ndipo ngakhale icho sichimawonedwa mwaukadaulo ngati chizindikiro, ndi chinthu chomwe chingathe; Ndikuganiza kuti zitha kupereka lingaliro kwa madokotala kapena akatswiri ena azaumoyo kuti munthu ameneyu, mukudziwa, ali ndi matenda a shuga kapena ali ndi matenda ashuga. Ndipo, mukudziwa, ali ndi kunenepa kwambiri komanso kunenepa kwambiri. Atha kukhala ndi chiwopsezo chowonjezereka cha metabolic syndrome ndipo chifukwa chake kukhala, mukudziwa, ngati sichinachiritsidwe, kukhala ndi zovuta zina zaumoyo monga matenda amtima ndi sitiroko. Ine ndikuganiza ndi izo zikunenedwa; ndiye ife tilowa mu nutraceutical.

 

Dr. Alex Jimenez DC*: Ndimakonda izi, ndimakonda izi. Tikupeza zinthu zabwino, ndipo tikupeza zambiri.

 

Astrid Ornelas: Ndipo ndikuganiza ndi zomwe zikunenedwa, tilowa muzakudya zopatsa thanzi. Monga ngati, Kenna amalankhula bwanji za takeaway? Mukudziwa, tili pano tikukamba zazaumoyo, ndipo tiri pano tikukamba za metabolic syndrome lero. Koma chotengera ndi chiyani? Kodi tingawauze chiyani anthu? Kodi angatenge chiyani pa nkhani yathu? Kodi kunyumba angatani? Kotero apa tili ndi zakudya zingapo zopatsa thanzi, zomwe ndalembapo zolemba zingapo mu blog yathu ndikuyang'ana. 

 

Dr. Alex Jimenez DC*:  Mukuganiza, Astrid? Mukayang'ana zolemba za 100 zolembedwa ku El Paso, makamaka m'dera lathu, zonse zidasungidwa ndi winawake. Inde. Chabwino.

 

Astrid Ornelas: Inde. Chifukwa chake tili ndi ma nutraceuticals angapo pano omwe adafufuzidwa. Ofufuza awerenga maphunziro onsewa ndipo adapeza kuti angathandize mwanjira ina ndipo mawonekedwe ena amayenda bwino, mukudziwa, metabolic syndrome ndi matenda okhudzana ndi awa. Chifukwa chake choyamba chomwe ndikufuna kukambirana ndi mavitamini a B. Ndiye vitamini B ndi chiyani? Awa ndi omwe nthawi zambiri mumatha kuwapeza palimodzi. Mutha kuwapeza m'sitolo. Mudzawawona ngati mavitamini a B-complex. Mudzawona ngati botolo laling'ono, ndiyeno limabwera ndi mavitamini B angapo. Tsopano, ndichifukwa chiyani ndimabweretsa mavitamini a B a metabolic syndrome? Chifukwa chake chimodzi mwazifukwa monga ofufuza adapeza kuti chimodzi mwazo, ndikuganiza, chimodzi mwazomwe zimayambitsa metabolic syndrome zitha kukhala kupsinjika. Chifukwa chake ndi zomwe zikunenedwa, tiyenera kukhala ndi mavitamini a B chifukwa tikakhala ndi nkhawa tikakhala ndi tsiku lovuta kuntchito tikakhala ndi nkhawa, ndikuganiza kuti ambiri mukudziwa, zovuta zambiri kunyumba kapena ndi banja, mantha athu. Mavitamini a B awa amathandizira kuti mitsempha yathu igwire ntchito. Choncho tikakhala ndi nkhawa zambiri, tidzagwiritsa ntchito mavitaminiwa, omwe amawonjezera nkhawa; mukudziwa, thupi lathu limatulutsa cortisol. Mukudziwa, zomwe zimagwira ntchito. Koma tonse tikudziwa kuti cortisol yochuluka, kupsinjika kwambiri kumatha. Zingakhale zovulaza kwa ife. Zikhoza kuonjezera chiopsezo chathu cha matenda a mtima.

 

Dr. Alex Jimenez DC*: Mukudziwa, monga ndimakumbukira titachita izi, misewu yonse imapita kukhitchini potengera chakudyacho m'thupi lanu. Misewu yonse imatsogolera ku mitochondria ikafika kudera lakuwonongeka. Dziko lopanga mphamvu za ATP lazunguliridwa ndikukulungidwa ndi nicotinamide, NADH, HDP, ATPS, ADP. Zinthu zonsezi zimalumikizana ndi vitamini B wamitundu yonse. Chifukwa chake ma vitamin B ali pa injini mu turbine ya zinthu zomwe zimatithandiza. Kotero ndizomveka kuti iyi inali pamwamba pa vitamini ndi yofunika kwambiri. Ndiyeno ali ndi mathero ena apa pa niacin. Kodi niacin ndi chiyani? Mwazindikira chiyani pamenepo?

 

Astrid Ornelas: Chabwino, niacin ndi vitamini B wina, mukudziwa, pali mavitamini B angapo. Ichi ndichifukwa chake ndili nacho pamenepo pansi pa kuchuluka kwake ndi niacin kapena vitamini B3, monga amadziwika bwino. Ambiri ndi anzeru kwambiri. Kafukufuku wambiri wapeza kuti kutenga vitamini B3 kungathandize kuchepetsa LDL kapena cholesterol choipa, kuthandiza kuchepetsa triglycerides, ndi kuonjezera HDL. Ndipo kafukufuku wochuluka wapeza kuti niacin, makamaka vitamini B3, ingathandize kuonjezera HDL ndi 30 peresenti.

 

Dr. Alex Jimenez DC*: Zodabwitsa. Mukayang'ana NADP ndi NADH, Awa ndi N ndi niacin, nicotinamide. Chifukwa chake mu biochemical compound, niacin ndi yomwe anthu amadziwa kuti mukaitenga yabwino kapena yomwe ikuyenera kukhala, mumamva kutulutsa uku ndipo kumakupangitsani kukanda mbali yanu yonse ya thupi lanu, ndipo imamveka. chabwino mukakanda chifukwa zimakupangitsani kumva choncho. Kulondola, okondeka kwambiri. Ndipo chachikulu ichi.

 

Astrid Ornelas: Inde. Inde, komanso, ndikungofuna kutsindika mfundo ya mavitamini a B. Mavitamini a B ndi ofunikira chifukwa amatha kuthandizira kagayidwe kathu tikamadya, mukudziwa, chakudya ndi mafuta, mafuta abwino, ndithudi, ndi mapuloteni. Thupi likamadutsa mumchitidwe wa kagayidwe kake, limasintha ma carbohydrate, mafuta, ndi mapuloteni. Mapuloteni amasandulika kukhala mphamvu, ndipo mavitamini a B ndi zigawo zazikulu zomwe zimayang'anira kuchita zimenezo.

 

Dr. Alex Jimenez DC*: Latinos, mwa anthu athu ambiri, timadziwa kuti takhala tikumva za namwino kapena munthu amene amapereka jekeseni wa vitamini B. Chotero inu munamva za zinthu zimenezo. Kulondola. Chifukwa chakuti mukuvutika maganizo, ndinu achisoni, akanatani? Chabwino, mukudziwa zomwe zingawabayire B12, sichoncho? Mavitamini B ndi ati, sichoncho? Ndipo munthuyo amatuluka ngati, Eya, ndipo amasangalala, chabwino? Chifukwa chake tidadziwa izi, ndipo ichi ndiye chowongolera zakale. Ogulitsa oyendayenda, omwe anali ndi mankhwala odzola ndi mafuta odzola, ankapeza ndalama zopatsa mavitamini a B. Zakumwa zoyamba zamphamvu zidapangidwa koyamba ndi B complex, mukudziwa, kuzinyamula. Tsopano apa pali mgwirizano. Tsopano popeza taphunzira kuti zakumwa zopatsa mphamvu zimayambitsa zovuta zambiri, kotero kuti tikubwerera ku ma B complex kuti tithandize anthu bwino. Chifukwa chake mavitamini otsatirawa omwe tili nawo ndi omwe tili ndi D, tili ndi vitamini D.

 

Astrid Ornelas: Eya, yotsatira yomwe ndimafuna kuti ndilankhulepo ndi vitamini D. Kotero pali kafukufuku wochuluka wokhudza vitamini D ndi ubwino wake, ubwino wa vitamini D pa matenda a kagayidwe kake, komanso momwe ndinafotokozera momwe mavitamini a B aliri opindulitsa pa kagayidwe kathu. Vitamini D imathandiziranso kagayidwe kathu, ndipo imatha kuthandizira kuwongolera shuga m'magazi athu, makamaka shuga. Ndipo izi pazokha ndizofunikira kwambiri chifukwa, monga chimodzi mwazinthu zomwe zimayambitsa metabolic syndrome, shuga wambiri m'magazi. Ndipo mukudziwa, ngati muli ndi shuga wambiri wamagazi, zimatha kuyambitsa, mukudziwa, zitha kuyambitsa prediabetes. Ndipo ngati zimenezi zitasiyidwa, zingayambitse matenda a shuga. Chifukwa chake kafukufuku wofufuza adapezanso kuti vitamini D yokha imathanso kukulitsa kukana kwa insulini, yomwe ndi yabwino kwambiri yomwe ingayambitse matenda a shuga.

 

Dr. Alex Jimenez DC*:  Inu mukudziwa, ine ndimangofuna kuzimitsa vitamini D si ngakhale vitamini; ndi hormone. Zinapezeka pambuyo pa C ndi Linus Pauling. Ataipeza, anangopitiriza kutchula kalata yotsatirayi. Chabwino, ndiye popeza ndi mahomoni, muyenera kungoyang'ana. Izi makamaka vitamini D kapena timadzi tocopherol. Itha kusintha zovuta zambiri za metabolism m'thupi lanu. Ndikulankhula za njira zenizeni mazana anayi mpaka mazana asanu zomwe tikupeza. Chaka chatha chinali 400. Tsopano tili pafupi ndi 500 njira zina zama biochemical zomwe zimakhudzidwa mwachindunji. Chabwino, zimakhala zomveka. Tawonani, chiwalo chathu chofunikira kwambiri m'thupi ndi khungu lathu, ndipo nthawi zambiri, tinkathamanga mozungulira ndi zovala zamtundu wina, ndipo tinali padzuwa kwambiri. Chabwino, sitinathe kuganiza kuti chiwalo chimenecho chikhoza kupanga mphamvu zambiri zochiritsa, ndipo vitamini D amachita zimenezo. Amapangidwa ndi kuwala kwa dzuwa ndikuyatsidwa. Koma dziko lamasiku ano, kaya ndife achiameniya, aku Iran, azikhalidwe zosiyanasiyana kumpoto, monga Chicago, anthu sapeza kuwala kochuluka. Kotero malingana ndi kusintha kwa chikhalidwe ndi kutsekedwa kwa anthu omwe akukhala ndikugwira ntchito mu nyali za fulorosenti izi, timataya mphamvu ya vitamini D ndikudwala kwambiri. Munthu amene amatenga vitamini D amakhala ndi thanzi labwino, ndipo cholinga chathu ndi kukweza vitamini D ndi vitamini wosungunuka ndi mafuta omwe amadzipaka okha ndikusungidwa m'chiwindi pamodzi ndi mafuta m'thupi. Chifukwa chake mutha kuyikweza pang'onopang'ono mukamayitenga, ndipo ndizovuta kupeza milingo yapoizoni, koma izi zimakhala pafupifupi ma nanograms zana limodzi ndi makumi awiri ndi zisanu pa desilita zomwe ndizokwera kwambiri. Koma ambiri aife timathamanga ndi 10 mpaka 20, omwe ndi otsika. Chifukwa chake, mwakutero, pakukweza izi, muwona kuti kusintha kwa shuga m'magazi kudzachitika zomwe Astrid akunena. Ndi zinthu ziti zomwe timaziwona, makamaka vitamini D? Chilichonse?

 

Astrid Ornelas: Ndikutanthauza, ndibwereranso ku vitamini D pang'ono; Ndikufuna kukambirana zazakudya zina zopatsa thanzi poyamba. CHABWINO. Koma vitamini D wochuluka ndi wothandiza chifukwa amathandizira kusintha kagayidwe kanu, ndipo amathandizira kukulitsa kukana kwa insulini, makamaka ku metabolic syndrome.

 

Dr. Alex Jimenez DC*: Nanga bwanji calcium?

 

Astrid Ornelas: Chifukwa chake kashiamu imayendera limodzi ndi vitamini D, ndi chinthu chomwe ndimafuna kuyankhula ndi vitamini D ndi calcium pamodzi. Nthawi zambiri timaganizira zinthu zisanu zomwe tazitchula kale zomwe zingayambitse metabolic syndrome. Komabe, pali, mukudziwa, ngati mukufuna kuganiza za izi, monga zomwe zimayambitsa zambiri mwazowopsa izi? Ndipo monga, mukudziwa, kunenepa kwambiri, moyo wongokhala, anthu omwe sachita masewera olimbitsa thupi kapena masewera olimbitsa thupi. Chimodzi mwazinthu zomwe zimatha kuyika munthu patsogolo kapena kukulitsa chiwopsezo cha metabolic syndrome. Ndiroleni ndifotokoze zochitika. Nanga bwanji ngati munthu ali ndi matenda opweteka kwambiri? Bwanji ngati ali ndi chinachake monga fibromyalgia? Nthawi zonse amamva kuwawa. Safuna kusuntha, choncho safuna kuchita masewera olimbitsa thupi. Safuna kukulitsa zizindikirozi. Nthawi zina, anthu ena amakhala ndi ululu wosatha kapena zinthu monga fibromyalgia. Tiyeni tipite pang'ono zoyambira. Anthu ena amangokhala ndi ululu wosalekeza wa msana, ndipo simukufuna kuchira. Chifukwa chake simukusankha monga ena mwa anthuwa sakusankha kukhala ofooka chifukwa akufuna. Ena mwa anthuwa ali ndi ululu movomerezeka, ndipo pali maphunziro angapo a kafukufuku, ndipo izi ndi zomwe ndimati ndimangirire mu vitamini D ndi calcium ndi vitamini D ndi calcium. Mukudziwa, mutha kuwatenga limodzi. Angathandize kusintha ululu wosatha mwa anthu ena.

 

Dr. Alex Jimenez DC*: Zodabwitsa. Ndipo ife tonse tikudziwa kuti calcium ndi chimodzi mwa zifukwa za spasms minofu ndi relaxers. Zifukwa zambiri. Ife tipita mu chirichonse cha izi. Tikhala ndi podcast ya vitamini D yokha komanso zovuta za calcium chifukwa titha kupita mwakuya. Tidzapita mwakuya, ndipo tidzapita mpaka ku genome. Genome ndi genomics, yomwe ndi sayansi yomvetsetsa momwe zakudya ndi majini zimavinira pamodzi. Ndiye tipita kumeneko, koma timakhala ngati tikulowa pang'onopang'ono munjira iyi chifukwa tikuyenera kuitenga nkhaniyi pang'onopang'ono. Chachitika ndi chiyani?

 

Astrid Ornelas: Chotsatira, tili ndi omega 3s, ndipo ndikufuna kutsindika kuti tikukamba za omega 3s ndi EPA, osati DHA. Chifukwa chake awa ndi EPA, yomwe ndi yomwe yalembedwa pamenepo, ndi DHA. Ndi mitundu iwiri yofunikira ya omega 3s. Kwenikweni, onsewo ndi ofunikira kwambiri, koma maphunziro angapo ofufuza ndipo ndapanga zolemba pa izi ndapezanso kuti ndikuganiza kutenga omega 3s makamaka ndi EPA, ndizopambana kuposa za DHA. Ndipo tikakamba za omega 3s, awa amapezeka mu nsomba. Nthawi zambiri, mukufuna kumwa omega 3s; mumawawona ngati mafuta a nsomba. Ndipo izi zikubwereranso ku zomwe Kenna adakambirana kale, monga kutsatira zakudya za ku Mediterranean, zomwe makamaka zimayang'ana kudya nsomba zambiri. Apa ndipamene mumadya omega 3s, ndipo kafukufuku wofufuza apeza kuti omega 3s eni eni angathandize kulimbikitsa thanzi la mtima, ndipo angathandize kuchepetsa cholesterol choipa ku LDL yanu. Ndipo izi zimathanso kusintha kagayidwe kathu, monga vitamini D.

 

Dr. Alex Jimenez DC*: Tikufuna kupita patsogolo ndikubisa zinthu zonsezi chifukwa tikuyang'ananso, ndipo tikakumana ndi metabolic syndrome, tikulimbana ndi kutupa. Kutupa ndi omegas zadziwika. Chifukwa chake chomwe tikuyenera kuchita ndikutulutsa zowona kuti omegas akhala muzakudya zaku America, ngakhale muzakudya za agogo. Ndiyeno, monganso, timamva tsiku lomwe agogo aakazi kapena agogo aakazi amakupatsirani mafuta a chiwindi a cod. Chabwino, nsomba yapamwamba kwambiri yomwe imakhala ndi omega ndi hering'i, yomwe imakhala pafupifupi mamiligalamu 800 pakudya. Cod ndi lotsatira pamene ili pafupi 600. Koma chifukwa cha kupezeka, khadi likupezeka kwambiri m'zikhalidwe zina. Kotero aliyense akanakhala ndi mafuta a chiwindi cha cod, ndipo iwo amakhoza kukupanga iwe kutseka mphuno yako ndi kumwa iwo, ndipo iwo ankadziwa kuti izo zimagwirizana. Iwo angaganize kuti ndi mafuta abwino. Komabe, anali odana ndi yotupa makamaka ndi anthu, ndipo kawirikawiri, agogo amene ankadziwa za ufulu kumathandiza ndi matumbo, kumathandiza kutupa, kumathandiza ndi mafupa. Iwo ankadziwa nkhani yonse kumbuyo kwa izo. Chifukwa chake tilowa mozama mu Omegas mu podcast yathu yamtsogolo. Tili ndi wina yemwe ali pano. Amatchedwa berberine, chabwino? Nkhani ya berberine ndi chiyani?

 

Astrid Ornelas: Chabwino, mokongola kwambiri seti yotsatira yazakudya zopatsa thanzi zomwe zalembedwa apa, berberine, glucosamine, chondroitin, acetyl L-carnitine, alpha-lipoic acid, ashwagandha, mochuluka kwambiri zonsezi zakhala zikugwirizana ndi zomwe ndidalankhula kale za ululu wosaneneka ndi zonse. za nkhani zaumoyo izi. Ndazilemba apa chifukwa ndapanga zolemba zingapo. Ndawerengapo maphunziro osiyanasiyana ofufuza omwe apanga izi m'mayesero osiyanasiyana komanso m'maphunziro ofufuza angapo ndi otenga nawo mbali ambiri. Ndipo awa apeza zambiri, mukudziwa, gulu ili lazakudya zopatsa thanzi zomwe zalembedwa; awa adamangidwanso kuti athandize kuchepetsa ululu wosatha. Mukudziwa, ndipo monga ndidakambirana kale, ngati kupweteka kosatha, mukudziwa, anthu omwe ali ndi fibromyalgia kapena amakonda, mukudziwa, tiyeni tipiteko pang'ono anthu omwe amamva ululu wammbuyo, mukudziwa, anthu osagwira ntchito awa omwe amakhala ndi moyo wongokhala. chifukwa cha zowawa zawo ndipo amatha kukhala pachiwopsezo cha metabolic syndrome. Zambiri mwazofukufukuzi zapeza kuti zakudya zopatsa thanzi zokha zingathandizenso kuchepetsa ululu wosatha.

