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Iinnabinoids

Ikliniki yangasemva Cannabinoids. Izityalo ziyiyeza, kwaye njengoko uphando luqhubeka ngala mayeza ahlukeneyo, ulwazi oluninzi luyafumaneka xa kuziwa kwiinketho zonyango kwizifo ezahlukahlukeneyo, iimeko, izifo, ukuphazamiseka, njl ... Ugqirha weChiropractor uDkt Alex Jimenez uphanda kwaye uzisa ingqiqo kula mayeza aphuhlayo, njani banokunceda izigulana, oko banokukwenza, noko bangakwaziyo ukuzenza.

Isityalo sentsangu yindlela abaninzi abazi ngayo malunga ne-cannabinoids. Yeyona cannabinoid eyaziwayo tetrahydrocannabinol (THC), yiyiphi isakhi esenza iimvakalelo zomsindo.

Izazinzulu zichonge ii-cannabinoids kuphela kwi-cannabis. Nangona kunjalo, uphando olutsha lufumene ezi mpawu zonyango ezifanayo kwizityalo ezininzi, kubandakanya ipepile emnyama, i-broccoli, iminqathe, i-clove, i-echinacea kunye ne-ginseng.

Le mifuno okanye iziqholo aziyi kukufumana phezulu, kodwa ukuqonda ukuba ezi zityalo zahlukeneyo zichaphazela njani umzimba womntu kunokukhokelela ekufumaneni okubalulekileyo kwezempilo.


Ukujongwa nzulu kwiMetabolic Syndrome | El Paso, TX (2021)

Ukujongwa nzulu kwiMetabolic Syndrome | El Paso, TX (2021)

Kwi-podcast yanamhlanje, uDkt Alex Jimenez, umqeqeshi wezempilo uKenna Vaughn, umhleli oyintloko u-Astrid Ornelas uxoxe nge-syndrome ye-metabolic ukusuka kwinqanaba elihlukeneyo lokujonga kunye, i-nutraceuticals eyahlukileyo yokulwa nokuvuvukala.

 

UGqr. Alex Jimenez DC*: Namkelekile, madoda, namkelekile kwipodcast kaGqr. Jimenez kunye nabasebenzi. Sixoxa nge-metabolic syndrome yanamhlanje, kwaye siza kuxoxa ngayo ngokwembono eyahlukileyo. Siza kukunika iingcebiso ezibalaseleyo, eziluncedo ezinokuthi zibe nentsingiselo kwaye zinokwenzeka lula ekhaya. I-Metabolic syndrome yingcamango enkulu kakhulu. Iqulethe imiba emihlanu emikhulu. Ineswekile yegazi ephezulu, inomlinganiselo wamafutha esiswini, ine-triglycerides, inemiba ye-HDL, kwaye intle kakhulu ine-conglomeration ye-dynamics ekufuneka ilinganiswe kuso sonke isizathu sokuxoxa nge-metabolic syndrome kuba ichaphazela uluntu lwethu kakhulu. kakhulu. Ke, siza kuxoxa ngale miba kunye nendlela esinokuyilungisa ngayo. Kwaye kukunika ukukwazi ukulungelelanisa indlela yakho yokuphila ukuze ungagqibi ukuba nayo. Sesinye sezona ngxaki zibalulekileyo ezichaphazela amayeza anamhlanje, singasathethi ke xa sele siyiqondile. Naphi na apho uya khona, uya kubona abantu abaninzi abane-metabolic syndrome. Kwaye yinxalenye yoluntu, kwaye yinto oyibonayo eYurophu kakhulu. Kodwa eMelika, ngenxa yokuba sinokutya okuninzi kwaye iipleyiti zethu zihlala zikhulu, sinamandla okulungelelanisa imizimba yethu ngokwahlukileyo ngento esiyityayo. Akukho kuphazamiseka kuya kutshintsha ngokukhawuleza kwaye ngokukhawuleza njengendlela elungileyo kunye neprotocol elungileyo yokukunceda ngokuphazamiseka kwe-metabolic kunye nesifo se-metabolic. Ke sele siyithethile loo nto, namhlanje, sineqela labantu. Sino-Astrid Ornelas kunye noKenna Vaughn, abaya kuxoxa kwaye bongeze ulwazi lokusinceda kule nkqubo. Ngoku, uKenna Vaughn ngumqeqeshi wethu wezempilo. Nguye osebenza kwiofisi yethu; xa ndingugqirha osebenza kumayeza omzimba kwaye xa ndisebenza nabantu omnye komnye, sinabanye abantu abasebenza ngemiba yokutya kunye neemfuno zokutya. Iqela lam apha lihle kakhulu. Sikwanaye nomphandi wethu ophezulu wezonyango kunye nomntu onyanga uninzi lwetekhnoloji yethu kwaye usemda wento esiyenzayo kunye nesayensi yethu. NguNkskz. Ornelas. Nks. U-Ornelas okanye u-Astrid, njengoko simbiza njalo, u-ghetto enolwazi. Uba mbi ngesayensi. Kwaye ngenene, ngenene apho sikhoyo. Namhlanje, siphila kwihlabathi apho uphando luza kunye nokutshiza ngaphandle kwe-NCBI, eyona ndawo yokugcina okanye i-PubMed, apho abantu banokubona ukuba sisebenzise olu lwazi kwaye sisebenzisa oko kusebenzayo kunye nokuba yintoni na. Ayizizo zonke iinkcukacha ezichanekileyo kwi-PubMed kuba unemibono eyahlukileyo, kodwa iphantse yafana nomnwe kwi-pulse xa sinomnwe wethu. Siyazibona izinto eziwuchaphazelayo. Ngamagama athile angundoqo kunye nezilumkiso ezithile, siyaziswa ngotshintsho, masithi, imiba yeswekile yokutya okanye imiba ye-triglyceride enemiba yamafutha, nantoni na malunga nokuphazamiseka kwemetabolism. Singenza uhlobo lokuza neprothokholi yonyango eguqulelwe ngqo koogqirha kunye nabaphandi kunye neePhDs kwihlabathi jikelele phantse ngoko nangoko, ngokoqobo nangaphambi kokuba zipapashwe. Umzekelo, namhlanje kwenzeka ngoFebruwari 1st. Akunjalo, kodwa siya kuba sifumana iziphumo kunye nezifundo ezivezwe yiNational Journal of Cardiology eya kuphuma ngoMatshi ukuba iyavakala. Ke olo lwazi lushushu kwangoko kushicilelo, kwaye i-Astrid isinceda ukuba sicinge ezi zinto kwaye ibone, "Heyi, uyazi, sifumene into eshushu kakhulu kunye nento yokunceda izigulana zethu" kwaye izisa i-N ilingana nenye, enomonde- Ugqirha ulingana nomnye. Isigulana kunye nonyango olulinganayo esingenzi iiprothokholi ezithile kuye wonke umntu ngokubanzi. Senza iiprothokholi ezithile kumntu ngamnye njengoko siqhubeka nenkqubo. Ke njengoko sisenza oku, uhambo lokuqonda i-metabolic syndrome lunamandla kwaye lunzulu kakhulu. Sinokuqala ngokujonga nje umntu ukuya kumsebenzi wegazi, yonke indlela eya kwiinguqu zokutya, kwiinguqu zemetabolism, yonke indlela ukuya kutsho kumsebenzi weselula osebenza ngokukhutheleyo. Silinganisa imiba ngee-BIA kunye ne-BMI, esizenzileyo ngeepodcasts zangaphambili. Kodwa sinokungena kwinqanaba, i-genomics kunye nokuguqulwa kweechromosomes kunye ne-telomeres kwi-chromosomes, esinokuyichaphazela ngokutya kwethu. Kulungile. Zonke iindlela zikhokelela ekutyeni. Kwaye into endiyithethayo ngendlela engaqhelekanga, zonke iindlela zikhokelela kwi-smoothies, Kulungile, i-smoothies. Ngenxa yokuba xa sijonga i-smoothies, sijonga amacandelo e-smoothies kwaye size ne-dynamics enekhono lokutshintsha ngoku. Into endiyijongayo kuxa ndikhangela unyango, ndijonge izinto ezenza ubomi babantu bubengcono, singayenza njani loo nto? Kwaye kubo bonke abo mama, bayaqonda ukuba abanakuqaphela ukuba bayayenza le nto, kodwa umama akavuki esithi, Ndiza kunika umntwana wam ukutya. Hayi, wenza uhlobo lokuhlamba ingqondo ngokuzisa ikhitshi lonke kuba efuna ukufaka esona sondlo silungileyo kumntwana wabo kwaye abonelele ngeyona ndlela ilungileyo yokhetho kumntwana wabo ukuba ahambe kwihlabathi okanye kukhathalelo lwasemini okanye kwisikolo samabanga aphantsi, ukuya kwisikolo esiphakathi, ngesikolo samabanga aphakamileyo ukuze umntwana akhule kakuhle. Akukho mntu uphumayo ecinga ukuba ndiza kunika umntwana wam inkunkuma kunye. Kwaye ukuba kunjalo, kulungile, oko mhlawumbi asingomzali olungileyo. Kodwa asiyi kuthetha ngaloo nto kakuhle; siza kuthetha ngesondlo esifanelekileyo kunye nokulungelelanisa ezo zinto. Ke ndingathanda ukwazisa uKenna ngoku. Kwaye uzakube exoxa kancinci ngento esiyenzayo xa sibona umntu onengxaki yemetabolism kunye nendlela yethu kuyo. Ke njengoko edlula kuloo nto, uya kuba nakho ukuqonda indlela esivavanya ngayo kwaye sivavanye isigulana kwaye sisizise ukuze siqalise ukufumana ulawulo oluncinci lwaloo mntu.

 

Kenna Vaughn: Konke kulungile. Ke okokuqala, ndifuna ukuthetha malunga neesmoothies kancinci ngakumbi. Ndingumama, ngoko kusasa, izinto ziyaphambana. Awunakuze ube nexesha elininzi njengoko ucinga ukuba wenza, kodwa ufuna ezo zondlo zondlo kwaye ngokunjalo nabantwana bakho. Ngoko ndiyazithanda ii-smoothies. Bakhawuleza kakhulu. Ufumana yonke into oyifunayo. Kwaye abantu abaninzi bacinga ukuba xa usitya, utyela ukugcwalisa isisu sakho, kodwa utyela ukugcwalisa iiseli zakho. Iiseli zakho zizo ezidinga ezo zondlo. Yiloo nto ekuqhubayo ngamandla, i-metabolism, yonke loo nto. Ke ezo smoothies lukhetho olukhulu kakhulu, esilunika izigulane zethu. Side sibe nencwadi ene-150 yeendlela zokupheka ze-smoothie ezichasene nokuguga, ukunceda isifo seswekile, ukwehlisa i-cholesterol, ukulawula ukuvutha, kunye nezinto ezinjalo. Ke sisixhobo esinye esisinika izigulane zethu. Kodwa sinazo ezinye iindlela ezininzi zokukhetha izigulana eziza nesifo se-metabolic.

 

UGqr. Alex Jimenez DC*:  Ngaphambi kokuba ungene apho, Kenna. Mandongeze nje into endiyifundileyo kukuba kufuneka siyenze ilula. Kufuneka sithathe amakhaya okanye sithathe izinto zokuhamba. Kwaye into esizama ukuyenza kukuba sizama ukunika izixhobo ezinokukunceda kuloo nkqubo. Kwaye sizakusa ekhitshini. Siza kubamba ngendlebe, ngoko kuthetha, kwaye siza kukubonisa iindawo apho kufuneka sijonge khona. Ke uKenna sele eza kusinika ulwazi ngokwemigaqo ye-smoothies eya kusinceda ngotshintsho lokutya esinokuthi sinikeze iintsapho zethu kwaye sitshintshe intlekele ye-metabolic echaphazela abantu abaninzi ababizwa ngokuba yi-metabolic syndrome. Qhubeka.

