Imisipha:
Iingqinisiso zokubhaliweyo:
- Fasciculation
- imisipha
- Abanyolukile
- Isifo seCeliac
- Chiropractic
- Ukutya kwe-hypersensitivity
Abstract
Injongo: Injongo yale ngxelo ichaza ukuchaza isigulane esinomzimba osisigxina, esixubileyo esasifaka kwiikliniki yokufundisa i-chiropractic kwaye siphathwa ngokuguqulwa kokutya.
Impawu zonyango: Indoda eneminyaka eyi-28 ubudala yayinemisipha ye-2 yeminyaka. I-fasciculations yaqala kwiso lakhe kwaye yaqhubela phambili kwimilebe kunye neendawo ezisezantsi. Ukongeza, wayenxunguphalo lwesisu kunye nokudinwa. Isigulana ngaphambili sasifunyaniswa sinengxaki yengqolowa xa sasineminyaka engama-24 kodwa sasingahambelani nokutya okungenagluteni ngelo xesha. Ukuvavanywa kobuntununtunu bokutya kutyhile i-immunoglobulin G based sensitivity kwizinto ezininzi zokutya, kubandakanya uninzi lweenkozo ezahlukeneyo kunye neemveliso zobisi. Ukuchongwa kokusebenza yayiyi-gluten neuropathy.
Ukungenelela kunye nesiphumo: Kwiinyanga ezi-6 zokuthobela ukuthintelwa kukutya okusekwe kuvavanyo lobuntununtunu, isisombululo somzimba wesigulana sisonjululwe ngokupheleleyo. Ezinye izikhalazo zengqondo yenkungu, ukudinwa, kunye noxinzelelo lwesisu nazo ziphuculwe.
Izigqibo: Le ngxelo ichaza ukuphucula kwimizimba engapheliyo, ukuxhaphazwa kwemisipha kunye neminye imiqondiso yeenkqubo kunye neenguqu zokutya. Kukho ukusola okuqinileyo ukuba le meko ibonisa enye ye-gluten neuropathy, nangona ukuvavanywa kwezifo ezingenakuqhelaniswa ngokungazange kwenziwe.
Contents
Intshayelelo: usMascle Fasciculations
Kukho iintlobo ezi-3 ezaziwayo zokuphendula okungalunganga kwiiproteni zengqolowa, ngokudibeneyo ezaziwa ngokuba yiprotein yengqolowa i-reactivity: i-wheat allergy (WA), i-gluten sensitivity (GS), � kunye nesifo se-celiac (CD). Kwi-3, i-CD kuphela eyaziwayo ukuba ibandakanya i-autoimmune reactivity, isizukulwana se-antibodies, kunye nomonakalo wamathumbu emathunjini. Ukwaliwa kwengqolowa kubandakanya ukukhutshwa kwe-histamine ngendlela ye-immunoglobulin (Ig) E-cross-linking kunye ne-gluten peptides kwaye inikezela kwiiyure ezimbalwa emva kokungeniswa kweeprotheni zengqolowa. Ubuzwe beGluten buthathwa njengoxilongo lokungabandakanywa; abanesigulo baphucula ngokubonakalayo ngokutya okungenayo i-gluten-free (GFD) kodwa abavezi izilwa-buhlungu okanye i-IgE reactivity.1
Ubuninzi obubiweyo be-WA bubonakala. Izigaba eziqhelekileyo ukusuka kwi-0.4% ukuya kwi-9% yabemi.2,3 Ukusabalalisa kwe-GS kunzima kunzima ukuyiqonda, njengoko ingenanto engqinelanayo kwaye ixilongo lokukhutshwa. I-Gluten ukukhathazeka kwe-0.55% isekelwe kwi-National Health and Nutrition Examination Survey data ukusuka kwi-2009 ukuya kwi-2010.4 Kwisifundo se-2011, ukuxhaphaka kwe-GS ye-10% kwabikwa kubantu base-United States.5 Ngokungafani nemizekelo ye-2 engentla, iCD ichazwe. Uvavanyo lwe-2012 ukuhlola iisampuli ze-serum kwizigulane ze-7798 kwiSiseko seNational Health and Nutrition Examination Survey ukusuka kwi-2009 ukuya kwi-2010 ibone ukuxhaphaka kwe-0.71% e-United States.6
Ukubonakaliswa kwe-Neurologic okunxulunyaniswa nokusabela okungalunganga kwiiproteni zengqolowa kubhalwe kakuhle. Kwangoko nge-1908, i-ipperipheral neuritis yayicingelwa ukuba inxulunyaniswa neCD.7 Ukuphononongwa kwazo zonke izifundo ezipapashiweyo kwesi sihloko ukusuka ngo-1964 ukuya ku-2000 kubonise ukuba ezona zinto zixhaphakileyo ze-neurologic ezinxulunyaniswa ne-GS yayiyi-ataxia (35%), i-peripheral neuropathy (35%), kunye ne-myopathy (16%). 8 Intloko, i-paresthesia, i-hyporeflexia, ubuthathaka, kunye nokunciphisa ukungcangcazela kwengqondo kuye kwaxelwa ukuba kuxhaphake kakhulu kwizigulana ze-CD ngokuchasene nolawulo.9 Ezi mpawu ezifanayo zazigcwele kwizigulana ze-CD ezingakhange zilandele ngokungqongqo i-GFD ngokuchasene nezo zazithobela i-GFD.