 

Dr. Alex Jimenez DC*: Ndikuganiza kuti chatsopanocho chimatchedwa alpha-lipoic acid. Ndikuwona acetyl L-carnitine. Tikhala ndi biochemist wokhalamo pa podcast yotsatira kuti alowe mozama mu izi. Ashwagandha ndi dzina lochititsa chidwi. Ashwagandha. Nenani izo. Bwerezaninso. Kenna, mungandiuzeko pang'ono za ashwagandha ndi zomwe tapeza za ashwagandha? Chifukwa ndi dzina lapadera ndi chigawo chomwe timayang'ana, tidzakambirana zambiri za izo. Tibwereranso ku Astrid mumphindi, koma ndimupatsa kupuma pang'ono ndikukhala ngati, lolani Kenna andiuze pang'ono za ashwagandha.

 

Kenna Vaughn: Ndimati ndiwonjezere china chake chokhudza berberine.

 

Dr. Alex Jimenez DC*: O, chabwino, tiyeni tibwerere ku berberine. Izi ndi berberine ndi ashwagandha.

 

Kenna Vaughn: Chabwino, kotero kuti berberine yasonyezedwanso kuti ikuthandiza kuchepetsa HB A1C kwa odwala omwe ali ndi vuto la shuga la magazi, lomwe lidzabwereranso ku prediabetes yonse ndikulemba matenda awiri a shuga omwe amatha kuchitika m'thupi. Kotero kuti mmodzi wasonyezedwanso kuchepetsa chiwerengero chimenecho kuti akhazikitse shuga wamagazi.

 

Dr. Alex Jimenez DC*:  Pali chinthu chonse chomwe tikhala nacho pa berberine. Koma chimodzi mwazinthu zomwe tidachita pankhani ya metabolic syndrome zidapanga mndandanda wapamwamba kwambiri pankhaniyi. Ndiye pali ashwagandha ndi berberine. Chifukwa chake tiuzeni zonse za ashwagandha. Komanso, ashwagandha ndiye. Chifukwa chake pankhani ya shuga wamagazi, A1C ndiye kuwerengera shuga komwe kumakuuzani zomwe shuga wamagazi amachita pafupifupi miyezi itatu. Glycosylation ya hemoglobin imatha kuyezedwa ndi kusintha kwa mamolekyulu komwe kumachitika mkati mwa hemoglobin. Ichi ndichifukwa chake Hemoglobin A1C ndiye cholembera chathu kuti tidziwe. Kotero pamene ashwagandha ndi berberine abwera pamodzi ndikugwiritsa ntchito zinthuzo, tikhoza kusintha A1C, yomwe ndi miyezi itatu yofanana ndi mbiri yakale ya zomwe zikuchitika. Tawona kusintha pa izo. Ndipo ndicho chimodzi mwazinthu zomwe timachita tsopano malinga ndi mlingo ndi zomwe timachita. Tidutsa pa izi, koma osati lero chifukwa ndizovuta kwambiri. Ulusi wosungunuka wakhalanso mbali ya zinthu. Ndiye tsopano, tikamalimbana ndi ulusi wosungunuka, chifukwa chiyani tikulankhula za ulusi wosungunuka? Choyamba, ndi chakudya cha nsikidzi zathu, choncho tiyenera kukumbukira kuti dziko la probiotic ndi chinthu chomwe sitingathe kuiwala. Anthu ayenera kumvetsetsa kuti, ngakhale, kuti ma probiotics, kaya ndi Lactobacillus kapena Bifidobacterium strains, kaya ndi matumbo aang'ono, matumbo akuluakulu, kumayambiriro kwa matumbo aang'ono, pali mabakiteriya osiyanasiyana mpaka kumapeto kuti awone akubwera kumapeto. Chotero tiyeni tiwatchule amenewo malo amene zinthu zimatulukira. Pali mabakiteriya paliponse pamagulu osiyanasiyana, ndipo aliyense ali ndi cholinga chodziwira zimenezo. Pali vitamini E ndi wobiriwira tiyi. Chifukwa chake ndiuzeni, Astrid, zamphamvu izi pankhani ya tiyi wobiriwira. Kodi tikuwona chiyani pankhani ya metabolic syndrome?

 

Astrid Ornelas: CHABWINO. Ndiye tiyi wobiriwira ali ndi zabwino zambiri, mukudziwa? Koma, mukudziwa, anthu ena sakonda tiyi, ndipo ena amakonda khofi, mukudziwa? Koma ngati mukufuna kumwa tiyi, mukudziwa, chifukwa cha thanzi lake. Tiyi wobiriwira ndi malo abwino kwambiri oyambira komanso pankhani ya metabolic syndrome. Tiyi wobiriwira wawonetsedwa kuti amathandizira kupititsa patsogolo thanzi la mtima, ndipo amathandizira kuchepetsa ziwopsezo zomwe zimakhudzana ndi metabolic syndrome. Ikhoza kuthandizira, mukudziwa, maphunziro angapo ofufuza omwe apeza kuti tiyi wobiriwira angathandize kuchepetsa mafuta m'thupi, cholesterol choipa, LDL.

 

Dr. Alex Jimenez DC*: Kodi tiyi wobiriwira amatithandiza ndi mafuta am'mimba?

 

Astrid Ornelas: Inde. Pali ubwino umodzi wa tiyi wobiriwira umene ndawerengapo. Chokongola kwambiri chimodzi mwazinthu zomwe mwina zimadziwika bwino ndikuti tiyi wobiriwira amatha kuthandizira kuwonda.

 

Dr. Alex Jimenez DC*: Oh my God. Choncho kwenikweni madzi ndi wobiriwira tiyi. Ndi zimenezo, anyamata. Ndizomwezo. Timachepetsa miyoyo yathu yomwe ilinso, ndikutanthauza, tinayiwala ngakhale chinthu champhamvu kwambiri. Zimasamalira ma ROS, omwe ndi mitundu ya okosijeni yokhazikika, ma antioxidants athu, kapena ma oxidants m'magazi athu. Chifukwa chake zimangowafinya ndikuzitulutsa ndikuziziziritsa ndikuletsa kuwonongeka kwanthawi zonse komwe kumachitika kapena kuwonongeka kwakukulu komwe kumachitika pakuwonongeka kwa metabolism, komwe kumapangidwa ndi ROS, mitundu yokhazikika ya okosijeni ndi yolusa, yopenga. oxidants, omwe tili ndi dzina labwino la zinthu zomwe zimawaphwanya ndikuzikhazika pansi ndikuziyika mu dongosolo lomwe amawatcha kuti antioxidants. Chifukwa chake mavitamini omwe ali ndi antioxidant ndi A, E, ndi C ndi antioxidants, nawonso. Kotero izo ndi zida zamphamvu zomwe timachita nazo pamene tikuchepetsa thupi. Timamasula poizoni wambiri. Ndipo pamene tiyi wobiriwira akulowa mu squirt, kuwafinya, kuwaziziritsa, ndi kuwachotsa mu gear. Tangoganizirani komwe kuli chiwalo china chomwe chimathandiza kupanga insulini, chomwe ndi impso. Impso zimatulutsidwa ndi tiyi wobiriwira ndipo zimathandizanso. Ndazindikira kuti chinthu chimodzi chomwe simunachite, Astrid, chachitika ndi zolemba za turmeric, sichoncho?

 

Astrid Ornelas: O, ndapanga zolemba zambiri za turmeric. Ndikudziwa chifukwa, kuchokera pamndandanda womwe uli pamwamba apo, turmeric ndi curcumin mwina zili ngati imodzi mwazakudya zomwe ndimakonda kunena.

 

Dr. Alex Jimenez DC*: Eya, ali ngati kuluma muzu komanso kangapo.

 

Astrid Ornelas: Eya, ndili ndi zina mu furiji yanga pompano.

 

Dr. Alex Jimenez DC*: Eya, mumakhudza turmeric, ndipo mukhoza kutaya chala. Chinachitika ndi chala changa ndi chiyani? Kodi mwafika pafupi ndi turmeric yanga? Muzu, sichoncho? Choncho. Chifukwa chake tiuzeni pang'ono za turmeric ndi curcumin pankhani ya metabolic syndrome.

 

Astrid Ornelas: CHABWINO. Ndachita zingapo, mukudziwa, zolemba zambiri za turmeric ndi curcumin. Ndipo tidakambiranaponso izi m'mbuyomu, ndipo ma podcasts athu angapo akale ndi ma turmeric ndikuti ndikuti chikasu chachikasu chimatha kuwoneka lalanje kwa anthu ena, koma nthawi zambiri chimatchedwa muzu wachikasu. Ndipo ndizodziwika kwambiri muzakudya zaku India. Ndi zomwe ndi chimodzi mwazosakaniza zazikulu zomwe mungapeze mu curry. Ndipo curcumin, ndithudi ena a inu anthu mudamvapo za curcumin kapena turmeric, inu mukudziwa? Kodi pali kusiyana kotani? Chabwino, turmeric ndi chomera chamaluwa, ndipo ndi muzu. Timadya muzu wa turmeric, ndipo curcumin ndizomwe zimagwiritsidwa ntchito mu turmeric zomwe zimapatsa mtundu wachikasu.

 

Dr. Alex Jimenez DC*: Anyamata, sindingalole chilichonse koma mtundu wapamwamba kwambiri wa curcumin ndi mankhwala a turmeric kupezeka kwa odwala awo chifukwa pali kusiyana. Zina zimapangidwa ndi zenizeni, ndikutanthauza, tili ndi zosungunulira, ndipo momwe timatulutsira zinthu ndi curcumin ndi turmeric kapena zinthu ngati cocaine, muyenera kugwiritsa ntchito distillate. Sichoncho? Ndipo kaya ndi madzi, acetone, benzene, OK, kapena mtundu wina wa mankhwala, tikudziwa lero kuti benzene amagwiritsidwa ntchito popanga mitundu yambiri ya zowonjezera, ndipo makampani ena amagwiritsa ntchito benzene kuti atulutse turmeric. Vuto ndi benzene imatulutsa khansa. Chifukwa chake tiyenera kusamala kwambiri ndi makampani omwe timagwiritsa ntchito. Acetone, lingalirani zimenezo. Chifukwa chake pali njira zomwe zimayenera kutulutsa turmeric moyenera komanso zopindulitsa. Chifukwa chake kupeza turmeric yoyenera, ma turmerics onse sali ofanana. Ndipo ndicho chimodzi mwazinthu zomwe tiyenera kuziwunika popeza zili ndi zinthu zambiri padziko lapansi zomwe zikuyenda mopenga kuyesa kukonza turmeric molondola, ngakhale ndichinthu chomaliza chomwe tikukambirana lero pamutu wathu. Koma ndi chimodzi mwa zinthu zofunika kwambiri masiku ano. Sitikumvetsa ngakhale aspirin. Tikudziwa kuti imagwira ntchito, koma kukula kwake sikunafotokozedwebe. Komabe, turmeric ili m'bwato lomwelo. Tikuphunzira zambiri za izi kotero kuti tsiku lililonse, mwezi uliwonse, maphunziro akupangidwa pa mtengo wa turmeric muzakudya zachilengedwe, kotero Astris akugwirizana ndi zomwe akufuna. Ndiye ndikutsimikiza kuti atibweretsera zambiri, sichoncho?

 

Astrid Ornelas: Inde kumene. 

 

Dr. Alex Jimenez DC*: Chifukwa chake ndikuganiza zomwe tingachite lero ndikuti tikayang'ana izi, ndikufuna ndikufunseni Kenna, tikayang'ana matenda a metabolic kuchokera kuzizindikiro zazizindikiro kapena kuchokera ku maphunziro a labotale. Chidaliro chodziwa kuti N ikufanana ndi chimodzi mwazinthu zofunika kwambiri zomwe tili nazo tsopano muzamankhwala ogwira ntchito komanso machitidwe a thanzi labwino omwe madokotala ambiri amachitira pakuchita kwawo. Chifukwa pankhani za metabolic, simungathe kuchotsa kagayidwe kachakudya m'thupi. Kodi metabolism imachitika pamavuto am'mbuyo? Timazindikira kulumikizana ndi kuvulala kwa msana, kupweteka kwa msana, zovuta zam'mbuyo, kusokonezeka kwa mawondo, kusokonezeka kwa minofu ndi mafupa, ndi metabolic syndrome. Kotero ife sitingakhoze kuziseka izo. Chifukwa chake tiuzeni pang'ono, Kenna, pamene tikutseka lero zomwe wodwala angayembekezere akabwera kuofesi yathu, ndipo amakhala ngati "Oops, muli ndi metabolic syndrome." Ndiye boom, tithana nazo bwanji?

 

Kenna Vaughn: Tikufuna kudziwa mbiri yawo chifukwa, monga mwanenera, zonse zimagwirizana; zonse ndi zozama. Pali zambiri zomwe tikufuna kudziwa zonse kuti tithe kupanga dongosolo lokhazikika. Chifukwa chake chimodzi mwazinthu zoyamba zomwe timachita ndi mafunso aatali kwambiri a Living Matrix, ndipo ndi chida chabwino kwambiri. Zimatenga kanthawi pang'ono, koma zimatipatsa kuzindikira kwakukulu kwa wodwalayo, zomwe ndi zabwino chifukwa zimatilola, monga ndanenera, kukumba mozama ndikuzindikira, mukudziwa, zoopsa zomwe mwina zidachitika zomwe zimabweretsa kutupa. , momwe Astrid amanenera kenako amatsogolera moyo wongokhala, womwe umatsogolera ku metabolic syndrome iyi kapena kungotsika mwanjira imeneyo. Chotero chimodzi mwa zinthu zoyamba zimene timachita ndi kufunsa mafunso aataliwo, ndiyeno timakhala pansi ndi kukambirana nanu mmodzimmodzi. Timamanga gulu ndikukupangani kukhala gawo la banja lathu chifukwa zinthu izi sizosavuta kudutsa panokha, ndiye kuti kupambana kwakukulu kumakhala mukakhala ndi banja logwirizana, ndipo muli ndi chithandizo chimenecho, ndipo timayesetsa kutero inu.

 

Dr. Alex Jimenez DC*: Tatenga izi ndikuzindikira kuti zinali zovuta kwambiri zaka zisanu zapitazo. Zinali zovuta. Mafunso amasamba 300 300. Lero tili ndi mapulogalamu omwe tingathe kudziwa. Imathandizidwa ndi IFM, Institute of Functional Medicine. Institute of Functional Medicine idayamba zaka khumi zapitazi ndipo idadziwika kwambiri, kumvetsetsa munthu wathunthu ngati payekha. Simungathe kulekanitsa diso ndi mtundu wa thupi chifukwa simungathe kulekanitsa kagayidwe kachakudya ndi zotsatira zake zonse. Kamodzi thupi limenelo ndi chakudya chimenecho, chopatsa thanzi chimenecho chimalowa m'thupi lathu. Kumbali ina ya pakamwa pathu pali tinthu ting’onoting’ono tolemera totchedwa ma chromosome. Iwo akuzungulira, ndipo akugwedezeka, ndipo akupanga ma enzyme ndi mapuloteni kutengera zomwe timawadyetsa. Kuti tidziwe zomwe zikuchitika, tiyenera kupanga mafunso okhudzana ndi uzimu wamaganizo. Zimabweretsa zimango za chigayidwe chokhazikika, momwe kutsekeka kumagwirira ntchito, komanso momwe moyo wonse umachitikira mwa munthu. Chifukwa chake tikaganizira za Astrid ndi Kenna palimodzi, timapeza njira yabwino kwambiri, ndipo timakhala ndi njira yopangira munthu aliyense. Timachitcha kuti IFM imodzi, ziwiri, ndi zitatu, zomwe ndi mafunso ovuta omwe amatilola kuti tikupatseni kufufuza mwatsatanetsatane ndi kusweka kolondola komwe kungayambitse komanso nutraceuticals zakudya zopatsa thanzi zomwe timaganizira. Timakukankhirani kolondola komwe kuli kofunikira kukhitchini. Timatha kukuphunzitsani inu ndi achibale anu momwe mungadyetse kuti mukhale abwino kwa ma genetic genomes, omwe inu, monga ndimanenera nthawi zonse, ontogeny, recapitulate phylogeny. Ndife omwe ife tiri kuyambira kale mpaka kwa anthu, ndipo anthu amenewo ali ndi ulusi pakati pa ife ndi zakale zanga, ndipo aliyense pano ndi wakale. Ndipo ndiwo majini athu, ndipo majini athu amayankha ku chilengedwe. Chifukwa chake kaya zipita kumwera mwachangu kapena zowonekera kapena zoyembekezeredwa, tikambirana izi, ndipo tilowa m'dziko la ma genomics posachedwa munjira iyi pamene tikulowera mozama mumayendedwe a metabolic syndrome. Chifukwa chake ndikukuthokozani nonse chifukwa chotimvera ndikudziwa kuti titha kulumikizana pano, ndipo akusiyirani nambala. Koma tili ndi Astrid pano yemwe akuchita kafukufuku. Tili ndi gulu lokhazikitsidwa ndi anthu ambiri omwe angakupatseni zambiri zomwe zikukhudza inu; N akufanana ndi mmodzi. Tili ndi Kenna pano yemwe amapezeka nthawi zonse ndipo tabwera kudzasamalira anthu m'tawuni yathu yokongola ya El Paso. Chifukwa chake zikomonso, ndikuyembekezera podcast yotsatira, yomwe mwina ikhala mkati mwa maola angapo otsatira. Ndikungocheza. Chabwino, chabwino, anyamata. 

Kusintha Kwaubongo Kogwirizana ndi Ululu Wosatha

Kusintha Kwaubongo Kogwirizana ndi Ululu Wosatha

Ululu ndi momwe thupi la munthu limachitira povulala kapena matenda, ndipo nthawi zambiri limakhala chenjezo kuti chinachake chalakwika. Vutoli litachira, kaŵirikaŵiri timasiya kukhala ndi zizindikiro zoŵaŵa zimenezi, komabe, kodi chimachitika nchiyani pamene ululuwo ukupitirira nthaŵi yaitali chifukwa chake chitatha? Kupweteka kosautsa amatanthauzidwa mwachipatala ngati kupweteka kosalekeza komwe kumatenga 3 kwa miyezi 6 kapena kuposerapo. Zowawa zosatha ndizovuta kwambiri kukhala nazo, zomwe zimakhudza chilichonse kuyambira momwe munthu amachitira komanso kuthekera kwawo kugwira ntchito komanso maubwenzi awo komanso malingaliro awo. Koma, kodi mukudziwa kuti ululu wosatha ukhoza kukhudzanso momwe ubongo wanu umagwirira ntchito? Zikuoneka kuti kusintha kwa ubongo uku kungayambitse kuwonongeka kwa chidziwitso komanso m'maganizo.

 

Kupweteka kosalekeza sikumangokhudza gawo limodzi la malingaliro, makamaka, kungayambitse kusintha kwa magawo ambiri aubongo, omwe ambiri amakhudzidwa ndi machitidwe ndi magwiridwe antchito ambiri. Kafukufuku wosiyanasiyana pazaka zambiri apeza kusintha kwa hippocampus, komanso kuchepa kwa imvi kuchokera ku dorsolateral prefrontal cortex, amygdala, brainstem ndi right insular cortex, kutchula ochepa, okhudzana ndi ululu wosatha. Kuwonongeka kwa magawo angapo a zigawozi ndi ntchito zake zofananira zingathandize kuyika kusintha kwa ubongo kumeneku, kwa anthu ambiri omwe ali ndi ululu wosatha. Cholinga cha nkhani yotsatirayi ndikuwonetsa komanso kukambirana za kusintha kwa ubongo ndi ntchito zomwe zimagwirizanitsidwa ndi ululu wosaneneka, makamaka ngati zomwe zikuwonetsa mwina sizikuwonongeka kapena atrophy.