 

Kenna Vaughn: Kulungile, njengoko wayethetha ngezo smoothies. Enye into omele uyifake kwi-smoothie yakho, into endiyithandayo ukuyongeza kwam sisipinatshi. Isipinatshi lolona khetho lubalaseleyo kuba sinika umzimba wakho izondlo ezininzi. Ufumana imifuno eyongezelelweyo, kodwa awukwazi ukuyingcamla, ngakumbi xa igqunywe bubumnandi bendalo obufumana kwiziqhamo. Ngoko ke lolona khetho lulungileyo xa kufikwa kwi-smoothies. Kodwa enye into awayeyikhankanya uGqr. Jiménez zezinye izinto zasekhitshini. Ke kukho ezinye izinto ezithatha indawo esifuna ukuba izigulana zethu zisebenzise kwaye ziphumeze. Ungaqala kancinci, kwaye iya kwenza umahluko omkhulu ngokutshintsha iioyile opheka ngazo. Kwaye uyakuqala ukubona ukuphucuka kumalungu akho, abantwana bakho, kwaye wonke umntu uya kuphucuka kakhulu. Ke into enye esifuna ukufumana izigulane zethu ukuba zisebenzise ezooyile, ezifana neoli ye-avocado, ioli yekhokhonathi, kunye ... Ioli yeoli? I-oyile ye-olivu. Ewe, enkosi, Astrid.

 

UGqr. Alex Jimenez DC*: Yayiyioli yomnquma leyo. YayinguAstrid ngasemva. Sifumana iinyani ngokugqwesileyo kwaye siqhubeke.

 

Kenna Vaughn: Xa utshintshela ngaphandle, umzimba wakho wophula izinto ngokwahlukileyo ngala mafutha angaxutywanga. Ke leyo yenye nje inketho onayo ekhitshini ngaphandle kokwenza ezo smoothies. Kodwa njengoko benditshilo ngaphambili, ndilungile ngokukhawuleza, kulula, kulula. Kulula kakhulu ukutshintsha indlela ophila ngayo xa uneqela elikungqongileyo. Kwaye xa kulula, awufuni. Awufuni ukuphuma kwaye wenze yonke into ibe nzima kakhulu kuba amathuba okuba ubambelele kuwo akaphezulu kakhulu. Ke into enye esifuna ukuyenza kukuqinisekisa ukuba yonke into esiyinika izigulana zethu kulula ukuyenza kwaye iyafikeleleka kubomi bemihla ngemihla.

 

UGqr. Alex Jimenez DC*: Ndibonakala kakhulu. Ngoko xa ndisiya ekhitshini, ndithanda ukwenza ikhitshi lam lifane ne-cocina okanye nantoni na abayibiza ngayo e-Italy, i-cucina kunye neebhotile ezintathu apho, kwaye ndine-avocado oil. Ndineoyile yekhokhonathi, kwaye ndineoyile yomnquma kanye apho. Kukho iibhotile ezinkulu apho. Benza ukuba bahle, kwaye bajonge iTuscan. Kwaye, uyazi, andikhathali nokuba liqanda, andikhathali. Ngamanye amaxesha, naxa ndisela ikofu, ndiye ndibambe ioli yekhokhonathi, ndiyigalele le ndizenzele i-java ngeoli yekhokhonathi. Ngoko, ewe, qhubeka.

 

Kenna Vaughn: Bendiza kuthi ukuba ukhetho olukhulu kakhulu. Ke ndisela iti eluhlaza, kwaye ndongeza ioyile yekhokhonathi kuloo tea eluhlaza ukunceda ukonyusa yonke into kwaye ndinike umzimba wam enye idosi yezo asidi ezinamafutha esizifunayo.

 

UGqr. Alex Jimenez DC*: Ndinombuzo kuwe xa unekofu yakho ngolo hlobo; xa unayo ioli kuyo, ngaba uhlobo lubricate imilebe yakho.

 

Kenna Vaughn: Yenza kancinci. Ngoko kukwafana ne-chapstick.

 

UGqr. Alex Jimenez DC*: Ewe, kuyenzeka. Kufana, oh, ndiyayithanda. Kulungile, qhubeka.

 

Kenna Vaughn: Ewe, kufuneka ndivuselele kancinci ngakumbi ukuze ndiqinisekise ukuba yonke into ihamba kakuhle. Ewe. Kwaye ke enye into ethetha nje ngento izigulane zethu ezinokuyenza xa kuziwa ekhaya, kukho iitoni zeenketho ezahlukeneyo ngokutya iintlanzi. Ukonyusa ukutya kwakho kweentlanzi kwiveki yonke, oko kuya kunceda. Kwaye ngenxa yokuba intlanzi ibonelela ngezinto ezininzi ezintle njenge-omegas, ndiyazi ukuba i-Astrid inolunye ulwazi malunga ne-omegas.

 

UGqr. Alex Jimenez DC*: Ndifumene umbuzo ngaphambi kokuba uAstrid angene apho. Uyazi, jonga, xa sithetha ngeecarbohydrates, abantu, ingaba yintoni icarbohydrates? Owu, abantu bathi iapile, ibhanana, iilekese, kunye nazo zonke iintlobo zezinto abantu abanokuzidla ngokukhupha iicarbohydrates okanye iiproteni. Inkukhu, inyama yenkomo, nantoni na abanokuyidla. Kodwa enye yezinto endiyifumeneyo ukuba abantu banexesha elinzima kukuba yintoni amafutha alungileyo? Ndifuna ezintlanu. Ndinike amafutha alishumi alungileyo ngesigidi seedola. Ndinike amafutha alishumi atyebileyo, anjengenyama, anjengenyama; Hayi, yile nto sithetha ngayo. Ngenxa yokuba into elula esiyisebenzisayo kwaye siya kongeza ngakumbi kuyo isihlobo esibi siya kuba yioli yeeavokhado. I-oyile ye-olivu. Ingaba yioyile yekhokhonathi? Singasebenzisa izinto ezifana neoyile yebhotolo, iintlobo ezahlukeneyo zemida, kwaye hayi imida, kodwa iintlobo zebhotolo ezivela, uyazi, iinkomo ezityiswe ingca. Ngokwesiseko sinokuphelelwa zikhrimu, uyazi, iikhrimu ezingezizo ezongezo, iikhrimu ezithe ngqo, ezo siphelelwe zizo, akunjalo? Ukukhawuleza ngokwenene. Ngoko kufana, yintoni enye inqatha, akunjalo? Kwaye ke siyayikhangela. Ke enye yeendlela ezilungileyo zokuyenza kukuba asizukuhlala sibeka i-creamer ngaphezulu okanye ibhotolo yethu ngaphezulu, nto leyo, ezinye iikofu abanazo, babeka ibhotolo kuyo kwaye bayidibanise, kwaye bayayenza. ukubetha okumnandi kwejava encinci. Kwaye wonke umntu uza nejinja yabo encinci kunye namafutha kunye nekofu yabo kwaye benza i-espresso evela ezulwini, akunjalo? Yintoni ke enye esinokuyenza?

 

Kenna Vaughn: Singakwazi, njengoko benditshilo, ukongeza ezo ntlanzi, eziya kunceda ukunika imizimba yethu ngaphezulu kwezo omega. Kwaye ke sinokwenza imifuno emfusa ngakumbi, kwaye ezo ziza kubonelela umzimba wakho ngee-antioxidants ezininzi. Ke olo lukhetho olulungileyo xa kufikwa kwivenkile yegrosari. Umthetho wesithupha endiwuthandayo kwaye ndawuva kwakudala kukuba ungathengi ezipasejini kukuzama ukuthenga emaphethelweni kuba emiphethweni kulapho uya kufumana khona yonke loo mveliso intsha kunye nazo zonke ezo nyama zibhityileyo. Kuxa uqala ukungena kwezo ndawo, kwaye kulapho uya kuqala khona ukufumana, uyazi, i-cereal, ezo carbohydrates ezimbi, ezo carbohydrates zilula ukuba ukutya kwaseMelika kuye kwathanda kodwa akuyomfuneko. IiOreos?

 

Kenna Vaughn: Ewe.

 

UGqr. Alex Jimenez DC*: Ipaseji yeelekese ukuba wonke umntwana uyazi. Kulungile, ewe. 

 

Kenna Vaughn: Ngoko ke enye ingongoma enkulu apho. Ke xa ungena e-ofisini yethu, ukuba unesifo se-metabolic syndrome okanye nantoni na nje ngokubanzi, senza izicwangciso zakho zibe zezomntu kakhulu kwaye sikunika iingcebiso ezininzi. Siyayimamela indlela ophila ngayo kuba into esebenzela omnye umntu isenokungasebenzi komnye. Ke siqinisekisa ukuba sikubonelela ngolwazi esaziyo ukuba uya kuphumelela kwaye unikezele ngemfundo kuba leyo yenye inxalenye enkulu yayo.

 

UGqr. Alex Jimenez DC*: Zonke iindlela zikhokelela ekhitshini, huh? Kunene? Ewe bayenza. KULUNGILE, ke masisondele ngokuchanekileyo kumanqatha kunye nezakhamzimba. Ndifuna ukukunika umbono wokuba loluphi uhlobo lwezondlo ezisifaneleyo kuba sifuna ukuyichitha le miba mihlanu ichaphazela isifo se-metabolic ebesixoxa ngayo. Ngoobani aba bahlanu? Masiqhubele phambili siziqalise. Yiswekile ephezulu, akunjalo?

 

Kenna Vaughn: I-glucose ephezulu yegazi, i-HDLs ephantsi, eya kuba yi-cholesterol efanelekileyo efunwa ngumntu wonke. Ewe. Kwaye kuya kuba uxinzelelo lwegazi oluphezulu, olungathathwa njengoluphezulu ukusuka kwinqanaba likagqirha, kodwa lithathwa njengeliphakamileyo. Ke leyo yenye into; sifuna ukuqinisekisa ukuba le yi-metabolic syndrome, ayisosifo semetabolism. Ke ukuba uya kugqirha kwaye uxinzelelo lwegazi lwakho luyi-130 ngaphezulu kwamashumi asibhozo anesihlanu, sisalathisi eso. Kodwa umboneleli wakho usenokungatsho ukuba uxinzelelo lwegazi lwakho luphezulu kakhulu. 

 

UGqr. Alex Jimenez DC*: Akukho nanye kwezi ziphazamiso apha ngokwazo ziimeko zonyango, kwaye, ngabanye, zizinto nje ezintle. Kodwa ukuba udibanisa zonke ezi zintlanu, une-metabolic syndrome kwaye uzive ngathi awulunganga kakhulu, akunjalo?

 

Astrid Ornelas: Yeah yeah.

 

Kenna Vaughn: Enye iya kuba bubunzima obugqithisileyo malunga nesisu kunye ne-triglycerides ephezulu.

 

UGqr. Alex Jimenez DC*: Kulula ukubona. Uyabona xa umntu enesisu esijingayo ngathi ngumthombo, akunjalo? Ke siyabona ukuba ungaya kuyo ngamanye amaxesha iindawo zokutyela zase-Italiya kwaye ubone umpheki omkhulu. Kwaye ngamanye amaxesha kufuneka ndikuxelele, ngamanye amaxesha, uyazi, sithethile noChef Boyardee wayengengomfo obhityileyo. Ndicinga ukuba uChef Boyardee, uyazi yintoni? Kwaye umfana wasePillsbury, akunjalo? Ewe, ibingekho mpilweni, akunjalo? Bobabini banengxaki ye-metabolic syndrome kwasekuqaleni. Ngoko kulula ukuyibona. Ke ezi zizinto esiza kucamngca ngazo. I-Astrid iya kudlula kwi-nutraceuticals, iivithamini, kunye nokunye ukutya esinokuthi siphucule izinto. Ke nantsi i-Astrid, kwaye nanku umlondolozi wethu wesayensi. Kodwa nantsi i-Astrid, qhubeka.