Okwangoku, akukho ziganeko zeengxelo ezichaza ukuphathwa kwe-chiropractic yesigulane kunye ne-gluten neuropathy. Ngoko ke, injongo yolu cwaningo luyilo ukuchaza isalathiso sesigulane esicatshulwayo i-gluten neuropathy kunye neprotocol yonyango usebenzisa ukulungiswa kokutya.
Ingxelo yeNgxelo
Indoda eneminyaka eyi-28 inikwe iklinikhi yokufundisa i-chiropractic kunye nezikhalazo ze-muscle fasciculations rhoqo iminyaka eyi-2. I-fasciculations ye-muscle ekuqaleni yaqala kwiso lasekhohlo kwaye yahlala khona malunga neenyanga ze-6. Isigulane ke saqaphela ukuba i-fasciculations yaqala ukufudukela kwezinye iindawo zomzimba wakhe. Baqala bangena kwiliso lasekunene, balandelwa yimilebe, emva koko baye ematholeni, kwi-quadriceps, nakwizihlunu zegluteus. Ukuxhuzula ngamanye amaxesha kwenzeka kwisihlunu esinye okanye kunokubandakanya zonke ezi zihlunu zingasentla ngaxeshanye. Ekunye nokuxhuzula, uxela rhoqo "ukubhubha" okanye "ukukhasa" emilenzeni yakhe. Kwakungekho sizathu emini okanye ebusuku xa ii-twitches zaphela.
Isigulana ekuqaleni sasichaza ukuba izihlunu ziyajija kukutya ikofuine (i-20 oz yekofu ngosuku) kunye noxinzelelo esikolweni. Isigulana siyakwala ukusetyenziswa kweziyobisi ezingekho mthethweni, icuba, okanye naliphi na iyeza likagqirha kodwa siyasela (ikakhulu ibhiya) ngokumodareyitha. Isigulana sitye ukutya okuphezulu kwiinyama, iziqhamo, imifuno, kunye nepasta. Kwiinyanga ezisibhozo emva kokuqala kokuqalisa, isigulana saqala ukufumana uxinzelelo lwesisu (GI). Iimpawu zibandakanya ukuqhina kunye nokudumba emva kokutya. Uye waqala ke ukuba namava oko akuchazayo njenge-rainubrain fog, lack ukunqongophala koxinzelelo, kunye nemvakalelo ngokubanzi yokudinwa. Isigulana siqaphele ukuba xa izihlunu zibonakala zibi kakhulu, iimpawu zakhe ze-GI ziya zisiba mandundu ngokufanayo. Okwangoku, isigulana sizibeka kwi-GFD engqongqo; kwaye kwinyanga ezi-2, iimpawu zaqala ukunciphisa kodwa azange ziyeke ngokupheleleyo. Iimpawu ze-GI ziphuculwe, kodwa usafumana ukuqunjelwa. Ukutya kwesigulana kubandakanya ikakhulu inyama, iziqhamo, imifuno, ukutya okuziinkozo okungenagluten, amaqanda, kunye nobisi.