 

Kusintha Kwaubongo Wamapangidwe mu Ululu Wosatha Kuwonetsa Mwina Palibe Zowonongeka Kapena Kupweteka Kwambiri

 

Kudalirika

 

Kupweteka kosatha kumawoneka kuti kumalumikizidwa ndi kuchepa kwa imvi muubongo m'malo omwe amapatsirana zowawa. Mapangidwe a morphological omwe amayambitsa kusintha kwamapangidwe awa, mwina kutsatira kukonzanso kwa magwiridwe antchito komanso pulasitiki yapakati muubongo, sizikudziwika. Kupweteka kwa m'chiuno osteoarthritis ndi amodzi mwa ma syndromes opweteka omwe amatha kuchiritsidwa. Tinafufuza odwala 20 omwe ali ndi ululu wosatha chifukwa cha unilateral coxarthrosis (zaka zapakati pa 63.25�9.46 (SD) zaka, 10 akazi) pamaso pa opaleshoni ya chiuno cha endoprosthetic (pain state) ndikuyang'anira kusintha kwa ubongo mpaka chaka chimodzi pambuyo pa opaleshoni: masabata a 1�6. , masabata 8�12 ndi miyezi 18�10 pamene palibe ululu. Odwala omwe amamva kupweteka kosalekeza chifukwa cha unilateral coxarthrosis anali ndi imvi yocheperako poyerekeza ndi zowongolera mu anterior cingulate cortex (ACC), insular cortex ndi operculum, dorsolateral prefrontal cortex (DLPFC) ndi orbitofrontal cortex. Zigawozi zimagwira ntchito monga machitidwe ambiri ophatikizana panthawi yachidziwitso komanso kuyembekezera zowawa. Odwalawo atamva ululu atachira pambuyo pa opaleshoni ya endoprosthetic, kuwonjezeka kwa imvi m'madera omwewo kunapezeka. Tidapezanso kuchulukirachulukira kwa imvi muubongo mu premotor cortex ndi malo owonjezera agalimoto (SMA). Timatsimikiza kuti imvi zowawa mu ululu wosatha sizomwe zimayambitsa, koma zachiwiri ku matendawa ndipo zimakhala zochepa chifukwa cha kusintha kwa magalimoto ndi kugwirizanitsa thupi.

 

Introduction

 

Umboni wa kukonzanso magwiridwe antchito ndi makonzedwe a odwala opweteka kwambiri amachirikiza lingaliro lakuti kupweteka kosalekeza sikuyenera kuganiziridwa ngati kusintha kwa ntchito, komanso chifukwa cha ubongo wogwira ntchito komanso wopangidwa ndi ubongo [1], [2], [3], [4], [5], [6]. M'zaka zisanu ndi chimodzi zapitazi, maphunziro opitilira 20 adasindikizidwa akuwonetsa kusintha kwaubongo mu 14 syndromes opweteka kwambiri. Chochititsa chidwi pa maphunziro onsewa ndi chakuti kusintha kwa imvi sikunagawidwe mwachisawawa, koma kumachitika m'madera odziwika bwino a ubongo � ndiko, kutenga nawo mbali mu supraspinal nociceptive processing. Zofukufuku zodziwika kwambiri zinali zosiyana pa ululu uliwonse wa ululu, koma umakhala mu cingulate cortex, orbitofrontal cortex, insula ndi dorsal pons [4]. Zina mwazinthu zimaphatikizapo thalamus, dorsolateral prefrontal cortex, basal ganglia ndi dera la hippocampal. Zomwe zapezazi nthawi zambiri zimakambidwa ngati ma cell atrophy, kulimbikitsa lingaliro la kuwonongeka kapena kutayika kwa ubongo wa imvi [7], [8], [9]. M'malo mwake, ofufuza adapeza kulumikizana pakati pa imvi yaubongo kumachepa komanso nthawi ya ululu [6], [10]. Koma nthawi ya ululu imalumikizidwanso ndi zaka za wodwalayo, komanso zaka zomwe zimadalira padziko lonse lapansi, komanso kuchepa kwapadera kwa imvi kumalembedwa bwino [11]. Kumbali ina, kusintha kwapangidwe kumeneku kungakhalenso kuchepa kwa kukula kwa maselo, madzi owonjezera, synaptogenesis, angiogenesis kapena chifukwa cha kusintha kwa magazi [4], [12], [13]. Kaya gwero liri lotani, chifukwa cha kutanthauzira kwathu kwa zomwe tapeza ndikofunikira kuti tiwone zomwe zapezedwazi potengera kuchuluka kwa maphunziro a morphometric muzochita zolimbitsa thupi zomwe zimadalira pulasitiki, popeza kusintha kwaubongo komwe kumachitika m'chigawocho kwawonetsedwa mobwerezabwereza potsatira chidziwitso ndi masewera olimbitsa thupi [ 14].

 

Sizikudziwika chifukwa chake anthu ochepa chabe amakhala ndi matenda opweteka kwambiri, poganizira kuti ululu ndizochitika padziko lonse. Funso limakhala ngati mwa anthu ena kusiyana kwapangidwe pakati pa machitidwe opatsirana ululu kungakhale ngati diathesis ya ululu wosatha. Imvi imasintha mu ululu wa phantom chifukwa cha kudulidwa [15] ndi kuvulala kwa msana [3] zimasonyeza kuti kusintha kwa morphological kwa ubongo ndi, mwina, chifukwa cha ululu wosatha. Komabe, ululu wa m'chiuno osteoarthritis (OA) ndi amodzi mwa ochepa matenda opweteka omwe amatha kuchiritsidwa, monga 88% mwa odwalawa nthawi zonse samva ululu potsatira opaleshoni yonse ya chiuno (THR) [16]. Mu kafukufuku woyendetsa ndege tasanthula odwala khumi omwe ali ndi chiuno cha OA asanachite opaleshoni komanso atangomaliza kumene. Tinapeza kuchepa kwa imvi mu anterior cingulated cortex (ACC) ndi insula panthawi ya ululu wosatha opaleshoni ya THR isanachitike ndipo tinapeza kuwonjezeka kwa imvi m'madera a ubongo omwe amamva ululu pambuyo pa opaleshoni [17]. Poyang'ana zotsatirazi, tsopano tinakulitsa maphunziro athu ofufuza odwala ambiri (n? =? 20) pambuyo pa THR yopambana ndikuyang'anira kusintha kwa ubongo kwa nthawi zinayi, mpaka chaka chimodzi pambuyo pa opaleshoni. Kuti tiwongolere kusintha kwa imvi chifukwa chakusintha kwagalimoto kapena kupsinjika, tidaperekanso mafunso okhudza kuwongolera magwiridwe antchito agalimoto ndi thanzi lamaganizidwe.

 

Zida ndi njira

 

Odzipereka

 

Odwala omwe adanenedwa pano ndi gulu la odwala 20 mwa odwala 32 omwe adasindikizidwa posachedwa omwe adafanizidwa ndi gulu lowongolera thanzi la zaka komanso jenda [17] koma adachita nawo kafukufuku wotsatira wa chaka chimodzi. Pambuyo pa opaleshoni odwala 12 anasiya chifukwa cha opaleshoni yachiwiri ya endoprosthetic (n?=?2), matenda aakulu (n?=?2) ndi kuchotsedwa kwa chilolezo (n?=?8). Izi zidasiya gulu la odwala makumi awiri omwe ali ndi unilateral primary hip OA (nthawi yayitali 63.25�9.46 (SD) zaka, 10 akazi) omwe adafufuzidwa kanayi: asanachite opaleshoni (pain state) komanso 6�8 ndi 12�18 masabata ndi 10 �Miyezi 14 pambuyo pa opareshoni ya endoprosthetic, pomwe ululu wopanda chilichonse. Odwala onse omwe ali ndi chiuno chachikulu cha OA anali ndi mbiri yopweteka kwambiri kuposa miyezi ya 12, kuyambira 1 mpaka zaka 33 (kutanthauza zaka 7.35) ndi chiwerengero cha ululu wa 65.5 (kuchokera ku 40 mpaka 90) pazithunzi za analogue (VAS) kuyambira 0 (palibe zowawa) mpaka 100 (zowawa zoyipitsitsa). Tinayesa zochitika zilizonse zowawa zazing'ono, kuphatikizapo dzino-, khutu- ndi mutu mpaka masabata a 4 musanayambe phunzirolo. Tidasankhanso mwachisawawa zambiri kuchokera ku 20 kugonana- ndi zaka zofananira zowongolera zathanzi (zaka zapakati pa 60,95�8,52 (SD) zaka, 10 akazi) pa 32 ya kafukufuku woyendetsa omwe tawatchulawa [17]. Palibe odwala 20 kapena 20 ogonana- ndi zaka zofanana ndi odzipereka athanzi omwe anali ndi mbiri yachipatala kapena yamkati. Kafukufukuyu anavomerezedwa ndi komiti ya Ethics m'deralo ndipo chilolezo cholembedwa chinapezedwa kuchokera kwa onse omwe adachita nawo kafukufuku asanayesedwe.

 

Deta Yamakhalidwe

 

Tinasonkhanitsa deta yokhudzana ndi kuvutika maganizo, somatization, nkhawa, ululu ndi thanzi labwino la thupi ndi maganizo kwa odwala onse ndi nthawi zonse zinayi pogwiritsa ntchito mafunso otsatirawa: Beck Depression Inventory (BDI) [18], Brief Symptom Inventory (BSI) [19], Schmerzempfindungs-Skala (SES?=?pain unpleasantness scale) [20] and Health Survey 36-Item Short Form (SF-36) [21] ndi Nottingham Health Profile (NHP). Tidachita mobwerezabwereza ANOVA ndikuphatikiza ma t-mayeso a michira iwiri kuti tifufuze deta yotalikirapo yamakhalidwe pogwiritsa ntchito SPSS 13.0 ya Windows (SPSS Inc., Chicago, IL), ndikugwiritsa ntchito kukonza kwa Greenhouse Geisser ngati lingaliro la sphericity linaphwanyidwa. Mulingo wofunikira udayikidwa pa p<0.05.

 

VBM - Kupeza Data

 

Chithunzi chopeza. Kujambula kwapamwamba kwa MR kunkachitika pa 3T MRI system (Siemens Trio) yokhala ndi mutu wamtundu wa 12. Pazigawo zinayi zilizonse, jambulani I (pakati pa tsiku limodzi ndi mwezi wa 1 musanayambe opaleshoni ya endoprosthetic), jambulani II (masabata 3 mpaka 6 mutatha opaleshoni), jambulani III (masabata 8 mpaka 12 mutatha opaleshoni) ndi kujambula IV (18�10) miyezi atachitidwa opaleshoni), MRI yolemetsa ya T14 idapezedwa kwa wodwala aliyense pogwiritsa ntchito 1D-FLASH sequence (TR 3 ms, TE 15 ms, flip angle 4.9�, 25 mm magawo, FOV 1�256, voxel size 256�1� 1 mm).

 

Kukonza Zithunzi ndi Kusanthula Mawerengero

 

Kukonzekera ndi kusanthula deta kunachitika ndi SPM2 (Wellcome Department of Cognitive Neurology, London, UK) yomwe ikuyenda pansi pa Matlab (Mathworks, Sherborn, MA, USA) ndipo inali ndi bokosi lachida la voxel-based morphometry (VBM) la data longitudinal, zimachokera pazithunzi zapamwamba za 3D MR ndipo zimalola kugwiritsa ntchito ziwerengero zanzeru za voxel kuti zizindikire kusiyana kwamadera mu kachulukidwe kazinthu zotuwa kapena ma voliyumu [22], [23]. Mwachidule, kukonza kusanachitike kunkakhudza kukhazikika kwa malo, magawo a imvi ndi kusalaza kwapakati kwa 10 mm ndi kernel ya Gaussian. Pamasitepe okonzekeratu, tidagwiritsa ntchito ndondomeko yokhathamiritsa [22], [23] ndi scanner- ndi template yophunzirira yeniyeni ya imvi [17]. Tidagwiritsa ntchito SPM2 osati SPM5 kapena SPM8 kuti kusanthula uku kufanane ndi kafukufuku wathu woyendetsa ndege [17]. chifukwa amalola normalization kwambiri ndi segmentation wa deta longitudinal. Komabe, pomwe zosintha zaposachedwa za VBM (VBM8) zidapezeka posachedwa (dbm.neuro.uni-jena.de/vbm/), tidagwiritsanso ntchito VBM8.

 

Cross-Sectional Analysis

 

Tinagwiritsa ntchito mayeso awiri a T-0.001 kuti tipeze kusiyana kwa zigawo mu utoto wa imvi pakati pamagulu (odwala nthawi yayitali) komanso kuwongolera kwathanzi). Tinagwiritsira ntchito pakhomo la p <9 (osakonzedwa) kudutsa mu ubongo wonse chifukwa cha mphamvu yathu yamphamvu, yomwe imachokera ku maphunziro odziimira a 7 ndi magulu omwe akuwonetsa kuchepa kwa imvi kwa odwala opweteka kwambiri [8], [9], [ [Chithunzi patsamba 15]. 24], [Chithunzi patsamba 25]. ). Maguluwa adafananizidwa zaka ndi kugonana popanda kusiyana kwakukulu pakati pa magulu. Kuti tifufuze ngati kusiyana pakati pa magulu atasintha patatha chaka chimodzi, tinali ofanana ndi odwala pofika nthawi yayitali.

 

Longitudinal Analysis

 

Kuti tipeze kusiyana pakati pa nthawi (Scan I�IV) tinayerekeza zojambulazo musanachite opaleshoni (pain state) komanso masabata a 6�8 ndi 12�18 ndi miyezi 10�14 pambuyo pa opaleshoni ya endoprosthetic (yopanda ululu) monga muyeso wobwerezabwereza ANOVA. Chifukwa ubongo uliwonse umasintha chifukwa cha ululu wopweteka kwambiri ungafunike nthawi kuti ubwerere pambuyo pa opaleshoni ndi kutha kwa ululu komanso chifukwa cha ululu wa opaleshoni pambuyo pa opaleshoni yomwe odwala adanena, tinafanizira mu kufufuza kwautali I ndi II ndi scan III ndi IV. Kuti tipeze kusintha komwe sikunagwirizane kwambiri ndi ululu, tinayang'ananso kusintha kwapang'onopang'ono pakapita nthawi. Tinatembenuza ubongo wa odwala omwe ali ndi OA ya chiuno chakumanzere (n? =? 7) kuti tikhale okhazikika kumbali ya ululu kwa onse awiri, kuyerekezera kwa gulu ndi kusanthula kwautali, koma makamaka kusanthula deta yosasinthika. Tidagwiritsa ntchito mphambu ya BDI ngati covariate pachitsanzocho.

 

Results

 

Dongosolo la Chikhalidwe

 

Odwala onse adanena kuti kupweteka kwa m'chiuno kusanachitike opaleshoni ndipo sanamve ululu (ponena za ululu wosaneneka) atangochitidwa opaleshoni, koma adanena kuti ululu wopweteka kwambiri pambuyo pa opaleshoniyo pa scan II zomwe zinali zosiyana ndi zowawa chifukwa cha osteoarthritis. Zotsatira za umoyo wamaganizo za SF-36 (F(1.925/17.322)?=?0.352, p?=?0.7) ndi BSI global score GSI (F(1.706/27.302)?=?3.189, p?=?0.064 ) sanawonetse kusintha pa nthawi ya nthawi komanso kusagwirizana ndi maganizo. Palibe zowongolera zomwe zidawonetsa kupweteka kwanthawi yayitali kapena kosalekeza ndipo palibe yemwe adawonetsa zizindikiro za kukhumudwa kapena kulumala kwakuthupi / m'maganizo.

 

Opaleshoni isanachitike, odwala ena amawonetsa kukhumudwa pang'ono mpaka pang'ono m'magulu a BDI omwe adatsika kwambiri pa scan III (t(17)?=?2.317, p?=?0.033) ndi IV (t(16)?=?2.132, p? =?0.049). Kuphatikiza apo, ziwerengero za SES (zosasangalatsa zowawa) za odwala onse zidasintha kwambiri kuchokera ku scan I (asanachite opareshoni) kuti ajambule II (t(16)?=?4.676, p<0.001), scan III (t(14)?=? 4.760, p<0.001) ndi scan IV (t (14)?=?4.981, p<0.001, 1 chaka pambuyo pa opaleshoni) pamene kusasangalatsa kwa ululu kunachepa ndi kupweteka kwambiri. Zowawa pa scan 1 ndi 2 zinali zabwino, mlingo womwewo pa tsiku 3 ndi 4 zoipa. SES imangofotokoza ubwino wa ululu womwe umamveka. Choncho zinali zabwino pa tsiku 1 ndi 2 (kutanthauza 19.6 pa tsiku 1 ndi 13.5 pa tsiku 2) ndi zoipa (na) pa tsiku 3 & 4. Komabe, odwala ena sanamvetse njirayi ndipo amagwiritsa ntchito SES monga � khalidwe lapadziko lonse. ya moyo� muyeso. Ichi ndichifukwa chake odwala onse adafunsidwa tsiku lomwelo payekha komanso ndi munthu yemweyo ponena za zowawa.

 

Mu kafukufuku wachidule wa zaumoyo (SF-36), womwe uli ndi mfundo zachidule za Physical Health Score ndi Mental Health Score [29], odwalawo adachita bwino kwambiri pamlingo wa Physical Health kuchokera pa scan I mpaka scan II (t( 17)?=??4.266, p?=?0.001), jambulani III (t(16)?=??8.584, p<0.001) ndi IV (t(12)?=??7.148, p<0.001), koma osati mu Mental Health Score. Zotsatira za NHP zinali zofanana, mu subscale �pain� (reversed polarity) tinawona kusintha kwakukulu kuchokera ku scan I kupita ku scan II (t(14)?=??5.674, p<0.001, scan III (t(12) )?=??7.040, p<0.001 ndi sikani IV (t(10)?=??3.258, p?=?0.009). Tinapezanso kuwonjezeka kwakukulu kwapang'onopang'ono �kusuntha kwathupi� kuchokera pa scan I kupita ku sikani III (t(12)?=??3.974, p?=?0.002) ndi sikani IV (t(10)?=??2.511, p?=?0.031). Panalibe kusintha kwakukulu pakati pa sikani I ndi sikani II ( masabata asanu ndi limodzi pambuyo pa opaleshoni).

 

Structural Data

 

Kusanthula kwamagulu. Tinaphatikizapo zaka monga covariate mu chitsanzo cha mzere wamba ndipo sitinapeze zosokoneza zaka. Poyerekeza ndi maulamuliro okhudzana ndi kugonana ndi msinkhu, odwala omwe ali ndi chiuno chachikulu cha OA (n? =? DLPFC), pole yanthawi yakumanja ndi cerebellum (Table 20 ndi Chithunzi 1). Kupatulapo putamen yoyenera (x?=?1, y?=??31, z?=??14; p<1, t?=?0.001) palibe kuwonjezeka kwakukulu kwa kachulukidwe ka imvi komwe kunapezeka mwa odwala OA poyerekeza kumawongolera athanzi. Poyerekeza odwala panthawi ya scan IV ndi zowongolera zofananira, zotsatira zomwezo zidapezeka monga pakuwunika kwapakatikati pogwiritsa ntchito scan I poyerekeza ndi zowongolera.

 

Chithunzi 1 Mapu a Ma Parametric

Chithunzi 1: Mapu owerengetsera owerengera omwe akuwonetsa kusiyana kwa mapangidwe a imvi kwa odwala omwe ali ndi ululu wopweteka chifukwa cha chiuno chachikulu cha OA poyerekeza ndi zowongolera komanso motalika poyerekeza ndi iwowo pakapita nthawi. Kusintha kwakukulu kwa imvi kumawonetsedwa mumtundu wapamwamba, deta yapakatikati imawonetsedwa muzofiira ndi zazitali zazitali zachikasu. Ndege ya Axial: Kumanzere kwa chithunzi ndi kumanzere kwa ubongo. pamwamba: Madera a kuchepa kwakukulu kwa imvi pakati pa odwala omwe ali ndi ululu wosatha chifukwa cha chiuno chachikulu cha OA ndi maphunziro osakhudzidwa. p<0.001 pansi osakonzedwa: Kuwonjezeka kwa Grey kwa odwala 20 opanda ululu pa nthawi yachitatu ndi yachinayi yojambula pambuyo pa opaleshoni yonse ya m'chiuno, poyerekeza ndi yoyamba (preoperative) ndi yachiwiri (masabata a 6�8 pambuyo pa opaleshoni). p<0.001 Mapulani Osakonzedwa: Kuyerekeza kuyerekezera ndi 90% nthawi yachidaliro, zotsatira zachiwongola dzanja, mayunitsi osagwirizana. x-axis: kusiyanitsa kwa 4 timepoints, y-axis: kuyerekezera kosiyana pa ?3, 50, 2 kwa ACC ndi kuyerekezera kwa 36, ​​39, 3 kwa insula.