 

Astrid Ornelas: Ewe, ndicinga ngaphambi kokuba singene kwi-nutraceuticals, ndifuna ukwenza into ecacileyo. Njengokuba besithetha nge-metabolic syndrome. I-Metabolic syndrome ayisiyiyo, kwaye ndiyaqikelela ukuba sisifo okanye ingxaki yezempilo ngokwayo. I-Metabolic syndrome yingqokelela yeemeko ezinokonyusa umngcipheko wokuphuhlisa eminye imiba yezempilo efana nesifo seswekile, isifo sohlangothi, kunye nesifo sentliziyo. Ngenxa yokuba isifo se-metabolic asiyiyo, uyazi, ingxaki yezempilo ngokwayo, ngakumbi kweli qela, le ngqokelela yezinye iimeko, zezinye iingxaki ezinokukhula zibe yimicimbi yezempilo embi kakhulu. Ngenxa yaloo nyaniso, i-metabolic syndrome ayinazo iimpawu ezicacileyo ngokwayo. Kodwa ke, njengoko besithetha ngayo, izinto ezintlanu ezinobungozi zihle kakhulu ezi sixoxe ngazo: amanqatha amaninzi esinqeni, uxinzelelo lwegazi oluphezulu, iswekile yegazi ephezulu, i-triglycerides ephezulu, i-HDL ephantsi, kwaye ngokutsho kwabasebenzi bezempilo. Koogqirha kunye nabaphandi, uyazi ukuba une-metabolic syndrome ukuba unesithathu kwezi zintlanu zemingcipheko.

 

UGqr. Alex Jimenez DC*: Ewe. Ntathu. Ngoku, oko akuthethi ukuba ukuba unayo, uneempawu. Njengoko ndibona kwabonakala. Kodwa ndimele ndikuxelele kumava am xa umntu enezinto ezingaphezu kwesithathu okanye ezintathu. Baqala ukuziva bekrunekile. Abaziva kakuhle. Baziva ngathi, uyazi, ubomi abukho mnandi. Baneovaroli nje. Abajongi kakuhle. Ngoko ke andibazi, mhlawumbi. Kodwa intsapho yabo iyazi ukuba ababukeki kakuhle. Njengomama akabonakali kakuhle. Utata ukhangeleka elungile.

 

Astrid Ornelas: Yeah yeah. Kwaye i-metabolic syndrome, njengoko benditshilo, ayinazimpawu zibonakalayo. Kodwa uyazi, bendihamba nomnye wemiba yomngcipheko ngamafutha esinqeni, kwaye kulapho uya kubona abantu abanento oyibiza ngokuba yi-apile okanye umzimba omile okwepere, ngoko ke banamafutha angaphezulu kwesisu sabo. Kwaye nangona oko akujongwa njengophawu ngokobugcisa, yinto enokuthi; Ndicinga ukuba inokunika ingcamango oogqirha okanye abanye abaqeqeshi bezempilo ukuba lo mntu, uyazi, unesifo seswekile okanye unesifo seswekile. Kwaye, uyazi, banobunzima obugqithisileyo kunye nokutyeba. Banokuba nomngcipheko owongeziweyo we-metabolic syndrome kwaye ke ngoko baphuhlise, uyazi, ukuba ishiywe inganyangwanga, iphuhlisa eminye imiba yezempilo efana nesifo sentliziyo kunye nesifo sohlangothi. Ndiyaqikelela ukuba kuthiwe; emva koko siya kungena kwi-nutraceutical.

 

UGqr. Alex Jimenez DC*: Ndiyayithanda le, ndiyayithanda le. Sifumana izinto ezilungileyo, kwaye sifumana ulwazi oluthile.

 

Astrid Ornelas: Kwaye ndiyaqikelela ukuba sele kuthethiwe, siyakungena kwi-nutraceuticals. Uhlobo olunje, uKenna ebethetha ngantoni malunga nokuba yintoni i-takeaway? Uyazi, silapha sithetha ngale miba yezempilo, kwaye silapha sithetha nge-metabolic syndrome namhlanje. Kodwa yintoni i-takeway? Singabaxelela ntoni abantu? Yintoni abanokuyigodusa ngentetho yethu? Banokwenza ntoni ekhaya? Ke apha sine Nutraceuticals ezininzi, endizibhalileyo amanqaku amaninzi kwibhlog yethu kwaye ndajonga. 

 

UGqr. Alex Jimenez DC*:  Ucinga, Astrid? Ukuba ujonga amanqaku e-100 abhalwe e-El Paso, ubuncinci kwindawo yethu, onke aphethwe ngumntu. Ewe. Konke kulungile.

 

Astrid Ornelas: Ewe. Ke sinezondlo ezininzi apha eziphandiweyo. Abaphandi baye bafunda zonke ezi zifundo zophando kwaye bafumanisa ukuba banokunceda ngandlela-thile kwaye olunye uhlobo luphucule, uyazi, isifo se-metabolic syndrome kunye nezi zifo ezinxulumene nazo. Ngoko eyokuqala endifuna ukuyixubusha yivithamini B. Ngoko ke yintoni iivithamini B? Ezi zezo onokuthi uzifumane kunye. Ungazifumana evenkileni. Uya kubabona njengeevithamini ze-B eziyinkimbinkimbi. Uya kubona njengengqayi encinci, kwaye ke iza neevithamini ezininzi ze-B. Ngoku, kutheni ndivelisa iivithamini ze-B ze-metabolic syndrome? Ke esinye sezizathu ezinje ngabaphandi bafumanise ukuba enye yazo, ndiyaqikelela, enye yezizathu ze-metabolic syndrome inokuba luxinzelelo. Ke ngoku kuthethiweyo, kufuneka sibe neevithamini ze-B kuba xa sinoxinzelelo xa sinosuku olunzima emsebenzini xa sinomsebenzi, ndicinga ukuba uninzi uyazi, zininzi izinto ezicinezelayo ekhaya okanye nosapho, uvalo lwethu. Inkqubo iya kusebenzisa ezi vitamin B ukuxhasa umsebenzi wethu wemithambo-luvo. Ngoko xa sinoxinzelelo oluninzi, siya kusebenzisa la mavithamini, okwandisa uxinzelelo; Uyazi, umzimba wethu uya kuvelisa i-cortisol. Uyazi, osebenza umsebenzi. Kodwa sonke siyazi ukuba i-cortisol eninzi, uxinzelelo oluninzi lunako ngokwenene. Inokuba yingozi kuthi. Inokunyusa umngcipheko wethu wesifo senhliziyo.

 

UGqr. Alex Jimenez DC*: Uyazi, njengoko ndikhumbula xa sisenza oku, zonke iindlela zikhokelela ekhitshini malunga nokubuyisela ukutya emzimbeni wakho. Zonke iindlela zikhokelela kwi-mitochondria xa ifika kwindawo yokuphuka. Ihlabathi lemveliso yamandla e-ATP lijikelezwe kwaye lihlanganiswe ne-nicotinamide, i-NADH, i-HDP, i-ATPS, i-ADP. Zonke ezi zinto zinonxibelelwano kunye ne-vitamin B yazo zonke iintlobo. Ngoko ke iivithamin B zikwi-injini ye-injini yezinto ezisincedayo. Ngoko kuyavakala ukuba le nto yayiphezulu kwivithamini kunye neyona nto ibalulekileyo. Kwaye ke unezinye iziphelo apha kwiniacin. Yintoni i-niacin? Uqaphele ntoni apho?

 

Astrid Ornelas: Ewe, i-niacin yenye ivithamini B, uyazi, kukho iivithamini B ezininzi. Yiyo loo nto ndinayo apho phantsi kwesininzi kunye ne-niacin okanye ivithamin B3, njengoko isaziwa ngakumbi. Uninzi lwabaninzi lukrelekrele. Izifundo ezininzi zophando zifumene ukuba ukuthatha i-vitamin B3 kunokunceda ukunciphisa i-LDL okanye i-cholesterol embi, ukunceda ukunciphisa i-triglycerides, kunye nokwandisa i-HDL. Kwaye uphando oluninzi lufumene ukuba i-niacin, ngokukodwa i-vitamin B3, inokunceda ukwandisa i-HDL ngama-30 ekhulwini.

 

UGqr. Alex Jimenez DC*: Ingakholeleki. Xa ujonga i-NADP kunye ne-NADH, Ezi ziyi-N yi-niacin, i-nicotinamide. Ke kwikhompawundi ye-biochemical, i-niacin yileyo abantu abaziyo ukuba xa uyithatha ilungile okanye le bekufanele ukuba yiyo, ufumana le mvakalelo yokugungxula kwaye ikwenza ukuba uzonwaya lonke ilungu lomzimba wakho, kwaye iyavakala. kuhle xa ukrwempa kuba ikwenza uzive ngolo hlobo. Kunjalo, intle kakhulu. Kwaye oku kukhulu.

 

Astrid Ornelas: Ewe. Ewe, kwaye kwakhona, ndifuna nje ukugqamisa inqaku malunga nevithamini B. Iivithamini ze-B zibalulekile kuba zinokunceda ukuxhasa imetabolism yethu xa sisitya, uyazi, i-carbohydrates kunye namafutha, amafutha alungileyo, kunjalo, kunye neeprotheni. Xa umzimba uhamba kwinkqubo yemetabolism, uguqula ezi carbohydrates, amafutha kunye neprotheni. Iiprotheyini zijika zibe amandla, kwaye iivithamini ze-B ziyinxalenye ephambili yokulawula ukwenza oko.

 

UGqr. Alex Jimenez DC*: ILatinos, kubemi bethu ngokubanzi, siyazi ukuba besisoloko sisiva ngomongikazi okanye umntu onikezela ngenaliti yevithamin B. Ngoko naziva ngezo zinto. Kunene. Kuba udakumbile, ulusizi, bebeza kwenza ntoni? Ewe, uyazi ukuba yintoni enokubatofa nge-B12, akunjalo? Zeziphi iivithamini B, akunjalo? Kwaye umntu uya kuphuma ngathi, Ewe, kwaye baya kuba nemincili, akunjalo? Ke siyayazi le nto, kwaye le yi-elixir yexesha elidlulileyo. Abo bathengisi bahambahambayo, ababenezithako zokuthambisa kunye nezinto zokuthambisa, babephila ngokunika i-vitamin B complex. Iziselo zokuqala zamandla zaqala ukuyilwa nge-B complex, uyazi, ukupakishwa kwazo. Ngoku nantsi isivumelwano. Ngoku sifundile ukuba iziselo zamandla zibangela imiba emininzi, kangangokuba sibuyela kwii-B complex ukunceda abantu ngcono. Ke le vitamin ilandelayo sinayo yileya sinayo iD, sinevithamin D.

 

Astrid Ornelas: Ewe, enye elandelayo endifuna ukuthetha ngayo yi-vitamin D. Ngoko kukho izifundo ezininzi zophando malunga ne-vitamin D kunye neenzuzo, iinzuzo ze-vitamin D kwi-syndrome ye-metabolic syndrome, kunye nendlela endixoxe ngayo ukuba iivithamini ze-B ziluncedo njani kwimetabolism yethu. I-Vitamin D nayo iluncedo kwimetabolism yethu, kwaye inokunceda ukulawula iswekile yegazi, ngokukodwa i-glucose yethu. Kwaye oko kukodwa kubaluleke kakhulu kuba, njengenye yezinto ezibeka phambili kwi-metabolic syndrome, iswekile ephezulu yegazi. Kwaye uyazi, ukuba uneswekile ephezulu engalawulekiyo, inokukhokelela ekubeni, uyazi, kunokukhokelela kwi-prediabetes. Yaye ukuba oko kuyekwa kunganyangwa, kunokukhokelela kwisifo seswekile. Ke izifundo zophando zikwafumanise ukuba ivithamin D ngokwayo inokuphucula ukunganyangeki kwe-insulin, into entle kakhulu enokukhokelela kwisifo seswekile.