Ngeminyaka eyi-24, isigulana kwafunyaniswa ukuba sine-WA emva kokubona ugqirha waso. Uvavanyo lweSerum luveze ii-antibodies ze-IgE eziphakamileyo ezichasene nengqolowa, kwaye isigulana sicetyisiwe ukuba sibambelele kwi-GFD engqongqo. Isigulana siyavuma ukuba asiyilandeli i-GFD de ubukho bayo benyuka ngoDisemba 2011. NgoJulayi we-2012, umsebenzi wegazi wavavanywa ngokwamanqanaba e-creatine kinase, creatine kinase MB, kunye ne-lactate dehydrogenase ukuphanda ukubola kwemisipha okunokwenzeka. Onke amaxabiso ayephakathi kwemida eqhelekileyo. Ngo-Septemba ka-2012, isiguli saphinda saya kuvavanya ukutya okwahlukileyo kokutya (US Biotek, Seattle, WA). Amanqanaba omzimba we-IgG aphakanyisiweyo afunyenwe ngokuchasene nobisi lweenkomo, ivili, iqanda lenkukhu emhlophe, iqanda ledada elimhlophe, iqanda lenkukhu, iqanda leqanda, irhasi, ingqolowa yegliadin, ingqolowa yegluten, irye, isipele, kunye nengqolowa epheleleyo (1 Table) . Ngokunikwa iziphumo zephaneli yokutya, isigulana sicetyiswa ukuba sisuse olu luhlu lokutya ekutyeni. Kwiinyanga ezi-6 zokuthotyelwa kotshintsho kwindlela otya ngayo, isisombululo somzimba wesigulana sisonjululwe ngokupheleleyo. Isigulana siye safumana uxinzelelo lwe-GI oluncinci, ukudinwa, kunye nokusilela koxinzelelo.
ingxoxo
Ababhali abakwazanga kufumana naziphi na izifundo ezipapashiweyo ezinxulumene nenkcazo-ntetho efana nale ichazwe apha. Sikholelwa ukuba le yinkcazo ekhethekileyo yeprotheyini yengqolowa kwaye imele igalelo kumzimba wolwazi kule ntsimi.
Le meko ibonisa intsingiselo engavumelekanga yentsholongwane ye-sensorimotor neuropathy eyayibonakala iyaphendula kwiinguqu zokutya. Nangona le ntshumayelo iyahambelana ne-gluten neuropathy, ukuxilongwa kweCD kwakungaphenywanga. Ngenxa yokuba isigulane saba ne-GI kunye neempawu ze-neurologic, amathuba okuba i-gluten neuropathy liphezulu kakhulu.
Kukho iifom ze-3 zeprotheyini ye-proactivity. Ngenxa yokuba kwakukho ubungqina be-WA ne-GS, kwagqitywa ukuba ukuhlolwa kweCD kwakungadingekile. Unyango lwazo zonke iifom ze-3 zifana: GFD.
I-pathophysiology ye-gluten neuropathy yintloko efuna uphando oluthe gqolo. Abalobi abaninzi bayavuma ukuba kuqulethe indlela yokuzivikela nge-immunologic, mhlawumbi isiphumo esingaqondanga ngqo okanye esingathanga ngqo se-antitigliadin. I-9,10 Briani et al 11 ifumene iintsholongwane kunye ne-acidilcholine receptors kwi-6 yezigulane ze-70 ze-CD. U-Alaedini kunye ne-al12 bafumene i-6 yezigulane ze-27 ze-XNUMX kunye ne-alXNUMX kwaye zicebise ukuba ubukho balezi zifo ziza kudibaniswa ne-gluten neuropathy.
Kufuneka kwakhona kuqatshelwe ukuba zombini ubisi kunye namaqanda kubonisa iimpendulo eziphezulu kwipaneli yokukhathazeka kokutya. Emva kokuphonononga iincwadi, akukho zifundo eziza kubakho ukudibanisa ukutya kunye neentsholongwane ze-neuromuscular ezihambelana nezo zilapha apha. Ngako-ke, akunakwenzeka ukuba ukutya ngaphandle kwe gluten kwakuxanduva lwezinto ezixutywa ngamascle ezichazwe kulo mzekelo. Ezinye iimpawu ezichazwe (ukukhathala, inkohlakalo yengqondo, ukuxakeka kwe-GI) ngokuqinisekileyo kunokunxulumana naliphi na inani lokutya / ukukhathazeka kokutya.
Imida
Omnye umda kule meko kukusilela ekuqinisekiseni iCD. Zonke iimpawu kunye neempendulo kutshintsho lokutya zikhomba oku njengento enokwenzeka, kodwa asikwazi ukuqinisekisa olu xilongo. Kwakhona kunokwenzeka ukuba impendulo yempawu ayizange ibangelwa ngokuthe ngqo kutshintsho lokutya kodwa enye into engaziwayo. Uvakalelo lokutya ngaphandle kwegluten lubhaliwe, kubandakanywa neempendulo kubisi kunye namaqanda. Ezi mvakalelo zokutya zinokuba negalelo kwezinye iimpawu ezikhoyo kule meko. Njengoko kunjalo uhlobo lweengxelo zamatyala, ezi ziphumo azinakwenzeka ngokubanzi kwezinye izigulane ezineempawu ezifanayo.