 

Table 1 Cross-Sectional Data

 

Kutembenuza deta ya odwala omwe ali ndi chiuno chakumanzere OA (n?=?7) ndi kuwafanizira ndi machitidwe abwino sikunasinthe zotsatira zake kwambiri, koma kuchepa kwa thalamus (x?=?10, y?=??20, z =?3, p<0.001, t?=?3.44) ndi kuwonjezeka kwa cerebellum yoyenera (x?=?25, y?=??37, z?=??50, p<0.001, t? =? 5.12) zomwe sizinafikire kufunikira kwa deta yosasinthika ya odwala poyerekeza ndi zowongolera.

 

Kusanthula kwautali. Pakufufuza kwa nthawi yayitali, kuwonjezeka kwakukulu (p <.001 osakonzedwa) kwa imvi kunazindikirika poyerekezera ndi kujambula koyamba ndi kwachiwiri (kupweteka kwapang'onopang'ono / kupweteka kwapambuyo kwa opaleshoni) ndi scan yachitatu ndi yachinayi (yopanda ululu) mu ACC, insular cortex, cerebellum ndi pars orbitalis mwa odwala omwe ali ndi OA (Table 2 ndi Chithunzi 1). Imvi inachepa pakapita nthawi (p<.001 kusanthula konse kwa ubongo kosakonzedwa) mu sekondale somatosensory cortex, hippocampus, midcingulate cortex, thalamus ndi caudate nucleus kwa odwala OA (Chithunzi 2).

 

Chithunzi 2 Kuwonjezeka kwa Brain Gray Matter

Chithunzi 2: a) Kuwonjezeka kwakukulu kwa imvi ya ubongo pambuyo pochita bwino. Kuwona kwa axial kwa kuchepa kwakukulu kwa imvi kwa odwala omwe ali ndi ululu wosatha chifukwa cha chiuno chachikulu cha OA poyerekeza ndi maphunziro olamulira. p<0.001 yosakonzedwa (kusanthula kwagawo), b) Kutalika kwakutali kwa imvi kwakanthawi kokangana chithunzi i & ICaCAN III> Scan IV) kwa odwala omwe ali ndi OA. P <0.001 Osavomerezeka (Kusanthulika Kwa Tizikulu). Mbali yakumanzere ya chithunzicho ndi mbali yakumanzere ya ubongo.

 

Table 2 Longitudinal Data

 

Kutembenuza deta ya odwala omwe ali ndi chiuno chakumanzere OA (n?=?7) sikunasinthe zotsatira zake kwambiri, koma kuchepa kwa ubongo wa imvi mu Heschl's Gyrus (x?=??41, y?=?? 21, z?=?10, p<0.001, t?=?3.69) ndi Precuneus (x?=?15, y?=??36, z?=?3, p<0.001, t?=?4.60) .

 

Posiyanitsa scanner yoyamba (presurgery) ndi scans 3 + 4 (postsurgery), tinapeza kuwonjezeka kwa imvi ku frontal cortex ndi motor cortex (p <0.001 osakonzedwa). Tikuwona kuti kusiyanitsa kumeneku kumakhala kovutirapo chifukwa tili ndi masikelo ochepa pa chikhalidwe chilichonse (kupweteka motsutsana ndi ululu). Tikatsitsa pakhomo timabwereza zomwe tapeza pogwiritsa ntchito kusiyana kwa 1 + 2 vs. 3 + 4.

 

Poyang'ana madera omwe amawonjezeka nthawi zonse, tapeza kusintha kwa ubongo wa imvi m'madera oyendetsa galimoto (dera la 6) kwa odwala omwe ali ndi coxarthrosis akutsatira m'malo mwa chiuno chonse (scan Idbm.neuro.uni-jena.de/vbm/) titha kubwereza zomwe tapezazi m'kati mwa cingate cortex komanso kumbuyo kwa insulae.

 

Tinawerengera kukula kwa zotsatira ndi kusanthula kwa magawo (odwala motsutsana ndi zowongolera) kunapereka Cohen�sd ya 1.78751 mu voxel yapamwamba ya ACC (x?=??12, y?=?25, z?=?? 16). Tidawerengeranso Cohen�sd pakuwunika kwa nthawi yayitali (kusiyanitsa jambulani 1+2 vs. scan 3+4). Izi zidapangitsa kuti Cohen�sd ya 1.1158 mu ACC (x?=??3, y?=?50, z?=?2). Ponena za insula (x?=??33, y?=?21, z?=?13) komanso zokhudzana ndi kusiyana komweko, Cohen�sd ndi 1.0949. Kuphatikiza apo, tidawerengera tanthauzo la ma voxel osakhala a ziro a mapu a Cohen�sd mkati mwa ROI (yomwe ili ndi gawo lakunja la cingulate gyrus ndi subcallosal cortex, yochokera ku Harvard-Oxford Cortical Structural Atlas): 1.251223.

 

Dr-Jimenez_White-Coat_01.png

Kuzindikira kwa Dr. Alex Jimenez

Odwala opweteka kwambiri amatha kukhala ndi zovuta zosiyanasiyana zaumoyo pakapita nthawi, kupatulapo zizindikiro zawo zofooketsa kale. Mwachitsanzo, anthu ambiri amakumana ndi vuto la kugona chifukwa cha ululu wawo, koma koposa zonse, kupweteka kosalekeza kumatha kubweretsanso zovuta zosiyanasiyana zamaganizidwe, kuphatikiza nkhawa ndi kukhumudwa. Zotsatira zomwe ululu ukhoza kukhala nazo pa ubongo zingawoneke ngati zovuta kwambiri koma umboni wochuluka umasonyeza kuti kusintha kwa ubongo kumeneku sikokhazikika ndipo kungathe kusinthidwa pamene odwala opweteka kwambiri akulandira chithandizo choyenera pazochitika zawo zaumoyo. Malinga ndi nkhaniyi, zovuta za imvi zomwe zimapezeka mu ululu wosatha siziwonetsa kuwonongeka kwa ubongo, koma ndizotsatira zosinthika zomwe zimakhala bwino pamene ululuwo ukuchiritsidwa mokwanira. Mwamwayi, njira zosiyanasiyana zochiritsira zilipo kuti zithandize kuchepetsa zizindikiro za ululu wosatha ndikubwezeretsanso mapangidwe ndi ntchito za ubongo.

 

Kukambirana

 

Kuyang'anira kapangidwe kaubongo wonse pakapita nthawi, timatsimikizira ndikukulitsa deta yathu yoyendetsa yomwe idasindikizidwa posachedwa [17]. Tinapeza kusintha kwa ubongo wa imvi kwa odwala omwe ali ndi chiuno chachikulu cha osteoarthritis mu chikhalidwe chopweteka kwambiri, chomwe chimasintha pang'ono pamene odwalawa sakumva ululu, potsatira opaleshoni ya chiuno cha endoprosthetic. Kuwonjezeka pang'ono kwa imvi pambuyo pa opaleshoni kuli pafupi ndi madera omwe kuchepa kwa imvi kumawonekera pamaso pa opaleshoni. Kutembenuza zidziwitso za odwala omwe ali ndi chiuno chakumanzere OA (ndichifukwa chake kukhazikika kwa mbali ya ululu) kunali ndi zotsatira zochepa chabe pa zotsatira koma kumasonyezanso kuchepa kwa imvi mu Heschl's gyrus ndi Precuneus zomwe sitingathe kuzifotokoza mosavuta, popeza palibe lingaliro lachiyambi lomwe liripo, samalani kwambiri. Komabe, kusiyana komwe kumawonedwa pakati pa odwala ndi kuwongolera kwathanzi pa sikani ndidawonekerabe pakuwunika kwapang'onopang'ono pa scan IV. Kuwonjezeka kwapang'onopang'ono kwa imvi pakapita nthawi ndikosavuta, mwachitsanzo, sikuli kosiyana mokwanira kukhala ndi zotsatira pakuwunika kwa gawo, zomwe zawonetsedwa kale m'maphunziro ofufuza za pulasitiki yodalirika [30], [31]. Timazindikira kuti chifukwa chakuti timawonetsa mbali zina za ubongo-kusintha chifukwa cha ululu wosatha kuti utembenuke sikumapatula kuti mbali zina za kusintha kumeneku sizingatheke.

 

Chochititsa chidwi n'chakuti, tinawona kuti imvi imachepa mu ACC mu odwala opweteka kwambiri opaleshoni isanayambe kupitirira masabata a 6 pambuyo pa opaleshoni (scan II) ndipo imangowonjezera ku scan III ndi IV, mwina chifukwa cha ululu wa pambuyo pa opaleshoni, kapena kuchepa kwa galimoto. ntchito. Izi zikugwirizana ndi chidziwitso cha khalidwe la masewera olimbitsa thupi omwe akuphatikizidwa mu NHP, yomwe pambuyo pa opaleshoni sinasonyeze kusintha kwakukulu pa nthawi ya II koma inawonjezeka kwambiri ku scan III ndi IV. Zindikirani, odwala athu adanena kuti palibe ululu m'chiuno pambuyo pa opaleshoni, koma adamva ululu pambuyo pa opaleshoni mu minofu yozungulira ndi khungu zomwe zinkawoneka mosiyana kwambiri ndi odwala. Komabe, monga odwala adakali ndi ululu wopweteka pa scan II, tinasiyanitsanso jambulani choyamba (pre-opareshoni) ndi ma scans III + IV (opaleshoni yapambuyo), kuwonetsa kuwonjezeka kwa imvi kutsogolo kwa cortex ndi motor cortex. Tikuwona kuti kusiyanitsa kumeneku kumakhala kovutirapo kwambiri chifukwa chosayang'ana pang'ono pa chikhalidwe chilichonse (kupweteka ndi kusapweteka). Pamene tidatsitsa pakhomo timabwereza zomwe tapeza pogwiritsa ntchito kusiyana kwa I + II vs. III + IV.

 

Deta yathu imasonyeza kuti kusintha kwa imvi kwa odwala opweteka kwambiri, omwe nthawi zambiri amapezeka m'madera omwe amagwiritsidwa ntchito mu supraspinal nociceptive processing [4] si chifukwa cha neuronal atrophy kapena kuwonongeka kwa ubongo. Mfundo yakuti kusintha kumeneku komwe kumawoneka muzochitika zowawa zosasintha sikungasinthe kotheratu kungafotokozedwe ndi nthawi yochepa yowonera (chaka chimodzi pambuyo pa opaleshoni poyerekeza ndi zaka zisanu ndi ziwiri za ululu wosatha usanayambe opaleshoni). Kusintha kwaubongo wa Neuroplastic komwe mwina kwachitika zaka zingapo (monga chotsatira cha kulowetsedwa kosalekeza) kumafunikira nthawi yochulukirapo kuti asinthe. Kuthekera kwina chifukwa chake kuwonjezereka kwa imvi kumatha kudziwika muzolemba zautali koma osati pazigawo zodutsamo (ie pakati pa magulu pa nthawi ya IV) ndikuti chiwerengero cha odwala (n?=?20) ndi chochepa kwambiri. Ziyenera kunenedwa kuti kusiyana pakati pa ubongo wa anthu angapo ndi kwakukulu kwambiri komanso kuti deta yotalikirapo ili ndi ubwino wakuti kusiyanako ndi kochepa chifukwa ubongo womwewo umasinthidwa kangapo. Chifukwa chake, zosintha zosawoneka bwino zitha kuwoneka mu data yautali [30], [31], [32]. Zachidziwikire, sitinganene kuti zosinthazi sizingasinthidwe pang'ono ngakhale kuti sizokayikitsa, chifukwa cha zomwe zapezeka pochita masewera olimbitsa thupi komanso kukonzanso bwino [4], [12], [30], [33], [34]. Kuti tiyankhe funsoli, maphunziro amtsogolo ayenera kufufuza odwala mobwerezabwereza kwa nthawi yayitali, mwina zaka.

 

Tikuwona kuti titha kupanga malingaliro ochepa okhudzana ndi kusintha kwaubongo wa morphological pakapita nthawi. Chifukwa chake ndi chakuti pomwe tidapanga kafukufukuyu mu 2007 ndikusanthula mu 2008 ndi 2009, sizinadziwike ngati kusintha kwamapangidwe kungachitike ndipo chifukwa chotheka tidasankha masiku ndi nthawi yojambula monga tafotokozera apa. Wina angatsutse kuti imvi imasintha nthawi, yomwe timafotokozera gulu la odwala, zikhoza kuchitika mu gulu lolamulira komanso (nthawi zotsatira). Komabe, kusintha kulikonse chifukwa cha ukalamba, ngati kuli kotheka, kungayembekezere kuchepa kwa voliyumu. Chifukwa cha lingaliro lathu la priori, lochokera ku maphunziro odziimira a 9 ndi magulu omwe amasonyeza kuchepa kwa imvi kwa odwala opweteka kwambiri [7], [8], [9], [15], [24], [25], [26], [27], [28], tidayang'ana kwambiri pakuwonjezeka kwa madera pakapita nthawi ndipo tikukhulupirira kuti kupeza kwathu sikukhala kophweka kwa nthawi. Zindikirani, sitinganene kuti imvi imachepa pakapita nthawi yomwe tapeza mu gulu lathu la odwala ikhoza kukhala chifukwa cha nthawi, chifukwa sitinayang'ane gulu lathu lolamulira nthawi yomweyo. Chifukwa cha zomwe zapezedwa, maphunziro amtsogolo akuyenera kukhala ndi nthawi yayitali komanso yayifupi, chifukwa chochita masewera olimbitsa thupi motengera kusintha kwaubongo kwa morphometric kumatha kuchitika mwachangu ngati sabata la 1 [32], [33].

 

Kuphatikiza pa kukhudzidwa kwa gawo la nociceptive la ululu pa ubongo wa imvi [17], [34] tinawona kuti kusintha kwa kayendetsedwe ka galimoto mwinamwake kumapangitsanso kusintha kwapangidwe. Tinapeza madera a magalimoto ndi ma premotor (dera la 6) kuti achuluke nthawi zonse (Chithunzi 3). Mwachidziwitso izi zitha kukhala chifukwa chakuyenda bwino kwa magalimoto pakapita nthawi popeza odwalawo analibenso malire pakukhala ndi moyo wabwinobwino. Makamaka ife sitinayang'ane pa ntchito yamagalimoto koma kusintha kwa zowawa, chifukwa chofuna kwathu koyambirira kuti tifufuze ngati kuchepetsedwa kodziwika bwino kwa ubongo wa imvi kwa odwala omwe ali ndi ululu wosachiritsika ndikosinthika. Chifukwa chake, sitinagwiritse ntchito zida zapadera kuti tifufuze ntchito zamagalimoto. Komabe, (ntchito) kukonzanso kotekisi kwa odwala omwe ali ndi ululu wa syndromes amalembedwa bwino [35], [36], [37], [38]. Komanso, motor cortex ndi chandamale chimodzi mu njira zochiritsira za odwala opweteka osachiritsika omwe amagwiritsa ntchito kukondoweza kwa ubongo [39], [40], transcranial mwachindunji stimulation panopa [41], ndi mobwerezabwereza transcranial maginito stimulation [42], [43]. Njira zenizeni za kusinthika koteroko (kuwongolera vs. kuletsa, kapena kungosokoneza maukonde okhudzana ndi ululu) sizinadziwikebe [40]. Kafukufuku waposachedwa adawonetsa kuti chokumana nacho chamoto chimatha kusintha mawonekedwe a ubongo [13]. Synaptogenesis, kukonzanso mawonekedwe amayendedwe ndi angiogenesis mu motor cortex zitha kuchitika ndi zofuna zapadera za ntchito yamagalimoto. Tsao et al. adawonetsa kukonzanso mu motor cortex ya odwala omwe ali ndi ululu wopweteka kwambiri wammbuyo womwe umawoneka ngati ululu wammbuyo [44] ndi Puri et al. adawona kuchepetsedwa kwa kumanzere kwamtundu wa imvi kwa odwala fibromyalgia [45]. Phunziro lathu silinapangidwe kuti lisokoneze zinthu zosiyanasiyana zomwe zingasinthe ubongo mu ululu wosaneneka koma timatanthauzira deta yathu yokhudza kusintha kwa imvi kotero kuti samangowonetsa zotsatira za kulowetsa kosalekeza kosalekeza. Ndipotu, kafukufuku waposachedwapa wa odwala opweteka a neuropathic adanena za zolakwika m'madera a ubongo omwe amakhudza maganizo, odziimira okha, komanso akumva ululu, kutanthauza kuti amagwira ntchito yofunika kwambiri pa chithunzi chachipatala cha ululu wosatha [28].

 

Chithunzi 3 Mapu a Ma Parametric

Chithunzi 3: Mapu owerengera owerengera omwe akuwonetsa kuwonjezeka kwakukulu kwa imvi yaubongo m'malo amagalimoto (dera la 6) mwa odwala omwe ali ndi coxarthrosis asanafanizidwe ndi pambuyo pa THR (kuwunika kwa nthawi yayitali, jambulani I. Kuyerekezera koyerekeza ndi x?=?19, y?=??12, z?=?70.

 

Maphunziro awiri aposachedwapa oyendetsa ndege adayang'ana pa chithandizo cha m'chiuno mwa odwala osteoarthritis, matenda okhawo omwe amatha kupweteka kwambiri omwe amatha kuchiritsidwa ndi chiuno chonse [17], [46] ndipo detayi ili pambali ndi kafukufuku waposachedwapa wa odwala opweteka kwambiri [ 47]. Maphunzirowa akuyenera kuwonedwa poyang'ana maphunziro angapo a nthawi yayitali omwe amafufuza mapulasitiki omwe amadalira chidziwitso cha neuronal mwa anthu pamlingo wapangidwe [30], [31] ndi kafukufuku waposachedwapa wokhudza kusintha kwa ubongo kwa odzipereka athanzi omwe akukumana ndi kukondoweza kowawa mobwerezabwereza [34] . Uthenga wofunikira wa maphunziro onsewa ndi wakuti kusiyana kwakukulu mu ubongo wa ubongo pakati pa odwala opweteka ndi maulamuliro akhoza kutha pamene ululu wachiritsidwa. Komabe, ziyenera kuganiziridwa kuti sizikudziwikiratu ngati kusintha kwa odwala opweteka kwambiri kumangochitika chifukwa cha kulowetsa kwa nociceptive kapena chifukwa cha zotsatira za ululu kapena zonse ziwiri. Ndizotheka kuti kusintha kwamakhalidwe, monga kulandidwa kapena kupititsa patsogolo kucheza ndi anthu, kulimba mtima, kuphunzitsa thupi ndi kusintha kwa moyo ndikokwanira kupanga ubongo [6], [12], [28], [48]. Makamaka kupsinjika maganizo monga co-morbidity kapena zotsatira za ululu ndizofunikira kwambiri kuti afotokoze kusiyana pakati pa odwala ndi maulamuliro. Kagulu kakang'ono ka odwala athu omwe ali ndi OA adawonetsa kutsika kwapang'onopang'ono mpaka kocheperako komwe kunasintha pakapita nthawi. Sitinapeze kusintha kwapangidwe kwa covary kwambiri ndi BDI-score koma funso limakhala ndi kusintha kwa makhalidwe ena angati chifukwa cha kusakhalapo kwa ululu ndi kusintha kwa magalimoto kungapangitse zotsatirazo komanso momwe amachitira. Kusintha kwa khalidwe kumeneku kungapangitse kuchepa kwa imvi mu ululu wosatha komanso kuwonjezeka kwa imvi pamene ululu wapita.