 

UGqr. Alex Jimenez DC*:  Uyazi, bendifuna nje ukukhupha ivithamin D ayikho nokuba yivithamin; yincindi yedlala. Yafunyanwa emva kweC nguLinus Pauling. Bakuba beyifumene, baqhubeka bechaza le leta ilandelayo. Kulungile, kuba iyihomoni, kufuneka uyijonge nje. Le vitamin D ethile okanye le hormone tocopherol. Ngokusisiseko inokutshintsha imiba emininzi yemetabolism emzimbeni wakho. Ndithetha ngenene ukuya kwamakhulu amahlanu eenkqubo ezahlukeneyo esizifumanayo. Kunyaka ophelileyo ibingama-400. Ngoku siphantse sibe ngama-500 ezinye iinkqubo zebhayomichiza ezichaphazeleka ngokuthe ngqo. Ewe, yenza uhlobo lwengqiqo. Jonga, elona lungu lethu libalulekileyo emzimbeni lulusu lwethu, kwaye ixesha elininzi, sasibaleka sijikeleza sinxibe iimpahla ezinqabileyo, kwaye sasiselangeni kakhulu. Ewe, asizange sicinge ukuba elo lungu lithile linokuvelisa amandla amaninzi okuphilisa, kwaye ivithamin D iyakwenza oko. Iveliswa kukukhanya kwelanga kwaye isebenze. Kodwa ihlabathi lanamhlanje, nokuba singama-Armenian, ama-Irani, iinkcubeko ezahlukeneyo zasemantla, njengeChicago, abantu abafumani kukhanya kangako. Ngoko kuxhomekeke kwiinguqu zenkcubeko kunye nabantu abavaliweyo abahlala kunye nokusebenza kwezi zibane ze-fluorescent, silahlekelwa ngundoqo we-vitamin D kwaye sigula kakhulu. Umntu othatha i-vitamin D unempilo kakhulu, kwaye injongo yethu kukuphakamisa i-vitamin D yi-vitamin e-fat-soluble kunye neyodwa ezifaka kuyo kwaye igcinwe esibindi kunye namafutha emzimbeni. Ngoko unokuwuphakamisa ngokucothayo njengoko uwuthatha, kwaye kunzima ukufumana amanqanaba anetyhefu, kodwa ezo zimalunga nekhulu elinamashumi amabini anesihlanu eenanogram ngedesilitha nganye ephezulu kakhulu. Kodwa uninzi lwethu lubaleka no-10 ukuya kuma-20, oluphantsi. Ke, ngokwenyani, ngokuphakamisa oko, uya kubona ukuba utshintsho lweswekile yegazi luyakwenzeka ukuba u-Astrid athetha ngalo. Zeziphi ezinye zezinto esiziqaphelayo, ngakumbi ivithamin D? Nantoni na?

 

Astrid Ornelas: Ndiyathetha, ndiza kubuyela kwi-vitamin D ngokukhawuleza; Ndifuna ukuxoxa ngezinye zezondlo zokuqala. KULUNGILE. Kodwa ivithamin D eninzi iluncedo kuba inceda ekuphuculeni imetabolism yakho, kwaye inceda ukuphucula ukunganyangeki kwakho kwe-insulin, ubuncinci kwi-metabolic syndrome.

 

UGqr. Alex Jimenez DC*: Kuthekani ngecalcium?

 

Astrid Ornelas: Ke i-calcium ihamba kunye ne-vitamin D, kwaye into ebendifuna ukuthetha ngayo kunye ne-vitamin D kunye ne-calcium kunye. Sihlala sicinga ngezi zinto zintlanu besikhe sazikhankanya ngaphambili ezinokubangela isifo se-metabolic syndrome. Sekunjalo, kukho, uyazi, ukuba ufuna ukucinga ngayo, njengokuba zeziphi izizathu ezisisiseko ezininzi zezi zinto zomngcipheko? Kwaye njengokuba, uyazi, ukutyeba, indlela yokuphila yokuhlala, abantu abangazibandakanyiyo kukuzivocavoca okanye ukwenza umthambo. Enye yezinto ezinokubeka umntu kwangaphambili okanye ukonyusa umngcipheko we-metabolic syndrome. Makhe ndibeke le scenario. Kuthekani ukuba umntu unesifo esibuhlungu esingapheliyo? Kuthekani ukuba banento efana ne-fibromyalgia? Bahlala besentlungwini. Abafuni kushukuma, ngoko abafuni ukwenza umthambo. Abafuni ukwenza mandundu ezi mpawu. Ngamanye amaxesha, abanye abantu baneentlungu ezingapheliyo okanye izinto ezifana ne-fibromyalgia. Masihambe kancinci kancinci esisiseko. Abanye abantu banentlungu engapheliyo emva, kwaye awufuni ukusebenza. Ngoko ke awukhethi njengabanye kwaba bantu abakhethi ukuba bangasebenzi kuba befuna. Abanye baba bantu babuhlungu ngokusemthethweni, kwaye kukho izifundo ezininzi zophando, kwaye yile nto ndiza kuyibopha kwi-vitamin D kunye ne-calcium kunye ne-vitamin D kunye ne-calcium. Uyazi, singakwazi ukubathatha kunye. Banokunceda ukuphucula intlungu engapheliyo kwabanye abantu.

 

UGqr. Alex Jimenez DC*: Ingakholeleki. Kwaye sonke siyazi ukuba i-calcium yenye yezizathu ze-muscle spasms kunye neziphumlisi. Iitoni zezizathu. Siza kungena kuyo nganye kwezi. Siza kuba ne-podcast kwi-vitamin D kunye nemiba ye-calcium kuba sinokungena nzulu. Siya kungena nzulu, kwaye siya kuhamba yonke indlela ukuya kwi-genome. I-genome yi-genomics, eyinzululwazi yokuqonda indlela isondlo kunye nofuzo oludansa kunye. Ke siya phaya, kodwa ngathi singena kancinci kule nkqubo kuba kufuneka silithathe kancinci ibali. Yintoni elandelayo?

 

Astrid Ornelas: Ke ngokulandelayo, sine-omega 3s, kwaye ndifuna ukuqaqambisa ngokukodwa ukuba sithetha nge-omega 3s kunye ne-EPA, hayi i-DHA. Ke ezi zi-EPA, yileyo idweliswe phaya phezulu, kunye neDHA. Zimbini iintlobo ezibalulekileyo ze-omega 3s. Ngokusisiseko, zombini zibaluleke kakhulu, kodwa izifundo ezininzi zophando kwaye ndiyenzile amanqaku kule nto kwaye ndifumanise ukuba ndiyaqikelela ukuthatha i-omega 3s ngokukodwa nge-EPA, ingaphezulu kwizibonelelo zayo kune-DHA. Kwaye xa sithetha nge-omega 3s, ezi zinokufumaneka kwiintlanzi. Amaxesha amaninzi, ufuna ukuthatha i-omega 3s; ubabona bekwimo ye fish oil. Kwaye oku kubuyela kwinto uKenna ebeyixoxile ngaphambili, njengokulandela ukutya kweMeditera, egxile kakhulu ekutyeni intlanzi eninzi. Kulapho ufumana khona ukutya kwakho kwe-omega 3s, kwaye izifundo zophando ziye zafumanisa ukuba i-omega 3s ngokwayo inokunceda ukukhuthaza impilo yentliziyo, kwaye inokunceda ukunciphisa i-cholesterol embi kwi-LDL yakho. Kwaye ezi zinokuphucula imetabolism yethu, njengevithamin D.

 

UGqr. Alex Jimenez DC*: Ufuna ukuqhubela phambili kwaye unxibe zonke ezi zinto phantsi kwento yokuba sikwajonge, kwaye xa sijongana nesifo se-metabolic syndrome, sijongana nokudumba. Ukudumba kunye ne-omegas ziyaziwa. Ke into ekufuneka siyenzile kukukhupha inyani yokuba ii-omega bezikwidayethi yaseMelika, nakukutya kukamakhulu. Kwaye ke, kwakhona, siva emva ngemini xa umakhulu okanye umakhulu kamakhulu wayekunika ioli yesibindi yecod. Ewe, eyona ntlanzi iphezulu ephethe i-omega yi-herring, emalunga ne-800 milligrams ngokuphakwayo. Ikhowudi ilandelayo xa ijikeleze 600. Kodwa ngenxa yokufumaneka, ikhadi lifumaneka kakhulu kwiinkcubeko ezithile. Ke wonke umntu uyakuba neoyile yesibindi, kwaye bakwenze ukuba uvale impumlo yakho kwaye uyisele, kwaye bayazi ukuba iyahambelana. Banokucinga ukuba sisithambiso esilungileyo. Sekunjalo, yayiyi-anti-inflammatory ngokukodwa kubantu, kwaye ngokuqhelekileyo, oogogo ababesazi malunga neli lungelo bancedisa amathumbu, kunceda ukuvutha, kunceda kumalungu. Babelazi lonke ibali emva koko. Ke sizakungena nzulu kwi-Omegas kwipodcast yethu yamva. Sinenye elapha. Ibizwa ngokuba yi-berberine, akunjalo? Lithini ibali kwiberberine?

 

Astrid Ornelas: Ewe, intle kakhulu iseti elandelayo ye-nutraceuticals edweliswe apha, i-berberine, i-glucosamine, i-chondroitin, i-acetyl L-carnitine, i-alpha-lipoic acid, i-ashwagandha, intle kakhulu zonke ezi zibotshelelwe kwinto endiyithethileyo malunga neentlungu ezingapheliyo kunye nazo zonke. kule miba yezempilo. Ndizidwelise apha phezulu kuba ndenze amanqaku amaninzi. Ndifunde izifundo zophando ezahlukeneyo ezithe zaqukumbela ezi kumalingo ahlukeneyo nakwizifundo zophando ezininzi kunye nabathathi-nxaxheba abaninzi. Kwaye ezi zifumene kakhulu, uyazi, eli qela lezondlo ezidweliswe apha; ezi nazo zibotshelelwe ekuncedeni ukunciphisa iintlungu ezingapheliyo. Uyazi, kwaye njengoko bendixoxile ngaphambili, njengeentlungu ezingapheliyo, uyazi, abantu abane-fibromyalgia okanye abathanda, uyazi, masihambe kancinci abantu abaneentlungu zomqolo, uyazi, aba bantu bangasebenziyo baphila ubomi obuhlala nje. ngenxa yeentlungu zabo kwaye banokuba sengozini ye-metabolic syndrome. Uninzi lwezi zifundo zophando zifumene ezi zondlo ngokwazo zinokunceda ukunciphisa intlungu engapheliyo.

 

UGqr. Alex Jimenez DC*: Ndicinga ukuba entsha ibizwa ngokuba yi-alpha-lipoic acid. Ndibona i-acetyl L-carnitine. Siza kuba ne-biochemist yethu yokuhlala kule podcast ilandelayo ukuba singene nzulu kwezi. I-Ashwagandha ligama elinomdla. Ashwagandha. Yitsho. Yiphinde. Kenna, ungandixelela kancinci malunga ne-ashwagandha kunye nento esiye sakwazi ukuyifumanisa nge-ashwagandha? Ngenxa yokuba ligama elikhethekileyo kunye necandelo esilijongayo, siya kuthetha ngalo ngakumbi. Siza kubuyela e-Astrid ngomzuzwana, kodwa ndiza kumnika ikhefu elincinci kunye nohlobo olunjalo, vumela uKenna andixelele i-ashwagandha.

 

Kenna Vaughn: Bendiza kongeza kwinto malunga naloo berberine.

 

UGqr. Alex Jimenez DC*: Owu, kulungile, masibuyele eberberine. Ezi zi-berberine kunye ne-ashwagandha.