Ukuqukumbela: Ukuqaqanjelwa kweMiscle
Le ngxelo ichaza ukuphucula kwimizimba engapheliyo, ukuxhaphazwa kwemisipha kunye neminye imiqondiso eyahlukeneyo kunye neenguqu zokutya. Kukho uxolo olunamandla ukuba le meko ibonisa enye i-gluten neuropathy, nangona ukuhlolwa kweCD ngokukodwa akuzange kwenziwe.
UBrian Anderson DC, CCN, MPHa,?, UAdam Pitsinger DCb
Ukuya kwiNtsholongwane, kwiYunivesithi yeSizwe yezeMpilo, uLombard, IL Uthando lwezilwanyana, ukuSebenza koBucala, i-Polaris, OH
Ukwamkela
Ingxelo yolu ngxelo ihanjiswe njengenzaliseko yenkalo yeemfuno zeDanga leNzululwazi kwi-Advanced Clinical Practice kwiLincoln College of Post-Professional, I-Graduate, neMfundo eqhubekayo kwiYunivesithi yeZiko lezeMpilo eNyuvesi.
Imithombo Yenkxaso kunye Neengxabano Zomdla
Akukho mithombo yenkxaso-mali okanye iimbambano zenzalo ezichazwe kulolu cwaningo.
Iingxelo:
1. Sapone A, Bai J, Ciacci C, et al. I-Spectrum ye-gluten
ukuphazamiseka: ukuvumelana malunga nomnyulo omtsha kunye nokwahlula.
BMC Med 2012; 10: 13.
2. UMatricardi PM, uBockelbrink A, Beyer K, et al. EziPrayimari
I-immunoglobulin yesi-2 Ukukhuthaza ukunyusa i-soy kunye nengqolowa
IsiGqeba soPhuculo lweZenzululwazi ezininzi. Iiklinikhi I-Expressergy
Ngo-2008; 38: 493-500.
3. UVerk KA, iKoehler KM, i-Fein SB, iDax Street. Ukwanda
Ukutya kokutya okuzimeleyo kubantu abadala baseMerika kunye nokusetyenziswa kokutya
iilebheli. J Iklinikhi yokunyanga i-Immunol 2007; 119: 1504-10.
4. DiGiacomo DV. Ubuninzi kunye nemimandla ye-non-celiac
Ubuninzi be-gluten eUnited States: iziphumo ezivela kuyo
Ucwaningo lweSizwe lwezeMpilo kunye neZondlo
2009-2010. Kuhanjiswa kwi: i-2012 American College
I-Gastroenterology yonyaka yeNzululwazi yeSayensi; Oktog. 19-24, Las
Vegas .; 2012.
5. Sapone A, uLammers KM, uCasolaro V. Ukuchithwa kwamanzi
ukugqithiswa kwempahla kunye ne-mucosal geni yegciwane lesibini kwiibini
Iimeko ezinxulumene ne-gluten: isifo se-celiac kunye nobutyebi buka gluten.
BMC Med 2011; 9: 23.
6. Rubio-Tapia A, uLudvigsson JF, Brantner TL, Murray JA,
Everhart JE. Ukuxhaphaka kwesifo se-celiac eUnited
Amazwe. NdinguJ Gastroenterol 2012 Okt; 107 (10): 1538-44.
7. Hadjivassiliou M, Grunewald RA, Davies-Jones GAB. Abanyolukile
uvakalelo njengengqondo yegazi. J Neurol Neurosurg
Ingqondo yengqondo 2002; 72: 560 3.
8. Hadjivassiliou M, i-Chattopadhyay A, i-Grunewald R, ne-al.
I-Myopathy ehambelana noveliso lwe-gluten. Umzimba weMisipha
Ngo-2007; 35: 443-50.
9. Cicarelli G, uDella Rocca G, u-Amboni C, et al. Iikliniki kunye
izifo ezingekho phantsi kweengxaki zesifo esiqhekezayo. Neurol Sci
Ngo-2003; 24: 311-7.
10. Hadjivassiliou M, Grunewald RA, Kandler RH. Neuropathy
ezinxulumene nobutyebi buka gluten. J Neurol Neurosurg
Ukunyangwa kwengqondo ngo-2006; 77: 1262-6.
11. UBriani C, uDoria A, Ruggero S, et al. Ama-antibodies kumascle kunye
i-ganglionic acetylcholine receptors kwisifo se-celiac. Ukuzimela
2008;41(1):100�4.
12. Alaedini A, iGreen PH, Sander HW, et al. I-Ganglioside
iintsholongwane ezithintekayo kwi-neuropathy ehambelana nesifo esiqhekezayo.
J Neuroimmunol 2002;127(1�2):145�8.
Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "Ukuphucula i-Muscle Fasciculation kunye neTshintsho lokutya: i-Gluten Neuropathy"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
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Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
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Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
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