 

Chinthu chinanso chofunika chomwe chingasokoneze kutanthauzira kwathu kwa zotsatira zake ndi chakuti pafupifupi odwala onse omwe ali ndi ululu wopweteka amamwa mankhwala oletsa ululu, omwe amasiya pamene sanamve ululu. Wina angatsutse kuti NSAIDs monga diclofenac kapena ibuprofen zimakhala ndi zotsatira zina pa mitsempha ya mitsempha ndipo zomwezo zimakhala zowona kwa opioids, antiepileptics ndi antidepressants, mankhwala omwe amagwiritsidwa ntchito mobwerezabwereza mu ululu wosatha. Zotsatira za opha ululu ndi mankhwala ena pazopeza za morphometric zitha kukhala zofunika (48). Palibe kafukufuku mpaka pano wasonyeza zotsatira za mankhwala opweteka pa ubongo wa ubongo koma mapepala angapo adapeza kuti kusintha kwa ubongo kwa odwala opweteka kwambiri sikungofotokozedwa kokha ndi kusagwira ntchito kwa ululu [15], kapena ndi mankhwala opweteka [7], [9], [49]. Komabe, maphunziro apadera akusowa. Kufufuza kwina kuyenera kuyang'ana kusintha kwazomwe zimadalira pazidziwitso za cortical plasticity, zomwe zingakhale ndi zotsatira zachipatala pa chithandizo cha ululu wosatha.

 

Tinapezanso kuchepa kwa imvi pakuwunika kwautali, mwina chifukwa cha kukonzanso njira zomwe zimayenderana ndi kusintha kwa magwiridwe antchito agalimoto ndi malingaliro opweteka. Palibe chidziwitso chochepa chokhudza kusintha kwa nthawi yayitali mu ubongo wa imvi muzochitika zowawa, chifukwa chake tilibe lingaliro la kuchepa kwa imvi m'maderawa pambuyo pa opaleshoni. Teutsch et al. [25] adapeza kuwonjezeka kwa ubongo wa imvi mu somatosensory ndi midcingulate cortex mwa odzipereka athanzi omwe adakumana ndi zowawa zowawa mu protocol ya tsiku ndi tsiku kwa masiku asanu ndi atatu otsatizana. Kupeza kwa imvi kumawonjezeka potsatira kuyesa koyesa kwa nociceptive kunadutsana ndi anatomically mpaka pang'ono ndi kuchepa kwa ubongo wa imvi mu phunziro ili kwa odwala omwe anachiritsidwa ndi ululu wosatha. Izi zikutanthawuza kuti kulowetsa kwa nociceptive mwa odzipereka athanzi kumapangitsa kuti azichita masewera olimbitsa thupi modalira, monga momwe amachitira odwala omwe ali ndi ululu wosaneneka, komanso kuti kusintha kumeneku kumasintha anthu odzipereka athanzi pamene kulowetsedwa kwa nociceptive kumasiya. Chifukwa chake, kuchepa kwa imvi m'maderawa omwe amawonedwa mwa odwala omwe ali ndi OA akhoza kutanthauziridwa kuti atsatire ndondomeko yofanana: zolimbitsa thupi zimasintha kusintha kwa ubongo [50]. Monga njira yosasokoneza, MR Morphometry ndiye chida choyenera chofuna kupeza magawo a morphological a matenda, kukulitsa kumvetsetsa kwathu ubale womwe ulipo pakati pa kapangidwe kaubongo ndi magwiridwe antchito, komanso kuyang'anira chithandizo chamankhwala. Chimodzi mwazovuta zazikulu m'tsogolomu ndikusintha chida champhamvu ichi cha ma multicentre ndi machiritso ochizira opweteka osatha.

 

Zolepheretsa Phunziroli

 

Ngakhale kuti phunziroli ndilowonjezereka kwa phunziro lathu lapitalo kukulitsa deta yotsatila kwa miyezi ya 12 ndikufufuza odwala ambiri, mfundo yathu yopeza kuti kusintha kwa ubongo wa morphometric mu ululu wosatha ndi kusinthika kumakhala kosaoneka bwino. Kukula kwake kumakhala kochepa (onani pamwambapa) ndipo zotsatira zake zimayendetsedwa ndi kuchepetsedwa kwina kwa gawo la ubongo wa imvi pa nthawi ya scan 2. Tikamapatula deta kuchokera ku scan 2 (mwachindunji pambuyo pa opaleshoni) ndizofunikira kwambiri. kuwonjezeka kwa imvi ya ubongo ya motor cortex ndi front cortex imapulumuka pamtunda wa p <0.001 osakonzedwa (Table 3).

 

Table 3 Longitudinal Data

 

Kutsiliza

 

Sizingatheke kusiyanitsa kuti kusintha kwapangidwe komwe tinawona chifukwa cha kusintha kwa nociceptive input, kusintha kwa galimoto kapena kugwiritsa ntchito mankhwala kapena kusintha kwabwino monga momwemo. Kuyika gulu kusiyanitsa koyamba ndi komaliza kunawonetsa kusiyana kocheperako kuposa momwe amayembekezera. Mwachiwonekere, kusintha kwaubongo chifukwa cha kupweteka kosalekeza ndi zotsatira zonse kukukula pakapita nthawi yayitali ndipo kungafunikenso nthawi kuti abwerere. Komabe, zotsatirazi zikuwonetsa njira zakukonzanso, kuwonetsa mwamphamvu kuti kulowetsedwa kwanthawi yayitali kwa nociceptive ndi kuwonongeka kwa magalimoto mwa odwalawa kumabweretsa kusintha kosinthika m'magawo a cortical ndipo chifukwa chake kusintha kwaubongo komwe kumasinthidwa.

 

Kuvomereza

 

Tikuthokoza anthu onse odzipereka chifukwa chochita nawo kafukufukuyu komanso gulu la Physics and Methods ku NeuroImage Nord ku Hamburg. Kafukufukuyu anavomerezedwa ndi komiti ya Ethics m'deralo ndipo chilolezo cholembedwa chinapezedwa kuchokera kwa onse omwe adachita nawo kafukufuku asanayesedwe.

 

Ndondomeko ya Zothandizira

 

Ntchitoyi inathandizidwa ndi ndalama zochokera ku DFG (German Research Foundation) (MA 1862/2-3) ndi BMBF (Federal Ministry of Education and Research) (371 57 01 ndi NeuroImage Nord). Othandizira ndalama analibe gawo pakupanga maphunziro, kusonkhanitsa deta ndi kusanthula, chisankho chosindikiza, kapena kukonzekera zolembazo.

 

Endocannabinoid System | El Paso, TX Chiropractor

 

Dongosolo la Endocannabinoid: Dongosolo Lofunikira lomwe simunamvepo

 

Ngati simunamvepo za endocannabinoid system, kapena ECS, palibe chifukwa chochitira manyazi. Kalelo m'ma 1960, ofufuza omwe adachita chidwi ndi bioactivity ya Cannabis pamapeto pake adapatula mankhwala ake ambiri. Zinatenga zaka zina za 30, komabe, ofufuza omwe amaphunzira zinyama kuti apeze cholandirira mankhwala a ECS mu ubongo wa makoswe, kutulukira komwe kunatsegula dziko lonse lofufuza za ECS zolandilira kukhalapo komanso cholinga chawo cha thupi.

 

Tsopano tikudziwa kuti nyama zambiri, kuchokera ku nsomba kupita ku mbalame kupita ku zoyamwitsa, zimakhala ndi endocannabinoid, ndipo tikudziwa kuti anthu samangopanga ma cannabinoids awo omwe amalumikizana ndi dongosolo ili, komanso amapanga zinthu zina zomwe zimagwirizana ndi ECS, zomwe zimawonedwa muzomera ndi zakudya zosiyanasiyana, kupitilira mitundu ya Cannabis.

 

Monga dongosolo la thupi la munthu, ECS si nsanja yokhazikika ngati dongosolo lamanjenje kapena mtima. M'malo mwake, ECS ndi gulu la zolandilira zomwe zimagawidwa kwambiri mthupi lonse zomwe zimayendetsedwa kudzera mumagulu angapo omwe timawadziwa kuti endocannabinoids, kapena endogenous cannabinoids. Ma receptor otsimikizika onsewa amangotchedwa CB1 ndi CB2, ngakhale pali ena omwe adafunsidwa. PPAR ndi TRP njira zimayimiranso ntchito zina. Momwemonso, mupeza ma endocannabinoids olembedwa bwino awiri okha: anadamide ndi 2-arachidonoyl glycerol, kapena 2-AG.

 

Kuphatikiza apo, chofunikira pa dongosolo la endocannabinoid ndi ma enzymes omwe amapanga ndikuphwanya ma endocannabinoids. Endocannabinoids amakhulupirira kuti amapangidwa mumaziko omwe amafunikira. Ma enzymes oyambilira omwe akukhudzidwa ndi diacylglycerol lipase ndi N-acyl-phosphatidylethanolamine-phospholipase D, omwe amaphatikiza 2-AG ndi anandamide. Ma enzymes awiri omwe amawononga kwambiri ndi mafuta acid amide hydrolase, kapena FAAH, omwe amaphwanya anandamide, ndi monoacylglycerol lipase, kapena MAGL, yomwe imaphwanya 2-AG. Kuwongolera kwa ma enzyme awiriwa kumatha kuwonjezera kapena kuchepetsa kusinthika kwa ECS.

 

Kodi Ntchito ya ECS ndi yotani?

 

ECS ndiye dongosolo lalikulu la homeostatic regulatory system. Zitha kuwonedwa mosavuta ngati dongosolo lamkati la adaptogenic la thupi, nthawi zonse limagwira ntchito kuti likhale logwirizana ndi ntchito zosiyanasiyana. Endocannabinoids amagwira ntchito ngati neuromodulators ndipo, motero, amayang'anira machitidwe osiyanasiyana amthupi, kuchokera ku chonde mpaka kupweteka. Zina mwa ntchito zodziwika bwino za ECS ndi izi:

 

mantha System

 

Kuchokera pakati pa mitsempha yapakati, kapena CNS, kukondoweza kwakukulu kwa ma CB1 receptors kudzalepheretsa kutulutsidwa kwa glutamate ndi GABA. Mu CNS, ECS imathandizira kupanga kukumbukira ndi kuphunzira, imalimbikitsa neurogenesis mu hippocampus, imayang'aniranso chisangalalo cha neuronal. ECS imakhalanso ndi gawo la momwe ubongo udzachitira kuvulala ndi kutupa. Kuchokera pamtsempha wa msana, ECS imasintha zizindikiro zowawa ndikuwonjezera analgesia yachilengedwe. Mu dongosolo lamanjenje lamkati, momwe ma CB2 receptors amawongolera, ECS imagwira ntchito makamaka mu dongosolo lamanjenje lachifundo kuwongolera ntchito zamatumbo, mkodzo, ndi zoberekera.

 

Kupsinjika ndi Maganizo

 

ECS imakhala ndi zotsatira zambiri pa kupsinjika maganizo ndi kuwongolera maganizo, monga kuyambitsa kuyankha kwa thupi ku kupsinjika maganizo ndi kusinthasintha kwa nthawi ndi kutengeka kwa nthawi yaitali, monga mantha ndi nkhawa. Dongosolo logwira ntchito lathanzi la endocannabinoid ndilofunika kwambiri momwe anthu amasinthira pakati pamlingo wokhutiritsa wa kudzutsidwa poyerekeza ndi mulingo womwe ndi wochulukira komanso wosasangalatsa. ECS imathandizanso pakupanga kukumbukira komanso makamaka makamaka momwe ubongo umasinthira kukumbukira kupsinjika kapena kuvulala. Chifukwa ECS imathandizira kutulutsidwa kwa dopamine, noradrenaline, serotonin, ndi cortisol, imathanso kukhudza kwambiri kukhudzidwa kwamalingaliro ndi machitidwe.

 

Chidutswa

 

Tract thirakiti ladzaza ndi ma CB1 ndi CB2 zolandila zomwe zimayang'anira mbali zingapo zofunika kwambiri za matenda a GI. Amaganiza kuti ECS ikhoza kukhala "cholumikizira" pofotokoza za m'matumbo omwe amalumikizana ndi mphamvu zomwe zimagwira ntchito yofunika kwambiri muumoyo wa m'mimba. ECS ndi wowongolera mphamvu ya m'matumbo, mwina poletsa chitetezo chamthupi kuti muwononge flora yabwino kwambiri, komanso kudzera pakusintha kwa ma cytokine. Anthu a EC amasinthanso yankho lachilengedwe mu thirakiti lazing'ono, lomwe lili ndi tanthauzo lofunikira kuti mupeze zovuta zosiyanasiyana. Gastric and general GI motility imawonekanso kuti imayendetsedwa pang'ono ndi ECS.

 

Kulakalaka ndi Metabolism

 

ECS, makamaka ma CB1 receptors, amathandizira pakufuna kudya, kagayidwe kazakudya, komanso kuwongolera mafuta amthupi. Kukondoweza kwa CB1 zolandilira kumadzutsa khalidwe lofunafuna chakudya, kumapangitsa kuzindikira kununkhira, kumayang'aniranso mphamvu. Zinyama zonse ndi anthu omwe ali olemera kwambiri amakhala ndi vuto la ECS lomwe lingapangitse kuti dongosololi likhale lopanda mphamvu, zomwe zimathandiza kuti pakhale kudya kwambiri komanso kuchepetsa kugwiritsa ntchito mphamvu. Miyezo yozungulira ya anandamide ndi 2-AG yasonyezedwa kuti ikukwera mu kunenepa kwambiri, zomwe zingakhale mbali imodzi chifukwa cha kuchepa kwa enzyme yowononga FAAH.

 

Thanzi la Chitetezo cha Mthupi ndi Mayankho Otupa

 

Maselo ndi ziwalo za chitetezo cha mthupi zimakhala ndi endocannabinoid receptors. Cannabinoid receptors amasonyezedwa mu thymus gland, ndulu, tonsils, ndi mafupa a mafupa, komanso pa T- ndi B-lymphocytes, macrophages, mast cell, neutrophils, ndi maselo akupha achilengedwe. ECS imawonedwa ngati dalaivala wamkulu wa chitetezo chamthupi komanso homeostasis. Ngakhale kuti si ntchito zonse za ECS kuchokera ku chitetezo cha mthupi zomwe zimamveka, ECS ikuwoneka kuti imayang'anira kupanga cytokine komanso kukhala ndi gawo loletsa kuchitapo kanthu kwa chitetezo cha mthupi. Kutupa ndi gawo lachilengedwe la chitetezo chamthupi, ndipo limagwira ntchito bwino kwambiri pakunyoza thupi, kuphatikizapo kuvulala ndi matenda; Komabe, ngati sichiyang'aniridwa bwino, imatha kudwala ndikupangitsa kuti pakhale zovuta zambiri zaumoyo, monga kupweteka kosalekeza. Poyang'anira chitetezo cha mthupi, ECS imathandiza kuti thupi likhale lopweteka kwambiri.

 

Madera ena azaumoyo oyendetsedwa ndi ECS:

 

  • Thupi labwino
  • Chiberekero
  • Thanzi la khungu
  • Arterial ndi kupuma thanzi
  • Kugona ndi circadian rhythm

 

Momwe mungathandizire bwino ECS yathanzi ndi funso lomwe ofufuza ambiri akuyesera kuyankha. Khalani tcheru kuti mudziwe zambiri pamutu womwe ukutulukawu.

 

Pomaliza,�Kupweteka kosatha kumayenderana ndi kusintha kwaubongo, kuphatikiza kuchepa kwa imvi. Komabe, nkhani yomwe ili pamwambapa ikuwonetsa kuti kupweteka kosalekeza kumatha kusintha momwe ubongo umagwirira ntchito. Ngakhale kupweteka kosalekeza kungayambitse izi, pakati pa nkhani zina zaumoyo, chithandizo choyenera cha zizindikiro zomwe zimayambira wodwalayo zimatha kusintha kusintha kwa ubongo ndikuwongolera imvi. Kuphatikiza apo, kafukufuku wochulukirachulukira adatulukira kumbuyo kwa kufunikira kwa dongosolo la endocannabinoid ndipo limagwira ntchito pakuwongolera komanso kuthana ndi ululu wosatha ndi zovuta zina zaumoyo. Zambiri zomwe zatchulidwa kuchokera ku National Center for Biotechnology Information (NCBI).�Zomwe tikudziwa zimangokhudza chiropractic komanso kuvulala kwa msana ndi mikhalidwe. Kuti mukambirane nkhaniyi, chonde muzimasuka kufunsa Dr. Jimenez kapena mutitumizireni pa�915-850-0900 .

 

Wosankhidwa ndi Dr. Alex Jimenez

Green-Call-Now-Button-24H-150x150-2-3.png

Mitu Yowonjezera: Ululu Wobwerera

Ululu wammbuyo ndi chimodzi mwa zifukwa zofala kwambiri za olumala ndi masiku osowa kuntchito padziko lonse lapansi. Kunena zoona, kupweteka kwa msana kwanenedwa kuti ndi chifukwa chachiwiri chofala kwambiri choyendera ofesi ya dokotala, choposa kokha ndi matenda apamwamba opuma. Pafupifupi 80 peresenti ya anthu adzakhala ndi mtundu wina wa ululu wammbuyo kamodzi pa moyo wawo wonse. Msana ndi dongosolo lovuta lopangidwa ndi mafupa, mafupa, mitsempha ndi minofu, pakati pa ziwalo zina zofewa. Chifukwa cha izi, kuvulala ndi / kapena zovuta, monga herniated discs, pamapeto pake zimatha kuyambitsa zizindikiro za ululu wammbuyo. Kuvulala kwamasewera kapena ngozi zapamsewu nthawi zambiri zimakhala zomwe zimayambitsa kupweteka kwa msana, komabe, nthawi zina kuyenda kosavuta kumakhala ndi zotsatira zowawa. Mwamwayi, njira zina zochiritsira, monga chisamaliro cha chiropractic, zingathandize kuchepetsa ululu wammbuyo pogwiritsa ntchito kusintha kwa msana ndi kusintha kwamanja, potsirizira pake kumathandiza kuchepetsa ululu.

 

 

 

chithunzi cha blog cha cartoon paperboy nkhani zazikulu

 

MUTU WOFUNIKA KWAMBIRI: Kuwongolera Ululu Wochepa

 

ZINTHU ZINA: ZOWONJEZERA: Kupweteka Kwambiri & Chithandizo

 

Palibe kanthu
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Tsekani Accordion
Biochemistry Of Pain

Biochemistry Of Pain

Biochemistry ya Ululu:�Mapain syndrome onse amakhala ndi mbiri yotupa. Mbiri yotupa imatha kusiyana pakati pa munthu ndi munthu komanso imatha kusiyanasiyana mwa munthu m'modzi nthawi zosiyanasiyana. Chithandizo cha ma syndromes opweteka ndikumvetsetsa mbiri yotupa iyi. Ma syndromes opweteka amathandizidwa ndi mankhwala, opaleshoni kapena onse awiri. Cholinga chake ndikuletsa / kupondereza kupanga oyimira pakati otupa. Ndipo zotsatira zopambana ndi zomwe zimabweretsa kutupa kochepa komanso zowawa zochepa.

Biochemistry Of Pain

Zolinga:

  • Osewera ofunikira ndi ndani
  • Kodi ma biochemical mechanisms ndi chiyani?
  • Zotsatira zake ndi zotani?