 

Kenna Vaughn: Kulungile, ukuze i-berberine nayo ibonakaliswe ukunceda ukunciphisa i-HB A1C kwizigulana ezineshukela egazini, eziya kubuyela kuyo yonke i-prediabetes kwaye ichwetheze iimeko ezimbini zeswekile ezinokuthi zenzeke emzimbeni. Ke loo nto ikwabonisiwe ukuba yehlise elo nani ukuzinzisa iswekile yegazi.

 

UGqr. Alex Jimenez DC*:  Kukho into yonke esiza kuba nayo kwi-berberine. Kodwa enye yezinto esizenzileyo ngokwemeko ye-metabolic syndrome ngokuqinisekileyo yenze uluhlu oluphezulu apha kwinkqubo. Ke kukho i-ashwagandha kunye ne-berberine. Ke sixelele konke malunga ne-ashwagandha. Kwakhona, i-ashwagandha nguye. Ke ngokweswekile yegazi, i-A1C lubalo lweswekile yegazi ekuxelela kanye into eyenziwa siswekile segazi malunga neenyanga ezintathu. I-glycosylation ye-hemoglobin inokulinganiswa ngotshintsho lwemolekyuli olwenzeka ngaphakathi kwe-hemoglobin. Yiyo loo nto iHemoglobin A1C sisimaki sethu sokugqiba. Ngoko xa i-ashwagandha kunye ne-berberine zidibana kwaye zisebenzise ezo zinto, sinokuyitshintsha i-A1C, eluhlobo lweenyanga ezintathu olufana nemvelaphi yembali yento eyenzekayo. Silubonile utshintsho kuloo nto. Kwaye yenye yezinto esizenzayo ngoku malunga needosi kunye nento esiyenzayo. Siza kudlula oko, kodwa hayi namhlanje kuba inzima kancinci. Imicu enyibilikayo nayo ibe yinxalenye yezinto. Ke ngoku, xa sijongana neentsinga ezinyibilikayo, kutheni sithetha ngeentsinga ezinyibilikayo? Okokuqala, kukutya kwezinambuzane zethu, ngoko kufuneka sikhumbule ukuba ihlabathi le-probiotic yinto esingenakuyilibala. Abantu kufuneka baqonde ukuba, nangona kunjalo, ukuba i-probiotics, ingaba yi-Lactobacillus okanye i-Bifidobacterium strains, nokuba yithumbu elincinci, amathumbu amakhulu, ekuqaleni kwamathumbu amancinci, kukho iibhaktheriya ezahlukeneyo ukuya ekupheleni ukubona ukuza ekupheleni. Ngoko ke masiyibize loo ndawo apho izinto ziphuma khona. Kukho iibhaktheriya kuyo yonke indawo kumanqanaba ahlukeneyo, kwaye ngamnye unenjongo yokufumanisa oko. Kukho ivithamin E kunye neti eluhlaza. Ke ndixelele, Astrid, malunga nala mandla ngokumalunga neti eluhlaza. Yintoni esiyiqaphelayo ngokubhekisele kwi-metabolic syndrome?

 

Astrid Ornelas: KULUNGILE. Ke iti eluhlaza ineenzuzo ezininzi, uyazi? Kodwa, uyazi, abanye abantu abayithandi iti, kwaye abanye bathanda ikofu, uyazi? Kodwa ukuba ufuna ukungena ekuseleni iti, uyazi, ngokuqinisekileyo ngenxa yeenzuzo zayo zempilo. Iti eluhlaza yindawo ebalaseleyo yokuqala kwaye ngokwemigaqo ye-metabolic syndrome. Iti eluhlaza ibonakaliswe ukunceda ukuphucula impilo yentliziyo, kwaye inokunceda ukunciphisa le miba yengozi ephathelele kwi-metabolic syndrome. Inokukunceda, uyazi, izifundo ezininzi zophando eziye zafumanisa ukuba iti eluhlaza inokunceda i-cholesterol ephantsi, i-cholesterol embi, i-LDL.

 

UGqr. Alex Jimenez DC*: Ngaba iti eluhlaza isinceda ngamafutha ethu esisu?

 

Astrid Ornelas: Ewe. Kukho enye yeenzuzo zeti eluhlaza endiyifundileyo. Mhle kakhulu enye leyo mhlawumbi eyaziwa kakhulu kukuba iti eluhlaza inokunceda ukunciphisa umzimba.

 

UGqr. Alex Jimenez DC*: Oh Nkosi yam. Ngoko ke amanzi kunye neti eluhlaza. Nantso ke, bafo. Kuko konke. Sinciphisa ubomi bethu obukwanjalo, ndiyathetha ukuba, silibale neyona nto inamandla. Iyakhathalela ezo ROS, ezizintlobo zeoksijini ezisebenzayo, i-antioxidants yethu, okanye i-oxidants egazini lethu. Ke ngokusisiseko iyabacinezela kwaye ibakhuphe kwaye ipholise ipholile kwaye ithintele ukuwohloka okuqhelekileyo okwenzekayo okanye ukuwohloka okugqithileyo okwenzeka ekwaphuleni kwemetabolism eqhelekileyo, eyimveliso eyi-ROS, iintlobo zeoksijini ezisebenzayo zisendle, ziyaphambana. ii-oxidants, esinegama elicocekileyo lezinto ezizityumzayo kwaye zithomalalise kwaye zibeke ngolungelelwano olubizwa ngokuba zii-antioxidants. Ke iivithamini eziyi-antioxidants yi-A, E, kunye ne-C zi-antioxidants, nazo. Ke ezo zizixhobo ezinamandla esijongana nazo njengoko sithoba ubunzima bomzimba. Sikhulula ezininzi iityhefu. Kwaye njengokuba iti eluhlaza ingena kwi-squirt, i-squirt kubo, ipholise, kwaye ibakhuphe egiyeni. Qikelela ukuba liphi elinye ilungu elinceda kuyo yonke imveliso ye-insulin, ezizintso. Izintso zikhutshelwa ngaphandle ngeti eluhlaza kwaye zinceda kwakhona. Ndiqaphela ukuba into enye ongayenzanga, i-Astrid, yenziwe amanqaku kwi-turmeric, akunjalo?

 

Astrid Ornelas: Owu, ndenze amanqaku amaninzi malunga ne-turmeric. Ndiyazi kuba, kuluhlu oluphezulu, i-turmeric kunye ne-curcumin mhlawumbi zifana nenye yezondlo endizithandayo ukuthetha ngazo.

 

UGqr. Alex Jimenez DC*: Ewe, ufana nokukrazula ingcambu kunye namaxesha ambalwa.

 

Astrid Ornelas: Ewe, ndinazo efrijini ngoku.

 

UGqr. Alex Jimenez DC*: Ewe, uchukumisa loo turmeric, kwaye unokulahlekelwa ngumnwe. Kwenzeka ntoni ngomnwe wam? Ngaba usondele kwi-turmeric yam? Ingcambu, akunjalo? Ngoko. Ke sixelele kancinci malunga neempawu ze-turmeric kunye ne-curcumin ngokwemigaqo ye-metabolic syndrome.

 

Astrid Ornelas: KULUNGILE. Ndenze ezininzi, uyazi, amanqaku amaninzi malunga ne-turmeric kunye ne-curcumin. Kwaye siye saxoxa ngayo ngaphambili, kwaye uninzi lweepodcasts zethu zangaphambili kunye ne-turmeric kukuba yinto etyheli etyheli inokujongeka iorenji kwabanye abantu, kodwa ihlala ibizwa ngokuba yingcambu emthubi. Kwaye ithandwa kakhulu kwi-Indian cuisine. Yeyona nto sesinye sezithako eziphambili oza kuzifumana kwikhari. Kwaye i-curcumin, ngokuqinisekileyo abanye benu bantu bevile nge-curcumin okanye i-turmeric, uyazi? Yintoni umahluko? Ewe, i-turmeric sisityalo esineentyatyambo, kwaye yingcambu. Sidla ingcambu ye-turmeric, kwaye i-curcumin yinto nje esebenzayo kwi-turmeric enika umbala ophuzi.

 

UGqr. Alex Jimenez DC*: Guys, andiyi kuvumela nantoni na kodwa uhlobo oluphezulu lwe-curcumin kunye neemveliso ze-turmeric zifumaneke kwizigulane zabo kuba kukho umehluko. Ezinye ziveliswa ngokoqobo, ndithetha ukuba, sinezinyibilikisi, kwaye ngendlela esikhupha ngayo izinto kunye ne-curcumin kunye ne-turmeric okanye izinto ezinjenge-cocaine, kuya kufuneka usebenzise i-distillate. Kulungile? Kwaye nokuba ngamanzi, i-acetone, ibenzene, Kulungile, okanye uhlobo oluthile lwemveliso, siyazi namhlanje ukuba ibenzene isetyenziselwa ukucubungula iintlobo ezininzi zezongezelelo, kwaye iinkampani ezithile zisebenzisa ibenzene ukufumana eyona nto ingcono kwi-turmeric. Ingxaki yibenzene ivelisa umhlaza. Ke kufuneka silumke kakhulu ukuba zeziphi iinkampani esizisebenzisayo. I-acetone, khawufane ucinge loo nto. Ke kukho iinkqubo ezikhoyo zokukhupha i-turmeric ngokufanelekileyo kwaye ziluncedo. Ke ukufumana i-turmeric efanelekileyo, zonke ii-turmerics azifani. Kwaye yenye yezinto ekufuneka sizivavanye kuba zinemveliso ezininzi emhlabeni ziphambana ngokwenene ukuzama ukucubungula i-turmeric kwaye ngokuchanekileyo, nokuba yinto yokugqibela esiyixoxayo namhlanje kumbandela wethu. Kodwa yenye yezona zinto zibalulekileyo namhlanje. Asiyiqondi neaspirin. Siyazi ukuba iyasebenza, kodwa ubukhulu bayo bubonke buza kuchazwa. Nangona kunjalo, i-turmeric ikwisikhephe esifanayo. Sifunda kakhulu malunga nayo kangangokuba yonke imihla, nyanga zonke, kuveliswa izifundo ngexabiso le-turmeric kukutya kwendalo, ke i-Astris ikwithagethi ekujoliswe kuyo. Ke ndiqinisekile ukuba uza kuzisa ngaphezulu kwaloo nto kuthi, akunjalo?

 

Astrid Ornelas: Ewe kunjalo. 

 

UGqr. Alex Jimenez DC*: Ke ndicinga into esinokuyenza namhlanje kuxa sijonga oku, ndingathanda ukubuza uKenna, xa sijonga i-metabolic syndrome ukusuka kwimiboniso yeempawu okanye nakwizifundo zaselabhoratri. Ukuzithemba kokwazi ukuba i-N ilingana nenye lelinye lamacandelo abalulekileyo esinawo ngoku kunyango olusebenzayo kunye nezenzo zempilo ezisebenzayo ezenziwa ngoogqirha abaninzi bezonyango kumda wabo wokuziqhelanisa. Kuba kwimiba yemetabolism, awungekhe uyisuse emzimbeni. Ngaba i-metabolism iyenzeka kwingxaki yomqolo? Siphawula ukulungelelaniswa nokulimala kwangemva, iintlungu zangasemva, imiba yangasemva, ukuphazamiseka kwamadolo okungapheliyo, ukuphazamiseka okungapheliyo kwamalungu e-musculoskeletal, kunye nesifo se-metabolic syndrome. Ngoko asinakuhlekisa ngayo. Ke sixelele kancinci, Kenna, njengoko sivala namhlanje kancinci into enokulindela isigulana xa sifika eofisini yethu, kwaye bafumana uhlobo lokufakwa "Oops, une-metabolic syndrome." Ke boom, siyiphatha njani?

 

Kenna Vaughn: Sifuna ukwazi imvelaphi yabo kuba, njengoko ubutshilo, yonke into iqhagamshelene; yonke into inzulu. Kukho iinkcukacha esifuna ukuzazi zonke ukuze sikwazi ukwenza eso sicwangciso somntu ngamnye. Ke enye yezinto zokuqala esizenzayo luluhlu lwemibuzo olude kakhulu nguLiving Matrix, kwaye sisixhobo esihle kakhulu. Kuthatha ixesha elincinci, kodwa kusinika ukuqonda okuninzi kwisigulana, nto leyo intle kuba isivumela ukuba, njengoko benditshilo, sembe nzulu kwaye sifumanise, uyazi, iintlungu ezinokuthi zenzekile ezikhokelela ekudumbeni. , indlela awayeyithetha ngayo uAstrid emva koko ikhokelela kwindlela yokuphila yokuhlala, ekhokelela kwesi sifo se-metabolic syndrome okanye uhlobo nje lokuhla ngaloo ndlela. Ke into yokuqala esiyenzayo kukwenza loo khweshine inde, emva koko sihlale phantsi sithethe nawe enye kwenye. Sakha iqela kwaye sikwenza ube yinxalenye yosapho lwethu kuba le nto ayilulanga ukuhamba wedwa, ke eyona mpumelelo ininzi kuxa unosapho lusondeleleneyo, kwaye unaloo nkxaso, kwaye sizama ukuba njalo wena.

 

UGqr. Alex Jimenez DC*: Siluthathile olu lwazi kwaye saqonda ukuba lwaluntsonkothile kakhulu kwiminyaka emihlanu eyadlulayo. Kwakulucelomngeni. Ikhweshine enamaphepha angama-300. Namhlanje sinesoftware esinokuyifumanisa. Ixhaswa yi-IFM, iZiko loNyango oluSebenzayo. Iziko loNyango oluSebenzayo linemvelaphi yalo kule minyaka ilishumi idlulileyo kwaye liye laduma kakhulu, liqonda umntu ephela njengomntu. Awukwazi ukwahlula i-eyeball kuhlobo lomzimba njengoko awukwazi ukwahlula i-metabolism kuzo zonke iziphumo ezinazo. Nje ukuba loo mzimba kunye noko kutya, eso sondlo singena emzimbeni wethu. Kwelinye icala lomlomo wethu kukho ezi zinto zincinane zobunzima ezibizwa ngokuba ziichromosomes. Bayajikeleza, kwaye bayaxovula, kwaye benza ii-enzymes kunye neeprotheni ezisekelwe kwinto esizondla ngayo. Ukufumanisa ukuba kuqhubeka ntoni na, kufuneka senze uluhlu lwemibuzo olubanzi malunga nobumoya bomzimba wengqondo. Izisa ubuchwephesha bokwetyisa okuqhelekileyo, indlela esebenza ngayo ukubanjiswa, kunye nendlela amava okuphila ewonke eyenzeka ngayo emntwini. Ke xa sithathela ingqalelo uAstrid kunye noKenna kunye, sifumana eyona ndlela ilungileyo, kwaye sinenkqubo eyenzelwe umntu ngamnye. Siyibiza ngokuba yi-IFM enye, ezimbini, kunye nezintathu, imibuzo enzima evumela ukuba sikunike uvavanyo olucacileyo kunye nokuphazamiseka okuchanekileyo apho unobangela unokuba yintoni kunye ne-nutraceuticals izondlo zezondlo esigxininisa kuzo. Sikutyhalela kwicala elifanelekileyo kwindawo apho kubaluleke khona ekhitshini. Siphela sikufundisa wena kunye namalungu osapho lwakho indlela yokondla ukuze ulunge kwezo genomes zofuzo, onokuthi, njengoko ndihlala ndisitsho, i-ontogeny, i-recapitulate phylogeny. Singoobani na ukusuka kudala ukuya ebantwini, kwaye abo bantu banentambo phakathi kwethu nexesha lam elidlulileyo, kwaye wonke umntu olapha udlule. Leyo yimfuza yethu, kwaye imfuza yethu iyasabela kwimekobume. Ngoko ke nokuba iya emazantsi ngokukhawuleza okanye evezwe okanye echazwe kwangaphambili, siza kuxubusha ezo, kwaye siza kungena kwihlabathi le-genomics ngokukhawuleza kule nkqubo njengoko singena nzulu kwinkqubo ye-metabolic syndrome. Ngoko ndiyanibulela nonke ngokusiphulaphula kwaye nazi ukuba singaqhagamshelwa apha, kwaye bazokushiya inombolo. Kodwa sine-Astrid apha eyenza uphando. Sineqela elisekwe ngabantu abaninzi abanokukunika olona lwazi lulungileyo lusebenza kuwe; N ilingana nenye. SineKenna apha ehlala ikhona kwaye silapha sikhathalela abantu kwidolophu yethu entle yase-El Paso. Ke enkosi kwakhona, kwaye ujonge phambili kule podcast ilandelayo, eya kuba phakathi kweeyure ezimbalwa ezizayo. Ndiyadlala. Kulungile, hamba, bafo. 

Iinguqu zeBrain ezixhamle nokuPhepha okungapheliyo

Iinguqu zeBrain ezixhamle nokuPhepha okungapheliyo

Ubuhlungu buyindlela yomzimba womntu okwenzakalayo kwingozi okanye ukugula, kwaye ngokuqhelekileyo isilumkiso sokuba into engalunganga. Emva kokuba ingxaki iphilisiwe, ngokuqhelekileyo siyeke ukuhlangabezana nale mpawu ebuhlungu, nangona kunjalo, kwenzeka ntoni xa intlungu iqhubeka ixesha elide emva kokuba imbangela ihambe? Ubuhlungu obungapheliyo ichazwe ngokuchanekileyo njengentlungu eqhubekayo eyenza i3 kwiinyanga ze-6 okanye ngaphezulu. Ubuhlungu obungapheliyo kuyimeko enzima ukuhlala nayo, echaphazela yonke into ukusuka kumanqanaba omsebenzi ngamnye kunye nokukwazi kwabo ukusebenza kunye nobudlelwane babo kunye neemeko zengqondo. Kodwa, ngaba uyazi ukuba intlungu engapheliyo ingaphinda ifuthe kwisakhiwo kunye nomsebenzi wengqondo yakho? Kuye kwenzeka ukuba olu tshintsho lwengqondo lunokubangela ukuphazamiseka kwengqondo kunye nengqondo.

 

Ubuhlungu obungapheliyo abuchaphazeli nje indawo engumnye wengqondo, njengento enokubangela ukuba utshintsho kwiindawo ezininzi ezibalulekileyo zobuchopho, ezininzi zazo zibandakanya kwiinkqubo ezininzi nemisebenzi. Uphando oluthile lophando malunga neminyaka luye lwafumana utshintsho kwi-hippocampus, kunye nokunciphisa imbobo egciniweyo kwi-cortex, i-amygdala, i-brainstem kunye ne-cortex efanelekileyo, ukubiza abantu abambalwa, abanxulumene nobuhlungu obungapheliyo. Ukuphazamiseka kwezimbalwa zesakhiwo kule mimandla kunye nemisebenzi enxulumene nayo kunokunceda ukubeka loo ngqondo inguqu kumxholo, ngenxa yabantu abaninzi abaneentlungu ezingapheliyo. Injongo yale nqaku ilandelayo kukubonisa kunye nokuxubusha iinguqu zengqondo kunye nezomsebenzi ezinxulumene nentlungu engapheliyo, ingakumbi kwimeko apho kubonakala ukuba akukho monakalo okanye i-atrophy.

 

Ubunzima boBunjine Utshintsho olusisigxina Ukucamngca Mhlawumbi akukho Monakalo okanye i-Atrophy

 

Abstract

 

Iintlungu ezingapheliyo zibonakala zinxulunyaniswa nokuncitshiswa kwengqondo engwevu kwindawo ezinokuhanjiswa kwentlungu. Inkqubo ye morphological exhasa olu tshintsho lolwakhiwo, mhlawumbi kulandela ukuhlengahlengiswa kokusebenza kunye neplastikhi esembindini kwingqondo, zihlala zingacacanga. Intlungu kwi-hip osteoarthritis yenye yeempawu zentlungu ezinganyangekiyo ezinganyangekiyo ngokuyintloko. Siphande izigulana ezingama-20 ezineentlungu ezingapheliyo ngenxa ye-coxarthrosis engabandakanyekanga (iminyaka yobudala engama-63.25 9.46 (SD), iminyaka eli-10 yabasetyhini) ngaphambi kotyando oludibeneyo lwe-hip (imeko yeentlungu) kunye nokujonga imeko yotshintsho lobuchopho ukuya kunyaka omnye emva kotyando: iiveki ezi-1 6 , Iiveki ezili-8-12 kunye neenyanga ezili-18 10 xa kungekho ntlungu kwaphela. Izigulana ezineentlungu ezinganyangekiyo ngenxa ye-coxarthrosis ye-unilateral yayinemicimbi engwevu kangako xa kuthelekiswa nolawulo lwe-cortex yangaphakathi (i-ACC), i-insular cortex kunye ne-operculum, i-dorsolateral preortal cortex (DLPFC) kunye ne-orbitofrontal cortex. Le mimandla isebenza njengezinto zokudibanisa ezininzi ngexesha lamava kunye nolindelo lwentlungu. Xa abaguli babekhululekile kwintlungu emva kokuchacha kuqhaqho lwe-endoprosthetic, inyani engwevu inyuka phantse kwiindawo ezifanayo. Sikwafumene ukonyuka okuqhubekekayo kwento engwevu yengqondo kwindawo yecortex yangaphambi kwendawo kunye nendawo eyongezelelweyo yemoto (SMA). Siphetha ngelithi ukungaqheleki komba ongwevu kwintlungu engapheliyo ayingonobangela, kodwa kwesibini kwesi sifo kwaye ubuncinci kwinxalenye ngenxa yotshintsho kwimoto kunye nokudityaniswa komzimba.

 

intshayelelo

 

Ubungqina bokuhlengahlengiswa okusebenzayo kunye nolwakhiwo kwizigulana ezinganyangekiyo ezixhasa uluvo lokuba iintlungu ezingapheliyo akufuneki zichazwe kuphela njengombuso osebenzayo, kodwa nanjengesiphumo seplastikhi yokusebenza kwengqondo kunye nolwakhiwo [1], [2], [3], [4], [5], [6]. Kule minyaka mithandathu idlulileyo, kupapashwe izifundo ezingaphezu kwe-20 ezibonisa utshintsho lobume bengqondo kwii-syndromes ezili-14 zentlungu engapheliyo. Inqaku elothusayo lazo zonke ezi zifundo kukuba utshintsho lwezinto ezingwevu aluzange luhanjiswe ngokungacwangciswanga, kodwa lwenzeka kwiindawo ezichaziweyo nezisebenza ngokukodwa zobuchwephesha - oko kukuthi, ukubandakanyeka ekusebenzeni kwenkqubo ye-supraspinal nociceptive. Iziphumo ezigqwesileyo zifunyenwe zihlukeneyo kwiintlungu zesifo ngasinye, kodwa zigqitywe kwi-cingate cortex, i-orbitofrontal cortex, i-insula kunye ne-dorsal pons [4]. Olunye ulwakhiwo lubandakanya i-thalamus, i-dorsolateral preortal cortex, indawo ye-basal ganglia kunye nehippocampal. Ezi ziphumo zihlala zixoxwa njenge-atrophy yeselula, eqinisa umbono wokonakala okanye ukulahleka kwengqondo engwevu yengqondo [7], [8], [9]. Ngapha koko, abaphandi bafumanise unxibelelwano phakathi kwengqondo engwevu iyancipha kunye nobude beentlungu [6], [10]. Kodwa ubude beentlungu bunxulunyaniswa nobudala besigulana, kunye nobudala obuxhomekeke kubudala behlabathi, kodwa nakwindawo ethile ukwehla kwezinto ezingwevu kubhalwe kakuhle [11]. Kwelinye icala, olu tshintsho lolwakhiwo lunokuba nokuhla kobungakanani beseli, ulwelo lwangaphandle, isynaptogenesis, angiogenesis okanye nangenxa yotshintsho lwevolumu yegazi [4], [12], [13]. Nokuba uyintoni na umthombo, kutoliko lwethu lweziphumo kubalulekile ukubona ezi zinto zifunyanisiweyo morphometric ekukhanyeni kobutyebi bezifundo ze-morphometric kwiiplastiki ezixhomekeke ekusebenzeni, ngenxa yokuba utshintsho oluthile lobume bengingqi lubonakaliswe kaninzi kulandela ukuzilolonga nokuzilolonga [ 14].