Ndemanga ya Kutupa:

osewera chinsinsi

biochemistry ya ululu el paso tx.

biochemistry ya ululu el paso tx.

biochemistry ya ululu el paso tx.

biochemistry ya ululu el paso tx.N'chifukwa Chiyani Mapewa Anga Amapweteka? Ndemanga Ya Neuroanatomical & Biochemical Basis Of Shoulder Pain

ZOKHUDZA

Ngati wodwala afunsa kuti, "N'chifukwa chiyani phewa langa likupweteka? � kukambiranako kumasintha mofulumira ku chiphunzitso cha sayansi komanso nthawi zina zopanda umboni. Kawirikawiri, dokotala amadziwa malire a maziko a sayansi a kufotokozera kwawo, kusonyeza kusakwanira kwa kumvetsetsa kwathu kwa chikhalidwe cha ululu wa mapewa. Ndemangayi imatenga njira yokhazikika yothandizira kuyankha mafunso ofunikira okhudzana ndi kupweteka kwa mapewa, ndi cholinga chopereka chidziwitso pa kafukufuku wamtsogolo ndi njira zatsopano zothandizira kupweteka kwa mapewa. Tidzafufuza ntchito za (1) zolandilira zotumphukira, (2) zowawa zotumphukira kapena �nociception�, (3) msana, (4) ubongo, (5) malo olandirira pamapewa ndi (6) ) Neural anatomy ya phewa. Timaganiziranso momwe zinthuzi zingathandizire kuti pakhale kusiyana pakati pa zochitika zachipatala, matenda ndi chithandizo cha kupweteka kwa mapewa. Mwanjira imeneyi timafuna kufotokozera mwachidule za zigawo za chigawo cha zotumphukira zowawa zotumphukira ndi njira zopangira zowawa zapakati pamapewa omwe amalumikizana kuti apange kupweteka kwachipatala.

MAU OYAMBA: MBIRI YACHIdule kwambiri YA SAYANSI YOPHUNZITSIRA ZOFUNIKA KWA MATONGO.

Chikhalidwe cha ululu, kawirikawiri, chakhala chotsutsana kwambiri m'zaka zana zapitazi. M'zaka za m'ma 17 Descartes� theory1 inanena kuti kukula kwa ululu kunali kogwirizana mwachindunji ndi kuchuluka kwa kuvulala kwa minofu yogwirizana ndi ululu umenewo unakonzedwa mu njira imodzi yosiyana. Malingaliro ambiri akale adadalira filosofi yotchedwa "dualist" Descartian filosofi, powona ululu monga chotsatira cha kukondoweza kwa "chapadera" cholandirira ululu mu ubongo. M'zaka za m'ma 20 nkhondo yasayansi pakati pa ziphunzitso ziwiri zotsutsana idachitika, zomwe ndi chiphunzitso chapadera ndi chiphunzitso cha pateni. The Descartian �specificity theory� inawona kupweteka ngati njira yosiyana ya kulowetsa kwa zomverera ndi zida zake, pamene �chiphunzitso chachitsanzo� ankaona kuti ululu umabwera chifukwa chokondoweza kwambiri kwa zolandilira zomwe sizinali zenizeni.2 Mu 1965, Wall ndi Melzack's 3 chiphunzitso cha chipata cha ululu chinapereka umboni wa chitsanzo chomwe malingaliro opweteka anasinthidwa ndi malingaliro onse okhudzidwa ndi dongosolo lapakati la mitsempha. Kupita patsogolo kwina kwakukulu mu chiphunzitso cha ululu panthawi yomweyi kunawona kupezeka kwa njira yeniyeni ya machitidwe a opioid.

Ndiye izi zikugwirizana bwanji ndi kupweteka kwa phewa?�Kupweteka kwa mapewa ndi vuto lodziwika bwino lachipatala, komanso kumvetsetsa kwamphamvu kwa momwe ululu umapangidwira ndi thupi ndikofunikira kuti muzindikire ndikuchiza ululu wa wodwala. Kupita patsogolo kwa chidziwitso chathu cha kupweteka kwapweteka kumalonjeza kufotokoza kusagwirizana pakati pa matenda ndi malingaliro a ululu, kungatithandizenso kufotokoza chifukwa chake odwala ena amalephera kuyankha mankhwala ena.

ZINTHU ZOTHANDIZA ZOTHANDIZA ZA UWAZI

Peripheral sensory receptors: mechanoreceptor ndi �nociceptor�

Pali mitundu yambiri ya zotumphukira sensory zolandilira zomwe zimapezeka mu musculoskeletal system. 5 Akhoza kugawidwa malinga ndi ntchito yawo (monga mechanoreceptors, thermoreceptors kapena nociceptors) kapena morphology (malekezero a mitsempha yaulere kapena mitundu yosiyanasiyana ya ma receptor encapsulated) . kukhalapo kwa zizindikiro za mankhwala. Pali kuphatikizika kwakukulu pakati pamagulu osiyanasiyana ogwira ntchito a ma receptor, mwachitsanzo

Peripheral Pain Processing: �Nociception�

Kuvulala kwa minofu kumaphatikizapo oyimira osiyanasiyana otupa omwe amatulutsidwa ndi maselo owonongeka kuphatikizapo bradykinin, histamine, 5-hydroxytryptamine, ATP, nitric oxide ndi ma ions ena (K + ndi H +). Kutsegula kwa njira ya arachidonic acid kumabweretsa kupanga prostaglandins, thromboxanes ndi leukotrienes. Ma Cytokines, kuphatikizapo interleukins ndi tumor necrosis factor ?, ndi neurotrophins, monga mitsempha ya kukula kwa mitsempha (NGF), amatulutsidwanso ndipo amakhudzidwa kwambiri ndikuthandizira kutupa.15 Zinthu zina monga excitatory amino acid (glutamate) ndi opioids ( endothelin-1) adakhudzidwanso ndi kuyankha kotupa kwambiri.16 17 Ena mwa othandizirawa amatha kuyambitsa mwachindunji ma nociceptors, pamene ena amabweretsa kulembedwa kwa maselo ena omwe amamasula othandizira ena. a nociceptive neurons ku zomwe amalowetsamo komanso / kapena kulembera mayankho kuzinthu zomwe zimakhudzidwa ndizomwe zimatchedwa "peripheral sensitization" .

biochemistry ya ululu el paso tx.NGF ndi transient receptor angathe cation channel subfamily V membala wa 1 (TRPV1) receptor ali ndi chiyanjano cha symbiotic pankhani ya kutupa ndi kulimbikitsana kwa nociceptor. Ma cytokines opangidwa mu minofu yowotcha amachititsa kuti NGF ichuluke.19 NGF imathandizira kutulutsidwa kwa histamine ndi serotonin (5-HT3) ndi maselo a mast, komanso imalimbikitsa ma nociceptors, mwina kusintha zinthu za A? ulusi kotero kuti gawo lalikulu limakhala losazindikira. Cholandira cha TRPV1 chilipo m'magulu ochepa a ma fiber oyambira ndipo amayendetsedwa ndi capsaicin, kutentha ndi ma protoni. Cholandilira cha TRPV1 chimapangidwa mu cell body ya afferent fiber, ndipo imatumizidwa kumadera onse apakati komanso apakati, komwe kumathandizira kukhudzidwa kwa ma nociceptive afferents. Kutupa kumabweretsa NGF kupanga zozungulira zomwe zimamangiriza ku tyrosine kinase receptor mtundu wa 1 receptor pa nociceptor terminals, NGF imatengedwa kupita ku selo cell komwe imatsogolera ku malamulo a TRPV1 kulembera ndipo chifukwa chake kuwonjezeka kwa nociceptor sensitivity.19 20 NGF ndi oyimira ena otupa amathandizanso TRPV1 kudzera m'njira zosiyanasiyana za amithenga achiwiri. Ma receptors ena ambiri kuphatikiza cholinergic receptors, ?-aminobutyric acid (GABA) receptors ndi somatostatin receptors amaganiziridwanso kuti akukhudzidwa ndi zotumphukira za nociceptor sensitivity.

Chiwerengero chachikulu cha oyimira pakati otupa chakhala chikukhudzidwa makamaka ndi ululu wa mapewa ndi matenda a rotator cuff.21�25 Ngakhale kuti oyimira pakati pamankhwala ena amayendetsa mwachindunji ma nociceptors, ambiri amayambitsa kusintha kwa neuron yodziwikiratu m'malo moiyambitsa mwachindunji. Zosinthazi zitha kukhala zotengera kumasulira koyambirira kapena kuchedwa kutengera mawu. Zitsanzo zakale ndikusintha kwa cholandilira cha TRPV1 kapena njira za ion za voltage-gated chifukwa cha phosphorylation ya mapuloteni omangidwa ndi membrane. Zitsanzo zotsirizirazi zikuphatikizapo NGF-induced kuwonjezeka kwa TRV1 kupanga njira ndi calcium-induced activation of intracellular transcription factor.

Ma Molecular Mechanism of Nociception

Kumva kupweteka kumatichenjeza za kuvulala kwenikweni kapena kumene kukubwera ndipo kumayambitsa mayankho oyenera otetezera. Tsoka ilo, ululu nthawi zambiri umaposa phindu lake ngati chenjezo ndipo m'malo mwake umakhala wokhazikika komanso wofowoka. Kusintha kumeneku kupita ku gawo losatha kumaphatikizapo kusintha kwa msana ndi ubongo, koma palinso kusintha kodabwitsa kumene mauthenga opweteka amayambika � pa mlingo wa neuron yaikulu ya sensory. Kuyesera kudziwa momwe ma neuroniwa amazindikirira zopangitsa zopweteka zamtundu wa kutentha, makina kapena mankhwala awonetsa njira zatsopano zowonetsera ndipo zatibweretsa ife pafupi kuti timvetsetse zochitika za maselo zomwe zimathandizira kusintha kuchokera ku ululu wopweteka mpaka kupweteka kosalekeza.

biochemistry ya ululu el paso tx.The Neurochemistry Of Nociceptors

Glutamate ndiye neurotransmitter yochititsa chidwi kwambiri m'ma nociceptors onse. Maphunziro a histochemical a DRG achikulire, komabe, amawulula magulu awiri otakata a C fiber osatulutsidwa.

Ma Transducers Opangira Ma Chemical Kuti Apangitse Kupweteka Kwambiri

Monga tafotokozera pamwambapa, kuvulala kumapangitsa kuti ululu wathu ukhale wopweteka powonjezera mphamvu ya nociceptors kuzinthu zonse zotentha komanso zamakina. Chodabwitsa ichi chimapangitsa, mwa zina, kupanga ndi kumasulidwa kwa oyimira pakati pa mankhwala kuchokera kumalo oyambirira a sensory komanso kuchokera ku maselo omwe si a neural (mwachitsanzo, fibroblasts, mast cell, neutrophils ndi mapulateleti) mu chilengedwe36 (mkuyu 3). Zigawo zina za supu yotupa (mwachitsanzo, ma protoni, ATP, serotonin kapena lipids) zingasinthe chisangalalo cha neuronal mwachindunji mwa kuyanjana ndi njira za ion pamtunda wa nociceptor, pamene zina (mwachitsanzo, bradykinin ndi NGF) zimamangiriza ku zolandilira za metabotropic ndi kuyanjanitsa zotsatira zawo kudzera mu ma cascades a messenger11. Kupita patsogolo kwakukulu kwachitika pakumvetsetsa maziko a biochemistry a njira zosinthira ngati izi.

Ma Protoni a Extracellular & Tissue Acidosis

Minofu acidosis ya m'deralo ndi chizindikiro chodziwikiratu kuyankha kuvulala, ndipo kuchuluka kwa ululu kapena kusapeza bwino kumayenderana ndi kukula kwa acidification37. Kugwiritsa ntchito asidi (pH 5) pakhungu kumatulutsa kutulutsa kosalekeza mu gawo limodzi mwa magawo atatu kapena kuposerapo a polymodal nociceptors omwe amasunga gawo lolandila 20.

biochemistry ya ululu el paso tx.Ma Cellular & Molecular Mechanism of Pain

Kudalirika

Dongosolo la manjenje limazindikira ndikutanthauzira mitundu yambiri yamafuta ndi makina amakasitomala komanso zowononga zachilengedwe komanso zachilengedwe. Zikafika povuta kwambiri, zochititsa chidwizi zimatulutsa ululu wowawa kwambiri, komanso pakuvulala kosalekeza, mbali zonse zam'mbali ndi zapakati zamanjenje zam'njira yopatsirana zowawa zimawonetsa pulasitiki, kukulitsa zizindikiro zowawa ndikutulutsa hypersensitivity. Pamene pulasitiki imathandizira zodzitetezera, zingakhale zopindulitsa, koma pamene kusintha kukupitirira, vuto lopweteka kwambiri likhoza kuchitika. Maphunziro a chibadwa, electrophysiological, ndi pharmacological akufotokoza njira za maselo zomwe zimayambitsa kuzindikira, kulembera, ndi kusinthasintha kwa zinthu zoopsa zomwe zimabweretsa ululu.

Mau Oyamba: Kupweteka Kwambiri Koposa Kusalekeza

biochemistry ya ululu el paso tx.

biochemistry ya ululu el paso tx.Chithunzi 5. Kulimbikitsa Msana (Chapakati) Kulimbikitsa

  1. Glutamate/NMDA receptor-mediated sensitization.�Kutsatira kukondoweza kwambiri kapena kuvulala kosalekeza, kutsegulidwa kwa C ndi A? nociceptors amatulutsa mitundu yosiyanasiyana ya ma neurotransmitters kuphatikizapo dlutamate, mankhwala P, calcitonin-gene peptide yokhudzana ndi jini (CGRP), ndi ATP, pamtundu wa neurons mu lamina I wa nyanga yapamwamba (yofiira). Zotsatira zake, nthawi zambiri amakhala chete a NMDA glutamate receptors omwe amakhala mu postsynaptic neuron amatha kuwonetsa, kuwonjezera calcium m'kati mwa cell, ndikuyambitsa njira zambiri zolumikizirana ndi calcium ndi amithenga achiwiri kuphatikiza mitogen-activated protein kinase (MAPK), protein kinase C (PKC) , protein kinase A (PKA) ndi Src. Kuchulukira kwa zochitika izi kukulitsa chisangalalo cha ma neuron otulutsa ndikuwongolera kutumiza kwa mauthenga opweteka ku ubongo.
  2. Kuletsa.�Munthawi yanthawi zonse, ma inhibitory interneurons (buluu) amamasula GABA ndi/kapena glycine (Gly) mosalekeza kuti achepetse chisangalalo cha lamina I linanena bungwe la neurons ndikuwongolera kufala kwa ululu (toni yoletsa). Komabe, pakuvulala, cholepheretsa ichi chikhoza kutayika, zomwe zimayambitsa hyperalgesia. Kuphatikiza apo, disinhibition imatha kupangitsa kuti non-nociceptive myelinated A? ma afferents oyambilira kuti agwirizane ndi zozungulira zopatsirana zowawa zomwe nthawi zambiri zoyambitsa zopanda vuto tsopano zikuwoneka ngati zowawa. Izi zimachitika, mwa zina, kudzera mu kuletsa kwa PKC yosangalatsa? kuwonetsa ma interneurons mu lamina II yamkati.
  3. Kuyambitsa kwa Microglial.�Kuvulala kwa minyewa yam'mitsempha kumalimbikitsa kutulutsidwa kwa ATP ndi chemokine fractalkine zomwe zimathandizira ma cell a microglial. Makamaka, kutsegula kwa purinergic, CX3CR1, ndi Toll-like receptors pa microglia (purple) kumabweretsa kutulutsidwa kwa ubongo-derived neurotrophic factor (BDNF), yomwe kupyolera mu kutsegula kwa TrkB zolandilira zomwe zimawonetsedwa ndi lamina I output neurons, zimalimbikitsa kuwonjezereka komanso Kupweteka kowonjezereka poyankha kukondoweza koyipa komanso kosavulaza (ndiko, hyperalgesia ndi allodynia). Activated microglia imatulutsanso ma cytokines ambiri, monga tumor necrosis factor? (TNF?), interleukin-1? ndi 6 (IL-1?, IL-6), ndi zinthu zina zomwe zimapangitsa kuti pakhale chidziwitso chapakati.

The Chemical Milieu Of Inflammation

Kukhudzidwa kwapang'onopang'ono kumabwera chifukwa cha kusintha komwe kumayenderana ndi kutupa komwe kumapangidwa ndi mitsempha ya mitsempha (McMahon et al., 2008). Choncho, kuwonongeka kwa minofu nthawi zambiri kumatsagana ndi kudzikundikira kwa zinthu zomwe zimatulutsidwa kuchokera ku nociceptors kapena maselo omwe sali a neural omwe amakhala mkati kapena kulowa m'dera lovulala (kuphatikizapo mast cells, basophils, platelets, macrophages, neutrophils, endothelial cell, keratinocytes, ndi mast cell, basophils, platelets, macrophages, neutrophils, endothelial cell, keratinocytes, ndi fibroblasts). Zonse pamodzi. Zinthu izi, zomwe zimatchedwa "nsopu yotupa", zimayimira mamolekyu ambiri ozindikiritsa, kuphatikiza ma neurotransmitters, peptides (chinthu P, CGRP, bradykinin), eicosinoids ndi lipids ogwirizana (prostaglandins, thromboxanes, leukotrienes, endocannabinoids), neurotokines, , ndi chemokines, komanso ma protoni a extracellular ndi ma protoni. Chochititsa chidwi n'chakuti, ma nociceptors amasonyeza chimodzi kapena zingapo zolandirira ma cell omwe amatha kuzindikira ndi kuyankha pazigawo zonse za anti-inflammatory kapena pro-algesic (Chithunzi 4). Kuyanjana kotereku kumawonjezera chisangalalo cha minyewa ya mitsempha, potero kumakulitsa chidwi chake pakutentha kapena kukhudza.

Mosakayikira njira yodziwika bwino yochepetsera ululu wopweteka imaphatikizapo kuletsa kaphatikizidwe kapena kudzikundikira zigawo za supu yotupa. Izi zimasonyezedwa bwino ndi mankhwala osagwiritsa ntchito steroidal anti-inflammatory, monga aspirin kapena ibuprofen, omwe amachepetsa ululu wopweteka komanso hyperalgesia mwa kuletsa cyclooxygenases (Cox-1 ndi Cox-2) yomwe imakhudzidwa ndi prostaglandin synthesis. Njira yachiwiri ndiyo kuletsa zochita za othandizira otupa pa nociceptor. Apa, tikuwonetsa zitsanzo zomwe zimapereka chidziwitso chatsopano cha njira zama cell zolimbikitsa zotumphukira, kapena zomwe zimapanga maziko a njira zochiritsira zatsopano zochizira ululu wotupa.

NGF mwina imadziwika bwino chifukwa cha udindo wake monga neurotrophic factor yomwe ikufunika kuti pakhale moyo ndi chitukuko cha ma neuroni okhudzidwa panthawi ya embryogenesis, koma mwa munthu wamkulu, NGF imapangidwanso poyambitsa kuvulala kwa minofu ndipo imapanga chigawo chofunikira cha supu yotupa (Ritner et. ndi., 2009). Pakati pa zolinga zake zambiri zama cell, NGF imachita mwachindunji pa peptidergic C fiber nociceptors, yomwe imasonyeza kuyanjana kwakukulu kwa NGF receptor tyrosine kinase, TrkA, komanso low affinity neurotrophin receptor, p75 (Chao, 2003; Snider ndi McMahon, 1998). NGF imapanga kwambiri hypersensitivity kwa kutentha ndi zokopa zamakina kudzera munjira ziwiri zosiyana zanthawi. Poyamba, kuyanjana kwa NGF-TrkA kumayambitsa njira zowonetsera pansi, kuphatikizapo phospholipase C (PLC), protein kinase (MAPK) ya mitogen-activated, ndi phosphoinositide 3-kinase (PI3K). Izi zimabweretsa mphamvu yogwira ntchito ya mapuloteni omwe amawunikira pamtundu wa nociceptor terminal, makamaka TRPV1, zomwe zimapangitsa kuti pakhale kusintha kofulumira kwa kutentha kwa ma cell ndi khalidwe (Chuang et al., 2001).