 

Akuqondwa ukuba kutheni inani elincinci labantu liphuhlisa isifo esinganyangekiyo, kuthathelwa ingqalelo ukuba iintlungu ngamava endalo iphela. Umbuzo uphakama ukuba ngaba abanye abantu umahluko wolwakhiwo kwiinkqubo zangaphakathi zokudlulisa iintlungu zinokusebenza njenge-diathesis yentlungu engapheliyo. Utshintsho lwento engwevu kwintlungu ye-phantom ngenxa yokunqunyulwa [15] kunye nokulimala kwentambo yomqolo [3] kubonisa ukuba utshintsho lwe-morphological yengqondo, ubuncinci ngokuyinxalenye, sisiphumo sobuhlungu obungapheliyo. Nangona kunjalo, iintlungu kwi-hip osteoarthritis (OA) sesinye sezifo zentlungu ezinganyangekiyo ezinganyangekiyo, njengoko i-88% yezi zigulana zihlala zikhululekile kwintlungu kulandela utyando lwe-hip olupheleleyo (THR) [16]. Kwisifundo somqhubi wenqwelomoya siye sahlalutya izigulana ezilishumi ezine-hip OA ngaphambi nasemva nje kotyando. Sifumene ukuncipha kwento engwevu kwi-cortex yangaphakathi ye-cingulated (ACC) kunye ne-insula ngexesha leentlungu ezingapheliyo ngaphambi kotyando lwe-THR kwaye safumana ukwanda kwezinto ezingwevu kwiindawo ezihambelana nengqondo kwimeko yentlungu emva kotyando [17]. Ukugxila kwesi siphumo, ngoku sizandisile izifundo zethu siphanda abaguli abaninzi (n? =? 20) emva kokuphumelela kwe-THR kunye nokujonga ubume bengqondo kulwakhiwo kumatyeli amane amaxesha, ukuya kunyaka omnye emva kotyando. Ukulawula utshintsho kwimicimbi engwevu ngenxa yokuphuculwa kweemoto okanye uxinzelelo sikwalawula amaphepha emibuzo ejolise ekuphuculeni ukusebenza kweemoto nakwimpilo yengqondo.

 

Impahla nenkqubo

 

Amavolontiya

 

Izigulana ezichazwe apha liqela elincinci lezigulana ezingama-20 kwizigulana ezingama-32 ezipapashwe kutshanje ezazithelekiswa neqela elilawulayo elisempilweni- kunye nesini [17] kodwa bathatha inxaxheba kuphando olulandelayo lonyaka. Emva kotyando abaguli abali-12 baphuma ngenxa yoqhaqho lwesibini lwe-endoprosthetic (n? =? 2), isifo esibi (n? =? 2) kunye nokurhoxa kwemvume (n? =? 8). Oku kushiye iqela lezigulana ezingamashumi amabini ezine-unilateral primary hip OA (iminyaka yobudala engama-63.25 9.46 (SD), i-10 yabasetyhini) ebiphandwe izihlandlo ezine: ngaphambi kotyando (imeko yeentlungu) kwaye kwakhona i-6 8 kunye ne-12-18 iiveki kunye ne-10 14 iinyanga emva kotyando lwe-endoprosthetic, xa kungekho ntlungu kwaphela. Zonke izigulana ezine-OA ephambili ye-hip zinembali yentlungu engaphezulu kweenyanga ezili-12, ukusuka kwi-1 ukuya kwi-33 iminyaka (kuthetha iminyaka eyi-7.35) kunye nenqaku leentlungu ezingama-65.5 (ukusukela kwi-40 ukuya kwi-90) kwisikali se-analogue (VAS) esivela 0 (akukho ntlungu) ukuya kwi-100 (eyona ntlungu inokwenzeka). Sivavanye nakuphi na ukwenzeka kweziganeko zentlungu encinci, kubandakanya izinyo-, indlebe- kunye nentloko ukuya kuthi ga kwiiveki ezi-4 ngaphambi kophononongo. Siphinde sakhetha ngokungacwangciswanga idatha kwi-20 yesini- kunye nobudala obuhambelana nolawulo olusempilweni (iminyaka yobudala engama-60,95 8,52 (SD), iminyaka eli-10 yabasetyhini) yama-32 kwesi sifundo sichazwe ngentla [17]. Akukho namnye kwizigulana ezingama-20 okanye i-20 yesini- kunye nobudala ehambelana namavolontiya asempilweni ayenayo nayiphi na imbali yezonyango okanye yangaphakathi. Isifundo sanikwa imvume yokuziphatha ngekomiti yeenqobo ezisesikweni kwaye imvume ebhaliweyo enolwazi yafunyanwa kubo bonke abathathi-nxaxheba ngaphambi koviwo.

 

Idatha yokuziphatha

 

Siqokelele idatha yoxinzelelo, ukomelela komzimba, unxunguphalo, iintlungu kunye nempilo yomzimba kunye nengqondo kuzo zonke izigulana kwaye onke amanqaku asine usebenzisa le mibuzo ilandelayo: I-Beck Depression Inventory (BDI) [18], Uluhlu olufutshane lweMpawu (BSI) [19], ISchmerzempfindungs-Skala (SES? =? Isikali sokungonwabi kwentlungu) [20] kunye noPhando lwezeMpilo i-36-Item yeFom emfutshane (SF-36) [21] kunye neProfayile yezeMpilo yeNottingham (NHP). Senze amanyathelo aphindaphindiweyo i-ANOVA kunye ne-t-test ta-tired ezimbini zokuhlalutya idatha yokuziphatha ye-longitudinal usebenzisa i-SPSS 13.0 yeWindows (SPSS Inc., Chicago, IL), kwaye sasebenzisa ukulungiswa kweGreenhouse Geisser ukuba ingcinga yokuba isiphithiphithi siphuliwe. Inqanaba lokubaluleka lisetelwe p <0.05.

 

I-VBM - Idatha yokuFumana

 

Ukufumana umfanekiso. Isisombululo esiphakamileyo se-MR senziwa kwinkqubo ye-3T MRI (i-Nokia Trio) ene-coil yentloko ye-12. Ngexesha ngalinye lamanqaku amane, skena mna (phakathi kosuku olu-1 kunye nenyanga ezi-3 ngaphambi kotyando lwe-endoprosthetic), scan II (kwiiveki ezi-6 ukuya kwezi-8 emva kotyando), skena III (kwiiveki ezili-12 ukuya kwezi-18 emva kotyando) kunye nokuskena i-IV (10-14 iinyanga emva koqhaqho), i-T1 enesisindo se-MRI yafunyanwa kwisigulana ngasinye kusetyenziswa ulandelelwano lwe-3D-FLASH (TR 15 ms, TE 4.9 ms, flip angle 25 , 1 mm slices, FOV 256V256, voxel size 1 1 1 mm).

 

UkuPhathwa kweZithombe kunye noHlolo lokuShwankathela

 

Ukulungiselela kwangaphambili kwedatha kunye nohlalutyo lwenziwa nge-SPM2 (iSebe le-Wellcome leCognitive Neurology, eLondon, e-UK) eqhuba phantsi kweMatlab (Mathworks, Sherborn, MA, USA) kwaye iqulethe i-voxel-based morphometry (VBM) -bhokisi yebhokisi yedatha ende, isekwe kwisisombululo esiphakamileyo semifanekiso ye-MR ye-3D kwaye ivumela ukusetyenziswa kwezibalo ze-voxel-wise ukubona ukungafani kwengingqi kubuninzi bezinto ezingwevu okanye imiqulu [22], [23]. Isishwankathelo, ukwenziwa kwangaphambili kokubandakanya ukubekwa kwindawo yesiqhelo, ukwahlulwa kwezinto ezingwevu kunye ne-10 mm yokuthanjiswa kwendawo ene-kernel yaseGaussian. Kumanyathelo okuphambi kokulungiswa, sisebenzise umthetho olungiselelwe [22], [23] kunye neskena- kunye nesifundo sokujonga grey template [17]. Sisebenzise i-SPM2 kune-SPM5 okanye i-SPM8 ukwenza olu hlalutyo luthelekiswe nesifundo sethu somqhubi [17]. njengoko ivumela ukuqhelaniswa okuhle kunye nokwahlulahlulwa kwedatha ende. Nangona kunjalo, njengohlaziyo lwamva nje lwe-VBM (VBM8) ifumaneke kutshanje (dbm.neuro.uni-jena.de/vbm/Sisebenzise iVBM8.

 

Uhlalutyo lweCandelo

 

Sisebenzise iisampulu ezimbini t-kuvavanywa ukuze kufunyanwe umahluko wengingqi kwimiba engwevu yengqondo phakathi kwamaqela (abaguli ngexesha lokuvavanywa kwe-I (iintlungu ezingapheliyo) kunye nolawulo olusempilweni). Sisebenzise umda we-p <0.001 (engachanekanga) kuyo yonke ingqondo ngenxa yokuba sinamandla e-hypothesis, esekwe kwizifundo ezizimeleyo ze-9 kunye namaqela abonisa ukwehla kwento engwevu kwizigulana ezingapheliyo [7], [8], [ 9], [15], [24], [25], [26], [27], [28], ukuba ukunyuka kwezinto ezingwevu kuya kuvela kwindawo enye (yokulungisa iintlungu ezifanelekileyo) njengakwisifundo sethu sokuqhuba (17 ). Amaqela afanelwe ubudala kunye nesondo kungekho mahluko ubalulekileyo phakathi kwamaqela. Ukuphanda ukuba ngaba umahluko phakathi kwamaqela utshintshile emva konyaka omnye, sikwathelekisa abaguli ngexesha lokuvavanywa kwe-IV (iintlungu ezikhululekileyo, ukulandelelwa konyaka omnye) kwiqela lethu lolawulo olusempilweni.

 

Uhlalutyo olude

 

Ukufumana umohluko phakathi kwamanqaku exesha (Skena I IV) sithelekise iskena ngaphambi kotyando (imeko yeentlungu) kwaye kwakhona iiveki ezi-6 kunye ne-8-12 kunye neenyanga ezili-18 ukuya ku-10 emva kotyando lwe-endoprosthetic (iintlungu ezikhululekileyo) njengenyathelo eliphindiweyo le-ANOVA. Ngenxa yokuba naluphi na utshintsho lobuchopho ngenxa yeentlungu ezingapheliyo lunokudinga ixesha lokuyeka ukusebenza kunye nokupheliswa kwentlungu kwaye ngenxa yentlungu emva kotyando oluchazwe zizigulana, sithelekise kuhlalutyo olude lwe-I kunye no-II ngovavanyo lwe-III no-IV. Ukufumanisa utshintsho olungahambelani ngokusondeleyo nentlungu, sikwajonga utshintsho oluqhubela phambili ngalo lonke ixesha lokuhamba. Sitshintshile iingqondo zezigulana ezine-OA zethambo lasekhohlo (n? =? 14) ukulungiselela imeko yesiqhelo kwicala leentlungu kubo bobabini, ukuthelekiswa kweqela kunye nohlalutyo olude, kodwa ikakhulu kuhlalutywa idatha engafakwanga. Sisebenzise inqaku le-BDI njenge-covariate kwimodeli.