Mosasamala kanthu za njira zawo zothandizira-nociceptive, kusokoneza zizindikiro za neurotrophin kapena cytokine zakhala njira yaikulu yothetsera matenda otupa kapena kupweteka. Njira yaikulu ikuphatikizapo kutsekereza NGF kapena TNF-? kuchitapo kanthu ndi anti-antibody. Pankhani ya TNF-?, izi zakhala zogwira mtima kwambiri pochiza matenda ambiri a autoimmune, kuphatikizapo nyamakazi ya nyamakazi, zomwe zimapangitsa kuchepetsa kwambiri kuwonongeka kwa minofu ndi kutsagana ndi hyperalgesia (Atzeni et al., 2005). Chifukwa chakuti zochita zazikulu za NGF pa nociceptor wamkulu zimachitika poyambitsa kutupa, ubwino wa njirayi ndikuti hyperalgesia idzachepa popanda kukhudza. yachibadwa ululu kuzindikira. Zowonadi, ma antibodies odana ndi NGF pakadali pano ali m'mayesero azachipatala kuti athe kuchiza ma syndromes opweteka (Hefti et al., 2006).

Glutamate/NMDA Receptor-Mediated Sensitization

Kupweteka koopsa kumasonyezedwa ndi kutulutsidwa kwa glutamate kuchokera kumadera apakati a nociceptors, kutulutsa mafunde a post-synaptic (EPSCs) mu dongosolo lachiwiri la dorsal horn neurons. Izi zimachitika makamaka kudzera mu activation ya postsynaptic AMPA ndi kainate subtypes ya ionotropic glutamate receptors. Chidule cha sub-threshold EPSCs mu postsynaptic neuron pamapeto pake chidzachititsa kuti pakhale kuwombera ndi kufalitsa uthenga wowawa ku ma neuron apamwamba.

Kafukufuku wina akuwonetsa kuti kusintha kwa neuron ya projection, komweko, kumathandizira kuletsa. Mwachitsanzo, kuvulala kwa mitsempha ya m'mitsempha kwambiri kumayang'anira K + - Cl-co-transporter KCC2, yomwe ndi yofunikira kuti mukhale ndi K + ndi Cl-gradients wamba kudutsa plasma membrane (Coull et al., 2003). Kuchepetsa KCC2, yomwe imasonyezedwa mu lamina I projection neurons, kumapangitsa kusintha kwa Cl- gradient, kotero kuti kutsegula kwa GABA-A receptors kumachepetsa, m'malo mwa hyperpolarize lamina I projection neurons. Izi zitha kukulitsa chisangalalo ndikuwonjezera kufalikira kwa ululu. Zowonadi, blockade ya pharmacological kapena siRNA-mediated downregulation ya KCC2 mu rat induces mechanical allodynia.

Gawani Ebook

Sources:

Chifukwa chiyani phewa langa likupweteka? Ndemanga ya neuroanatomical ndi biochemical maziko a ululu wa mapewa

Benjamin John Floyd Dean, Stephen Edward Gwilym, Andrew Jonathan Carr

Njira Zowawa za Ma cell ndi Mamolekyulu

Allan I. Basbaum1, Diana M. Bautista2, Gre?gory Scherrer1, ndi David Julius3

1Department of Anatomy, University of California, San Francisco 94158

2Department of Molecular and Cell Biology, University of California, Berkeley CA 94720 3Department of Physiology, University of California, San Francisco 94158

Njira za mamolekyu a nociception

David Julius* & Allan I. Basbaum�

*Department of Cellular and Molecular Pharmacology, and �Departments of Anatomy and Physiology and WM Keck Foundation Center for Integrative Neuroscience, University of California San Francisco, San Francisco, California 94143, USA (imelo: julius@socrates.ucsf.edu)

Chidule cha Pathophysiology of Neuropathic Pain

Chidule cha Pathophysiology of Neuropathic Pain

Ululu wa Neuropathic ndizovuta, zowawa zosatha zomwe nthawi zambiri zimatsagana ndi kuvulala kwa minofu yofewa. Ululu wa Neuropathic umakhala wofala m'zachipatala komanso umabweretsa zovuta kwa odwala komanso azachipatala. Ndi ululu wa neuropathic, ulusi wa minyewa womwewo ukhoza kuwonongeka, kusagwira ntchito kapena kuvulala. Ululu wa Neuropathic ndi zotsatira za kuwonongeka kwa kuvulala kapena matenda kupita kumalo ozungulira kapena apakati pa mitsempha, kumene chotupacho chikhoza kuchitika pamalo aliwonse. Chotsatira chake, minyewa yowonongekayi imatha kutumiza zizindikiro zolakwika kumalo ena opweteka. Zotsatira za kuvulala kwa mitsempha ya mitsempha imakhala ndi kusintha kwa ntchito ya neural, kudera la kuvulala komanso kuzungulira chovulalacho. Zizindikiro zachipatala za ululu wa neuropathic nthawi zambiri zimaphatikizapo zochitika zamaganizo, monga ululu wodzidzimutsa, paresthesias ndi hyperalgesia.

 

Ululu wa Neuropathic, monga momwe bungwe la International Association of the Study of Pain kapena IASP, limafotokozera, ndi ululu womwe umayambitsidwa kapena kuyambitsidwa ndi chotupa chachikulu kapena kusokonekera kwa dongosolo lamanjenje. Zitha kuchitika chifukwa cha kuwonongeka kulikonse pa neuraxis: zotumphukira zamanjenje, msana kapena supraspinal nerve system. Makhalidwe omwe amasiyanitsa ululu wa neuropathic ndi mitundu ina ya zowawa ndi monga ululu ndi zizindikiro zomveka zopitirira nthawi yochira. Amadziwika mwa anthu ndi zowawa zodziwikiratu, allodynia, kapena kumva kukondoweza kopanda vuto ngati kowawa, ndi causalgia, kapena kuwawa kosalekeza. Kupweteka kodziwikiratu kumaphatikizapo kumva kwa "zikhomo ndi singano", kuyaka, kuwombera, kubaya ndi kupweteka kwa paroxysmal, kapena kupweteka kwamagetsi monga kupweteka, komwe nthawi zambiri kumagwirizanitsidwa ndi dysesthesias ndi paresthesias. Zomverera izi sizimangosintha zida zomvera za wodwalayo, komanso momwe wodwalayo alili bwino, momwe amamvera, chidwi chake komanso kuganiza kwake. Ululu wa neuropathic umapangidwa ndi zizindikiro zonse "zoipa", monga kutayika kwa kumverera ndi kumva kugwedeza, ndi zizindikiro "zabwino", monga paresthesias, ululu wodzidzimutsa komanso kuwonjezeka kwa ululu.

 

Mikhalidwe yomwe nthawi zambiri imakhudzana ndi ululu wa neuropathic imatha kugawidwa m'magulu awiri akuluakulu: ululu chifukwa cha kuwonongeka kwa dongosolo lapakati la mitsempha ndi ululu chifukwa cha kuwonongeka kwa dongosolo la mitsempha. Mikwingwirima ya Cortical ndi sub-cortical, kuvulala koopsa kwa msana, syringo-myelia ndi syringobulbia, trigeminal ndi glossopharyngeal neuralgias, neoplastic ndi zilonda zina zokhala ndi malo ndizochitika zachipatala zomwe zili gulu lakale. Kupanikizika kwa mitsempha kapena kutsekeka kwa mitsempha, ischemic neuropathy, peripheral polyneuropathies, plexopathies, compression root root, post-amputation chitsa ndi kupweteka kwa phantom, postherpetic neuralgia ndi neuropathies zokhudzana ndi khansa ndizochitika zachipatala zomwe zili m'gulu lomaliza.

 

Pathophysiology ya Neuropathic Pain

 

Njira za pathophysiologic ndi malingaliro omwe amayambitsa ululu wa neuropathic ndi angapo. Asanafotokoze njirazi, kuwunikiranso kwanthawi zonse zowawa zapakatikati ndikofunikira. Maulendo opweteka nthawi zonse amaphatikizapo kuyambitsa kwa nociceptor, komwe kumatchedwanso ululu receptor, poyankha kukakamiza kowawa. Mafunde a depolarization amaperekedwa ku ma neurons oyambira, kuphatikiza kuthamanga kwa sodium kudzera mumayendedwe a sodium ndi potaziyamu kuthamangira kunja. Ma neurons amatha mu tsinde la ubongo mu phata la trigeminal kapena nyanga yakumbuyo ya msana. Apa ndi pamene chizindikiro chimatsegula njira za calcium za voltage-gated mu pre-synaptic terminal, kuti calcium ilowe. Calcium imalola glutamate, neurotransmitter yosangalatsa, kutulutsidwa m'dera la synaptic. Glutamate imamangiriza ku ma receptor a NMDA pama neurons a dongosolo lachiwiri, kuchititsa depolarization.

 

Mitsemphayi imadutsa mumsana ndikuyenda mpaka thalamus, kumene imagwirizanitsa ndi mitsempha yachitatu. Izi zimalumikizana ndi limbic system ndi cerebral cortex. Palinso njira yolepheretsa yomwe imalepheretsa kutumiza kwa zizindikiro zowawa kuchokera ku nyanga ya dorsal. Ma anti-nociceptive neurons amachokera mu tsinde laubongo ndikuyenda pansi pamsana pomwe amalumikizana ndi ma interneurons afupiafupi mu nyanga yakumbuyo potulutsa dopamine ndi norepinephrine. Ma interneurons amasintha synapse pakati pa neuron ya dongosolo loyamba komanso lachiwiri la neuron potulutsa gamma amino butyric acid, kapena GABA, neurotransmitter yoletsa. Chifukwa chake, kutha kwa ululu ndi chifukwa cha kuletsa kwa ma synapses pakati pa ma neuroni oyamba ndi achiwiri, pomwe kukulitsa ululu kungakhale chifukwa cha kupondereza kwa ma synaptic oletsa.

 

Pathophysiology ya Neuropathic Pain Diagram | El Paso, TX Chiropractor

 

Njira yomwe imayambitsa ululu wa neuropathic, komabe, sizodziwika bwino. Kafukufuku wambiri wa zinyama awonetsa kuti pali njira zambiri zomwe zingatheke. Komabe, munthu ayenera kukumbukira kuti zomwe zimagwira zolengedwa sizingagwire ntchito kwa anthu nthawi zonse. Ma neuroni oyitanitsa oyamba amatha kuwonjezera kuwombera kwawo ngati awonongeka pang'ono ndikuwonjezera kuchuluka kwa njira za sodium. Ectopic discharge ndi chotsatira cha kuwonjezereka kwa depolarization pamalo ena mu ulusi, kumabweretsa ululu wodzidzimutsa ndi ululu wokhudzana ndi kuyenda. Mabwalo oletsa amatha kuchepetsedwa mulingo wa dorsal horn kapena cell stem cell, komanso zonse ziwiri, kulola zowawa kuyenda mosatsutsidwa.

 

Kuonjezera apo, pangakhale kusintha pakati pa kupweteka kwapakati pamene, chifukwa cha kupweteka kosalekeza ndi kugwiritsa ntchito mankhwala osokoneza bongo ndi / kapena mankhwala, mitsempha yachiwiri ndi yachitatu imatha kupanga "chikumbutso" cha ululu ndikukhala tcheru. Ndiye pali kuchulukitsidwa kwa ma neurons a msana ndikuchepetsa kutsegulira. Chiphunzitso china chimasonyeza lingaliro la ululu wa neuropathic wosungidwa mwachifundo. Lingaliro limeneli linasonyezedwa ndi analgesia kutsatira sympathectomy kuchokera ku nyama ndi anthu. Komabe, kusakanikirana kwamakina kumatha kukhudzidwa ndi zovuta zambiri za neuropathic kapena zosakanikirana za somatic ndi neuropathic ululu. Zina mwa zovuta zomwe zili m'gawo la ululu, komanso zina zambiri zokhudzana ndi ululu wa neuropathic, ndikutha kuziwona. Pali mbali ziwiri za izi: choyamba, kuyesa khalidwe, mphamvu ndi kupita patsogolo; ndipo chachiwiri, kudziwa bwino ululu wa neuropathic.

 

Pali, komabe, zida zina zowunikira zomwe zingathandize asing'anga pakuwunika ululu wa neuropathic. Poyambira, maphunziro a mitsempha ya mitsempha ndi mphamvu zowonongeka zimatha kuzindikira ndi kuwerengera kuchuluka kwa kuwonongeka kwa njira, koma osati nociceptive, poyang'anira mayankho a neurophysiological ku mphamvu zamagetsi. Kuphatikiza apo, kuyezetsa kwamphamvu kwamphamvu kumatengera kuzindikira potengera kukopa kwakunja kwamphamvu zosiyanasiyana pogwiritsa ntchito kukondoweza pakhungu. Kuzindikira kwamakina ku zokopa zamakina kumayesedwa ndi zida zapadera, monga von Frey hairs, pinprick yokhala ndi singano zolumikizana, komanso kumva kunjenjemera pamodzi ndi ma vibrameter ndi kupweteka kwamafuta ndi ma thermodes.

 

Ndikofunikiranso kwambiri kuyeza mwatsatanetsatane za minyewa kuti muzindikire zovuta zamagalimoto, zomverera komanso za autonomic. Pamapeto pake, pali mafunso ambiri omwe amagwiritsidwa ntchito kusiyanitsa ululu wa neuropathic mu ululu wa nociceptive. Zina mwazo zimaphatikizapo mafunso oyankhulana okha (mwachitsanzo, Neuropathic Questionnaire ndi ID Pain), pamene ena ali ndi mafunso oyankhulana ndi mayesero a thupi (mwachitsanzo, Leeds Assessment of Neuropathic Symptoms and Signs scale) ndi chida chenichenicho, Standardized Evaluation of Ululu, womwe umaphatikiza mafunso asanu ndi limodzi oyankhulana ndi kuwunika kwa thupi khumi.

 

Neuropathic Pain Chithunzi | El Paso, TX Chiropractor

 

Njira Zochiritsira Zopweteka za Neuropathic

 

Mankhwala a pharmacological amayang'ana njira za ululu wa neuropathic. Komabe, mankhwala onse a pharmacologic komanso osakhala a pharmacologic amapereka mpumulo wathunthu kapena pang'ono mwa pafupifupi theka la odwala. Maumboni ambiri ozikidwa pa umboni akuwonetsa kugwiritsa ntchito mankhwala osakaniza ndi/kapena mankhwala kuti agwire ntchito m'njira zambiri momwe angathere. Kafukufuku wambiri adafufuza makamaka pambuyo pa herpetic neuralgia ndi ululu wowawa wa matenda a shuga koma zotsatira zake sizingagwire ntchito pazochitika zonse za ululu wa neuropathic.

 

Kudetsa nkhaŵa

 

Ma antidepressants amawonjezera kuchuluka kwa synaptic serotonin ndi norepinephrine, potero kumathandizira kutsika kwamankhwala ochepetsa ululu omwe amalumikizidwa ndi ululu wa neuropathic. Zakhala zochiritsira zowawa za neuropathic. Zochita za analgesic zitha kukhala chifukwa cha nor-adrenaline ndi dopamine reuptake blockade, zomwe mwina zimathandizira kutsika kwapang'onopang'ono, kutsutsa kwa NMDA-receptor antagonism ndi sodium-channel blockade. Tricyclic antidepressants, monga TCAs; mwachitsanzo, amitriptyline, imipramine, nortriptyline ndi doxepine, ndi amphamvu motsutsana ndi kuwawa kosalekeza kapena kupweteka koyaka pamodzi ndi ululu wodzidzimutsa.

 

Ma Tricyclic antidepressants atsimikiziridwa kuti ndi othandiza kwambiri pa ululu wa neuropathic kuposa serotonin reuptake inhibitors, kapena SSRIs, monga fluoxetine, paroxetine, sertraline ndi citalopram. Chifukwa chikhoza kukhala chakuti amaletsa kubwezeretsanso kwa serotonin ndi nor-epinephrine, pamene SSRIs imangolepheretsa serotonin reuptake. Tricyclic antidepressants ikhoza kukhala ndi zotsatira zosasangalatsa, kuphatikizapo nseru, kusokonezeka, kutsekeka kwa mtima, tachycardia ndi ventricular arrhythmias. Zingayambitsenso kunenepa, kuchepa kwa khunyu, ndi orthostatic hypotension. Ma Tricyclics ayenera kugwiritsidwa ntchito mosamala kwa okalamba, omwe ali pachiwopsezo cha zovuta zawo. The mankhwala ndende mu magazi ayenera kuyang`aniridwa kupewa kawopsedwe odwala amene pang`onopang`ono mankhwala metabolizer.

 

Serotonin-norepinephrine reuptake inhibitors, kapena SNRIs, ndi gulu latsopano la antidepressants. Monga ma TCA, amawoneka kuti ndi othandiza kwambiri kuposa ma SSRIs pochiza ululu wa neuropathic chifukwa amalepheretsanso kubwezeretsanso kwa nor-epinephrine ndi dopamine. Venlafaxine ndi othandiza polimbana ndi matenda a polyneuropathies, monga kupweteka kwa matenda a shuga, monga imipramine, potchula TCA, ndipo awiriwa ndi aakulu kwambiri kuposa placebo. Monga ma TCA, ma SNRI akuwoneka kuti amapereka mapindu osatengera kupsinjika kwawo. Zotsatira zake ndi monga sedation, kusokonezeka, kuthamanga kwa magazi komanso kukomoka.

 

Mankhwala a Antiepileptic

 

Mankhwala oletsa khunyu amatha kugwiritsidwa ntchito ngati chithandizo choyambirira makamaka pamitundu ina ya ululu wa neuropathic. Amagwira ntchito posintha njira za calcium ndi sodium ndi voltage, popititsa patsogolo zolepheretsa za GABA komanso poletsa kufalikira kwa glutaminergic. Mankhwala oletsa khunyu sanawonetsedwe kuti ndi othandiza pa ululu wopweteka kwambiri. Muzochitika zopweteka kwambiri, mankhwala oletsa khunyu amawoneka kuti ndi othandiza kokha mu trigeminal neuralgia. Carbamazepine amagwiritsidwa ntchito pafupipafupi pamtunduwu. Gabapentin, yomwe imagwira ntchito poletsa njira ya calcium kudzera mu zochita za agonist pa alpha-2 delta subunit ya calcium channel, imadziwikanso kuti ndi yothandiza pa ululu wa neuropathic. Komabe, gabapentin imagwira ntchito pakati ndipo imatha kuyambitsa kutopa, chisokonezo komanso kugona.

 

Non-Opioid Analgesics

 

Palibe chidziwitso champhamvu chothandizira kugwiritsa ntchito mankhwala osagwiritsa ntchito steroidal anti-inflammatory, kapena NSAIDs, pochepetsa ululu wa neuropathic. Izi zikhoza kukhala chifukwa cha kusowa kwa gawo lotupa pochotsa ululu. Koma akhala akugwiritsidwa ntchito mosinthana ndi ma opioid ngati othandizira pochiza ululu wa khansa. Pakhala pali zovuta zina zomwe zanenedwa, komabe, makamaka mwa odwala omwe ali ofooka kwambiri.

 

Opioid Analgesics

 

Opioid analgesics ndi nkhani yotsutsana kwambiri pochotsa ululu wa neuropathic. Iwo amachita poletsa chapakati kukwera ululu zikhumbo. Mwachizoloŵezi, ululu wa neuropathic wakhala ukuwonedwa kale kuti ndi opioid-resistant, momwe ma opioid ndi njira zoyenera kwambiri za ululu wa coronary ndi somatic nociceptive. Madokotala ambiri amaletsa kugwiritsa ntchito ma opioid pochiza ululu wa neuropathic, makamaka chifukwa cha nkhawa zokhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo, kuledzera komanso kuwongolera. Koma, pali mayesero ambiri omwe apeza kuti opioid analgesics apambane. Oxycodone inali yabwino kuposa placebo pochotsa ululu, allodynia, kukonza kugona ndi kulemala. Ma opioid olamulidwa, malinga ndi nthawi yokonzekera, amalangizidwa kwa odwala omwe amamva kupweteka kosalekeza kuti alimbikitse kupwetekedwa mtima kosalekeza, kuteteza kusinthasintha kwa shuga m'magazi ndikuletsa zochitika zovuta zomwe zimagwirizanitsidwa ndi mlingo wapamwamba. Nthawi zambiri, kukonzekera pakamwa kumagwiritsidwa ntchito chifukwa chosavuta kugwiritsa ntchito komanso kutsika mtengo. Kukonzekera kwa Trans-dermal, parenteral ndi rectal nthawi zambiri kumagwiritsidwa ntchito kwa odwala omwe sangathe kulekerera mankhwala apakamwa.

 

Anesthetics Kumidzi

 

Mankhwala ogonetsa apafupi ndi ochititsa chidwi chifukwa, chifukwa cha zochita zawo za m'madera, amakhala ndi zotsatira zochepa. Amagwira ntchito pokhazikitsa njira za sodium pa ma axon a ma neuroni oyambira oyambira. Amagwira ntchito bwino ngati pali kuvulala pang'ono kwa minyewa komanso njira zochulukirapo za sodium zomwe zasonkhanitsidwa. Lidocaine wapamutu ndiye woyimira bwino kwambiri pamaphunzirowa a ululu wa neuropathic. Makamaka, kugwiritsa ntchito 5 peresenti ya lidocaine patch ya post-herpetic neuralgia kwachititsa kuti avomerezedwe ndi FDA. Chigambacho chikuwoneka kuti chimagwira ntchito bwino pamene chawonongeka, koma chosungidwa, chozungulira cha mitsempha ya mitsempha ya nociceptor ntchito kuchokera ku dermatome yokhudzidwa yomwe ikuwonetsa ngati allodynia. Iyenera kukhazikitsidwa mwachindunji pamalo omwe ali ndi zizindikiro kwa maola 12 ndikuchotsedwa kwa maola ena 12 ndipo ingagwiritsidwe ntchito kwa zaka motere. Kuwonjezera pa zochitika zapakhungu, nthawi zambiri zimalekerera bwino odwala ambiri omwe ali ndi ululu wa neuropathic.

 

Mankhwala Osiyanasiyana

 

Clonidine, alpha-2-agonist, adawonetsedwa kuti ndi othandiza pagawo la odwala omwe ali ndi matenda a shuga a peripheral neuropathy. Cannabinoids apezeka kuti amathandizira pakuyesa kusintha kwa ululu m'zitsanzo za nyama komanso umboni wokwanira wokwanira. CB2-selective agonists amapondereza hyperalgesia ndi allodynia ndikupangitsa kuti ma nociceptive ayambe popanda kuchititsa analgesia.

 

Interventional Pain Management

 

Chithandizo chamankhwala chosokoneza chikhoza kuganiziridwa kwa odwala omwe ali ndi ululu wosasunthika wa neuropathic. Mankhwalawa amaphatikizapo jakisoni wa epidural kapena perineural wamankhwala am'deralo kapena corticosteroids, kuyika kwa epidural ndi intrathecal njira zoperekera mankhwala ndikuyika zolimbikitsa msana. Njirazi zimasungidwa kwa odwala omwe ali ndi ululu wosasunthika wa neuropathic omwe alephera kuyang'anira chithandizo chamankhwala mosamalitsa komanso adawunikanso bwino m'maganizo. Mu kafukufuku wa Kim et al, zidawonetsedwa kuti chotsitsimutsa chamsana chinali chothandiza pochiza ululu wa neuropathic wa chiyambi cha mitsempha.

 

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Kuzindikira kwa Dr. Alex Jimenez

Ndi ululu wa neuropathic, zizindikiro za ululu wosatha zimachitika chifukwa cha minyewa ya mitsempha yomwe imawonongeka, yosagwira ntchito kapena yovulala, nthawi zambiri imatsagana ndi kuwonongeka kwa minofu kapena kuvulala. Chotsatira chake, minyewa ya minyewayi imatha kuyamba kutumiza zizindikiro zowawa zolakwika kumadera ena a thupi. Zotsatira za ululu wa neuropathic chifukwa cha kuvulala kwa mitsempha ya mitsempha imaphatikizapo kusintha kwa mitsempha ya mitsempha pamalo ovulala komanso m'madera ozungulira chovulalacho. Kumvetsetsa matenda a matenda a neuropathic kwakhala cholinga cha akatswiri ambiri azachipatala, kuti adziwe bwino njira yabwino yothandizira kuti athandizidwe ndi kuwongolera zizindikiro zake. Kuchokera kugwiritsa ntchito mankhwala osokoneza bongo ndi / kapena mankhwala, chisamaliro cha chiropractic, masewera olimbitsa thupi, masewera olimbitsa thupi ndi zakudya, njira zosiyanasiyana zothandizira zingathandize kuchepetsa ululu wa neuropathic pa zosowa za munthu aliyense.

 

Zowonjezera Zowonjezera Pakupweteka kwa Neuropathic

 

Odwala ambiri omwe ali ndi ululu wa neuropathic amatsata njira zowonjezera ndi zina zothandizira kuti athetse ululu wa neuropathic. Ma regimens ena odziwika bwino omwe amagwiritsidwa ntchito pochiza ululu wa neuropathic ndi monga kutema mphini, kuwotcha kwamphamvu kwa mitsempha yamagetsi, transcutaneous electro nerve stimulation, chidziwitso cha khalidwe lachidziwitso, kujambula zithunzi zamagalimoto ndi chithandizo chothandizira, ndi masewera olimbitsa thupi. Pakati pa izi, chisamaliro cha chiropractic ndi njira yodziwika bwino yothandizira yomwe imagwiritsidwa ntchito pochiza ululu wa neuropathic. Chisamaliro cha Chiropractic, limodzi ndi chithandizo chamankhwala, masewera olimbitsa thupi, zakudya komanso kusintha kwa moyo kumatha kupereka mpumulo kuzizindikiro zowawa za neuropathic.

 

Chisamaliro cha Chiropractic

 

Chomwe chimadziwika ndi chakuti kugwiritsa ntchito kasamalidwe kokwanira ndikofunikira kwambiri polimbana ndi zowawa za neuropathic. Mwanjira imeneyi, chisamaliro cha chiropractic ndi pulogalamu yothandizira anthu onse yomwe ingakhale yothandiza popewa zovuta zokhudzana ndi thanzi lomwe limakhudzana ndi kuwonongeka kwa mitsempha. Chisamaliro cha Chiropractic chimapereka chithandizo kwa odwala omwe ali ndi matenda osiyanasiyana, kuphatikizapo omwe ali ndi ululu wa neuropathic. Odwala ululu wa neuropathic nthawi zambiri amagwiritsa ntchito mankhwala osagwiritsa ntchito steroidal-anti-inflammatory, kapena NSAIDs, monga ibuprofen, kapena mankhwala opha ululu omwe amalembedwa kuti achepetse ululu wa neuropathic. Izi zitha kupereka chithandizo kwakanthawi koma zimafunikira kugwiritsidwa ntchito pafupipafupi kuti muchepetse ululu. Izi nthawi zonse zimathandizira ku zotsatira zovulaza komanso muzochitika zovuta kwambiri, kudalira mankhwala osokoneza bongo.

 

Chisamaliro cha Chiropractic chingathandize kusintha zizindikiro za ululu wa neuropathic ndikukulitsa bata popanda zovuta izi. Njira monga chisamaliro cha chiropractic imapereka pulogalamu yapayokha yopangidwa kuti iwonetse chomwe chimayambitsa vutoli. Kupyolera mukugwiritsa ntchito kusintha kwa msana ndi kuwongolera pamanja, chiropractor amatha kukonza mosamalitsa misalignment iliyonse ya msana, kapena ma subluxation, omwe amapezeka kutalika kwa msana, zomwe zingachepetse zotsatira za kusweka kwa mitsempha kudzera pakuwongolera msana. Kubwezeretsa umphumphu wa msana n'kofunikira kuti musunge dongosolo lalikulu la mitsempha.

 

A chiropractor amathanso kukhala chithandizo chanthawi yayitali kuti mukhale ndi moyo wabwino. Kupatula kusintha kwa msana ndi kuwongolera pamanja, chiropractor atha kupereka upangiri wopatsa thanzi, monga kupatsa zakudya zokhala ndi ma antioxidants, kapena atha kupanga pulogalamu yolimbitsa thupi kapena masewera olimbitsa thupi kuti athe kuthana ndi ululu wamtsempha. Kudwala kwanthawi yayitali kumafuna chithandizo chanthawi yayitali, ndipo chifukwa cha izi, katswiri wazachipatala yemwe amagwira ntchito yovulala komanso / kapena mikhalidwe yomwe imakhudza minofu ndi mitsempha yamanjenje, monga dokotala wa chiropractic kapena chiropractor, ikhoza kukhala yothandiza kwambiri akamagwira ntchito. kudziwa kusintha kwabwino pakapita nthawi.

 

Thandizo la thupi, masewero olimbitsa thupi ndi njira zowonetsera kayendetsedwe ka kayendetsedwe kake zasonyezedwa kuti ndizopindulitsa pa chithandizo cha ululu wa neuropathic. Chisamaliro cha Chiropractic chimaperekanso njira zina zothandizira zomwe zingakhale zothandiza pakuwongolera kapena kukonza ululu wa neuropathic. Low level laser therapy, kapena LLLT, mwachitsanzo, yatchuka kwambiri ngati chithandizo cha ululu wa neuropathic. Malingana ndi kafukufuku wosiyanasiyana, zinatsimikiziridwa kuti LLLT inali ndi zotsatira zabwino pa kuwongolera analgesia chifukwa cha ululu wa neuropathic, komabe, maphunziro owonjezera a kafukufuku amafunika kufotokozera ndondomeko zachipatala zomwe zimafotokozera mwachidule zotsatira za mankhwala otsika a laser mu mankhwala opweteka a neuropathic.

 

Chisamaliro cha Chiropractic chimaphatikizanso upangiri wopatsa thanzi, womwe ungathandize kuwongolera zizindikiro zomwe zimagwirizanitsidwa ndi matenda a shuga. Pakafukufuku wofufuza, zakudya zokhala ndi mafuta ochepa zotengera mbewu zidawonetsedwa kuti zimathandizira kuwongolera glycemic kwa odwala omwe ali ndi matenda amtundu wa 2. Pambuyo pa masabata pafupifupi 20 a kafukufuku woyendetsa ndegeyo, anthu omwe adakhudzidwawo adanena kuti kusintha kwa thupi lawo ndi kusintha kwa khungu la electrochemical pamapazi kunanenedwa kukhala bwino ndi kuchitapo kanthu. Kafukufuku wofufuza adawonetsa phindu lomwe lingakhalepo muzakudya zokhala ndi mafuta ochepa pazakudya zamtundu wa diabetesic neuropathy. Komanso, maphunziro azachipatala adapeza kuti kugwiritsa ntchito pakamwa kwa magnesium L-threonate kumatha kuletsa komanso kubwezeretsa kukumbukira kukumbukira komwe kumakhudzana ndi ululu wa neuropathic.

 

Chisamaliro cha Chiropractic chingaperekenso njira zowonjezera zothandizira kulimbikitsa kusinthika kwa mitsempha. Mwachitsanzo, kupititsa patsogolo kusinthika kwa ma axon kwaperekedwa kuti kuthandizire kukonza magwiridwe antchito pambuyo povulala kwa mitsempha. Kukondoweza kwa magetsi, pamodzi ndi masewera olimbitsa thupi kapena masewera olimbitsa thupi, kunapezeka kuti kumalimbikitsa kusinthika kwa mitsempha pambuyo pochedwa kukonzanso mitsempha mwa anthu ndi makoswe, malinga ndi kafukufuku waposachedwapa. Kukondoweza kwamagetsi ndi kuchita masewera olimbitsa thupi potsirizira pake kunatsimikiziridwa kukhala akulonjeza chithandizo choyesera cha kuvulala kwa mitsempha ya m'mitsempha yomwe imawoneka yokonzeka kusamutsidwira ku ntchito yachipatala. Kafukufuku wowonjezereka angafunike kuti adziwe bwino zotsatira za izi kwa odwala omwe ali ndi ululu wa neuropathic.

 

Kutsiliza

 

Ululu wa Neuropathic ndi gulu losiyanasiyana lomwe lilibe malangizo apadera oti musamalire. Zimayendetsedwa bwino pogwiritsa ntchito njira zosiyanasiyana. Kusamalira ululu kumafuna kuyesedwa kosalekeza, maphunziro a odwala, kuonetsetsa kuti odwala akutsatiridwa ndi kutsimikiziridwa. Kupweteka kwa Neuropathic ndi vuto lalikulu lomwe limapangitsa kusankha kwamankhwala abwino kukhala kovuta. Kupereka chithandizo payekha kumaphatikizapo kulingalira za zotsatira za ululu pa umoyo wa munthu, kuvutika maganizo ndi kulemala pamodzi ndi maphunziro opitilira ndi kuwunika. Maphunziro a ululu wa neuropathic, pamagulu a maselo ndi zinyama, ndi atsopano koma odalirika kwambiri. Zosintha zambiri zimayembekezeredwa m'magawo oyambira komanso azachipatala a ululu wa neuropathic motero kutsegulira zitseko zowongolera kapena njira zatsopano zochizira matendawa. Kukula kwa chidziwitso chathu kumangokhala kwa chiropractic komanso kuvulala kwa msana ndi mikhalidwe. Kuti mukambirane nkhaniyi, chonde muzimasuka kufunsa Dr. Jimenez kapena mutitumizireni pa�915-850-0900 .

 

Wosankhidwa ndi Dr. Alex Jimenez

 

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Mitu Yowonjezera: Ululu Wobwerera

 

Ululu wammbuyo ndi chimodzi mwa zifukwa zofala kwambiri za olumala ndi masiku osowa kuntchito padziko lonse lapansi. Kunena zoona, kupweteka kwa msana kwanenedwa kuti ndi chifukwa chachiwiri chofala kwambiri choyendera ofesi ya dokotala, choposa kokha ndi matenda apamwamba opuma. Pafupifupi 80 peresenti ya anthu adzakhala ndi mtundu wina wa ululu wammbuyo kamodzi pa moyo wawo wonse. Msana ndi dongosolo lovuta lopangidwa ndi mafupa, mafupa, mitsempha ndi minofu, pakati pa ziwalo zina zofewa. Chifukwa cha izi, kuvulala ndi / kapena zovuta, monga herniated discs, pamapeto pake zimatha kuyambitsa zizindikiro za ululu wammbuyo. Kuvulala kwamasewera kapena ngozi zapamsewu nthawi zambiri zimakhala zomwe zimayambitsa kupweteka kwa msana, komabe, nthawi zina kuyenda kosavuta kumakhala ndi zotsatira zowawa. Mwamwayi, njira zina zochiritsira, monga chisamaliro cha chiropractic, zingathandize kuchepetsa ululu wammbuyo pogwiritsa ntchito kusintha kwa msana ndi kusintha kwamanja, potsirizira pake kumathandiza kuchepetsa ululu.

 

 

 

chithunzi cha blog cha cartoon paperboy nkhani zazikulu

 

MUTU WOFUNIKA KWAMBIRI: Kuwongolera Ululu Wochepa

 

ZINTHU ZINA: ZOWONJEZERA: Kupweteka Kwambiri & Chithandizo

 

Kutaya Tulo Kumawonjezera Chiwopsezo cha Kunenepa Kwambiri

Kutaya Tulo Kumawonjezera Chiwopsezo cha Kunenepa Kwambiri

Kutaya tulo kumawonjezera chiopsezo chokhala onenepa, malinga ndi kafukufuku wa ku Sweden. Ofufuza ochokera ku yunivesite ya Uppsala ati kusowa tulo kumakhudza kagayidwe kachakudya kamene kamasokoneza kugona komanso kusokoneza momwe thupi limayankhira chakudya ndi masewera olimbitsa thupi.

Ngakhale kuti maphunziro angapo apeza kugwirizana pakati pa kugona tulo ndi kulemera kwa thupi, chifukwa chake sichidziwika bwino.

Dr. Christian Benedict ndi anzake achita maphunziro angapo a anthu kuti afufuze momwe kutaya tulo kungakhudzire mphamvu ya metabolism. Kafukufukuyu adayesa ndikuwonetsa mayankho amakhalidwe, thupi, ndi biochemical pazakudya pambuyo posowa tulo.

Zotsatira zamakhalidwe zimavumbula kuti anthu omwe ali ndi thanzi labwino, osagona tulo amakonda kudya zakudya zambiri, amafunafuna zopatsa mphamvu zambiri, amawonetsa kukhudzika kokhudzana ndi chakudya, komanso amawononga mphamvu zochepa.

Kafukufuku wokhudza thupi la gululi akuwonetsa kuti kugona kumasintha kuchuluka kwa mahomoni kuchokera ku mahomoni omwe amalimbikitsa kukhuta (kukhuta), monga GLP-1, kupita ku omwe amalimbikitsa njala, monga ghrelin. Kuletsa kugona kumawonjezeranso kuchuluka kwa endocannabinoids, omwe amadziwika kuti amalimbikitsa chidwi.

Kuphatikiza apo, kafukufuku wawo adawonetsa kuti kugona kwakanthawi kochepa kumasintha mabakiteriya am'matumbo, omwe amadziwika kuti ndi chinsinsi chothandizira kuti metabolism ikhale yathanzi. Kafukufuku yemweyo adapezanso kuchepa kwa chidwi cha insulin pambuyo pogona.

“Popeza kuti kugona movutitsidwa ndi chinthu chofala kwambiri m’moyo wamakono, kafukufukuyu akusonyeza kuti n’zosadabwitsa kuti matenda a kagayidwe kachakudya, monga kunenepa kwambiri, nawonso akuchulukirachulukira,” anatero Benedict.

"Kafukufuku wanga akuwonetsa kuti kugona kumapangitsa kuti anthu azilemera," adatero. "Zingaganizidwenso kuti kuwongolera kugona kungakhale njira yabwino yopezera moyo kuti muchepetse chiopsezo cha kulemera kwamtsogolo."

Sikuti kusowa tulo kumangowonjezera mapaundi, kafukufuku wina wapeza kuti kuwala kochuluka pamene mukugona kungayambitsenso chiopsezo cha kunenepa kwambiri. Kafukufuku wa ku Britain pa amayi 113,000 adapeza kuti kuwala komwe kumawonekera nthawi yogona, kumakhala ndi chiopsezo chachikulu chokhala ndi mafuta. Kuwala kumasokoneza kayimbidwe ka thupi ka circadian, komwe kumakhudza kugona ndi kudzuka, komanso kumakhudza kagayidwe kake.

Koma kuyatsa kuwala m'maola oyambirira kungathandize kuchepetsa thupi. Kafukufuku wochokera ku yunivesite ya Northwestern University adapeza kuti anthu omwe amakhala ndi dzuwa nthawi zambiri, ngakhale kunja kuli mvula, m'mawa kwambiri amakhala ndi index yotsika ya thupi (BMI) kuposa omwe amadzuka ndi dzuwa pambuyo pake masana, mosasamala kanthu za thupi. ntchito, kudya kwa caloric, kapena zaka.