 

iziphumo

 

Idatha yokuziphatha

 

Zonke izigulana zixele iintlungu ezingapheliyo ngaphambi kotyando kwaye zazingenazintlungu (ngokubhekisele kwintlungu engapheliyo) kwangoko emva kotyando, kodwa zaxela iintlungu zasemva koqhaqho kwi-scan II eyahlukileyo kwintlungu ngenxa ye-osteoarthritis. Inqaku lempilo yengqondo le-SF-36 (F (1.925 / 17.322)? =? 0.352, p? =? 0.7) kunye nenqaku le-BSI lehlabathi GSI (F (1.706 / 27.302)? =? 3.189, p? =? 0.064 ) khange abonise lutshintsho kwikhosi yexesha kwaye akukho buhlungu bokuziphatha ngengqondo. Akukho nanye kulawulo oluchaze nayiphi na intlungu ebuhlungu okanye engapheliyo kwaye akukho namnye ubonakalise naziphi na iimpawu zoxinzelelo okanye ukukhubazeka emzimbeni / engqondweni.

 

Phambi kotyando, ezinye izigulana zabonisa ukudakumba okuphakathi ukuya kumodareyitha amanqaku e-BDI anciphise kakhulu kwiskena III (t (17)? =? 2.317, p? =? 0.033) kunye ne-IV (t (16)? =? 2.132, p? =? 0.049). Ukongeza, amanqaku e-SES (iintlungu ezingathandekiyo) zazo zonke izigulana ziphuculwe kakhulu ukuskena mna (ngaphambi kotyando) ukuskena II (t (16)? =? 4.676, p <0.001), scan III (t (14)? =? 4.760, p <0.001) kunye nokuskena i-IV (t (14)? =? 4.981, p <0.001, 1 unyaka emva kotyando) njengentlungu yokungathandeki yehle ngoxinzelelo lwentlungu. Ukulinganiswa kwentlungu kwiskena 1 kunye no-2 kwakulungile, ukulinganiswa okufanayo ngosuku lwe-3 nolwe-4 olubi. I-SES ichaza kuphela umgangatho wentlungu ebonwayo. Kwakunjalo ke ngomhla we-1 kunye no-2 (kuthetha ukuba ngu-19.6 ngosuku lwe-1 kunye ne-13.5 ngosuku lwe-2) kunye nokungalunganga (na) ngomhla we-3 & 4. Nangona kunjalo, ezinye izigulana zazingayiqondi le nkqubo kwaye zisebenzisa i-SES njengobulungisa behlabathi yomlinganiselo wobomi. Kungenxa yoko le nto zonke izigulana zacelwa ngemini enye ngokwahlukeneyo nangomntu ofanayo ngokubhekisele kwintlungu.

 

Kwifomu emfutshane yophando lwezempilo (i-SF-36), equka amanyathelo okushwankathela amaNqaku eMpilo eMzimbeni kunye neNqaku lezeMpilo yeNgqondo [29], abaguli baphuculwe kakhulu kumanqaku eMpilo yezeMpilo ukuskena I ukuskena II (t ( 17)? = ?? 4.266, p? =? 0.001), skena III (t (16)? = ?? 8.584, p <0.001) kunye no-IV (t (12)? = ?? 7.148, p <0.001), kodwa hayi kuManqaku eMpilo yeNgqondo. Iziphumo ze-NHP zazifana, kwi-subscale pain (reversible polarity) sabona utshintsho olukhulu kwiskena I ukuskena II (t (14)? = ?? 5.674, p <0.001, scan III (t (12) )? = ?? 7.040, p <0.001 kunye nokuskena IV (t (10)? = ?? 3.258, p? =? 0.009) Sikwafumene ukonyuka okubonakalayo kwi-subscale physical mobility ukusuka kwiskena I ukuskena III (t (12)? = ?? 3.974, p? =? 0.002) kunye nokuskena i-IV (t (10)? = ?? 2.511, p? =? 0.031) Kwakungekho lutshintsho lubalulekileyo phakathi kokuskena mna kunye no-scan II ( iiveki ezintandathu emva kotyando).

 

Iinkcukacha zeZakhiwo

 

Uhlalutyo lwamacandelo. Sibandakanye iminyaka yobudala njenge-covariate kwimodeli yomgca ngokubanzi kwaye asifumananga siphithiphithi sobudala. Xa kuthelekiswa nokwabelana ngesondo kunye nobudala kuhambelana nolawulo, abaguli abane-OA ephambili ye-hip (n? =? 20) babonise ukusebenza kwangaphambili (Skena I) kuncitshiswe into engwevu kwi-cortex yangaphakathi (i-ACC), i-cortex yangaphakathi, i-operculum, i-dorsolateral preortal cortex ( I-DLPFC), ipali yexeshana lasekunene kunye necerebellum (1 Table kunye noMzobo 1). Ngaphandle kwe-putamen elungileyo (x? =? 31, y? = ?? 14, z? = ?? 1; p <0.001, t? =? 3.32) akukho lonyuka lubalulekileyo kubunzulu bezinto ezingwevu olufunyenwe kwizigulana ezine-OA xa kuthelekiswa kulawulo olusempilweni. Ukuthelekisa izigulana ngexesha lokuvavanywa kwe-IV kunye nolawulo oluhambelanayo, iziphumo ezifanayo zafunyanwa kuhlalutyo olunamacandelo kusetyenziswa i-scan endiyithelekisileyo nolawulo.

 

Umfanekiso we-1 Statistical Parametric Maps

Umzobo we-1: Iimephu zeempawu ze-parametric ezibonisa ukungafani kobunzima kwimeko ebomvu kwizigulane ezinentlungu engapheliyo ngenxa ye-OA eyona nto yokuqhathaniswa ne-OA xa kuthelekiswa nokulawula kunye nokude ngokuthelekiswa nabo ngokwedlula ixesha. Utshintsho olubalulekileyo lwegrey luboniswa lubekwe ngaphezulu kombala, idatha yecandelo elinqamlezayo iboniswe kwidatha ebomvu kunye nelongitudinal etyheli. I-Axial plane: icala lasekhohlo lomfanekiso licala lasekhohlo lobuchopho. phezulu: Iindawo zokuncipha okukhulu kwe-gray matter phakathi kwezigulane ezineentlungu ezingapheliyo ngenxa ye-OA yokuqala ye-hip kunye nezifundo zokulawula ezingathintekiyo. p<0.001 ezantsi engalungiswanga: Ukunyuka kwegrey kwizigulane ze-20 ezingenazintlungu kwixesha lesithathu nesine lokuskena emva kokuhlinzwa okupheleleyo kokutshintshwa kwe-hip, xa kuthelekiswa neyokuqala (i-preoperative) kunye neyesibini (iiveki ze-6�8 emva kokuhlinzwa). p<0.001 IZiqendwana ezingalungiswanga: Uthelekiso lothelekiso kunye ne-90% yexesha lokuzithemba, iziphumo zomdla, iiyunithi ezingafanelekanga. i-x-axis: umahluko kwiipointpoints ezi-4, i-y-axis: uqikelelo olwahlukileyo ku-?3, 50, 2 ye-ACC kunye noqikelelo oluchaseneyo kuma-36, 39, 3 kwi-insula.

 

Idatha ye-1 Data-Sectional Data

 

Ukutsiba idatha yezigulana ezine-hip OA yasekhohlo (n? =? 7) kunye nokuzithelekisa nolawulo olusempilweni akuzange kutshintshe iziphumo kakhulu, kodwa ukwehla kwe-thalamus (x? =? 10, y? = ?? 20, z? =? 3, p <0.001, t? =? 3.44) kunye nokwanda kwe-cerebellum elungileyo (x? =? 25, y? = ?? 37, z? = ?? 50, p <0.001, t? =? 5.12) engakhange ifikelele ekubalulekeni kwedatha engafakwanga yezigulana ngokuthelekiswa nolawulo.

 

Uhlalutyo olude. Kuhlalutyo lwe-longitudinal, ukwanda okubonakalayo (p <.001 okungalunganga) kwento engwevu kwafunyanwa ngokuthelekisa ukuskena kokuqala kunye nesibini (iintlungu ezingapheliyo / iintlungu zasemva koqhaqho) kunye novavanyo lwesithathu nolwesine (ngaphandle kwentlungu) kwi-ACC, I-cortex ye-insular, i-cerebellum kunye ne-par orbitalis kwizigulana ezine-OA (2 Table kunye noMzobo 1). Imba engwevu yehle ngokuhamba kwexesha (p <.001 uhlalutyo lobuchwephesha olungalunganga) kwi-cortex yesibini ye-somatosensory, hippocampus, midcingulate cortex, thalamus kunye ne-caudate nucleus kwizigulana ezine-OA (Umzobo 2).

 

Umzobo we-2 Ukwanda kweBrain Matter

Umzobo 2: a) Ukonyuka okubonakalayo kwimiba engwevu yengqondo emva kokusebenza ngempumelelo. Umbono we-Axial wokuncipha okubonakalayo kwento engwevu kwizigulana ezinentlungu engapheliyo ngenxa ye-OA ephambili ye-hip xa kuthelekiswa nezifundo zolawulo. p <0.001 engachanekanga (uhlalutyo lwamacandelo), b) Ukunyuka kwexesha elide kwezinto ezingwevu ekuhambeni kwexesha ngokuthelekisa okuthe tyaba I & IIscan III> ukuskena i-IV) kwizigulana ezine-OA. p <0.001 engachanekanga (uhlalutyo olude). Icala lasekhohlo lomfanekiso licala lasekhohlo lengqondo.

 

Itafile 2 Data Longitudinal Data

 

Ukutsiba idatha yezigulana ezine-hip OA yasekhohlo (n? =? 7) khange itshintshe iziphumo kakhulu, kodwa ukwehla kwemeko engwevu yengqondo kwiHeschl s Gyrus (x? = ?? 41, y? = ?? 21, z? =? 10, p <0.001, t? =? 3.69) kunye nePrecuneus (x? =? 15, y? = ?? 36, z? =? 3, p <0.001, t? =? 4.60) .

 

Ngokuchasanisa ukuskena kokuqala (unyango lokuqala) kunye nezikeni 3 + 4 (isithuba sokuhlinzwa), sifumene ukwanda kwento engwevu kwi-cortex yangaphambili nakwi-motor cortex (p <0.001 engachanekanga). Siyaqaphela ukuba lo mmahluko awunangxaki njengoko ngoku sinesikeni esincinci kwimeko nganye (iintlungu kuthelekiswa non-iintlungu). Xa sihlisa umbundu siphinda into esiyifumeneyo sisebenzisa umahluko ka-1 + 2 no-3 + 4.

 

Ngokujonga iindawo ezonyuka ngaphezulu kwamaxesha onke, safumana utshintsho lwengqondo engwevu kwimimandla yeemoto (indawo ye-6) kwizigulana ezine-coxarthrosis elandela ukutshintshwa kwe-hip iyonke (scan Idbm.neuro.uni-jena.de/vbm/) sinokuluphinda olu phando kwi-cortex yangaphakathi kunye ne-cingate cortex kunye nakwi-insulae engaphandle.

 

Sabala ubungakanani besiphumo kunye nohlalutyo lwamacandelo (izigulana ngokuchasene nolawulo) kwavelisa iCohen sd ye-1.78751 kwincopho ye-voxel ye-ACC (x? = ?? 12, y? =? 25, z? = ?? 16). Sikwabala iCohen sd yohlalutyo lobude (umahluko wokuskena 1 + 2 vs. scan 3 + 4). Oku kukhokelele kwi-Cohen sd ye-1.1158 kwi-ACC (x? = ?? 3, y? =? 50, z? =? 2). Ngokumalunga ne-insula (x? =? 33, y? =? 21, z? =? 13) kwaye inxulumene nolwahluko ofanayo, uCohen sd ngu-1.0949. Ukongeza, sibala intsingiselo yexabiso elingeyo-zero voxel yemephu yeCohen sd ngaphakathi kwe-ROI (enecandelo langaphambili le-cingate gyrus kunye ne-subcallosal cortex, ethathwe kwiHarvard-Oxford Cortical Structural Atlas): 1.251223.

 

UDkt-Jimenez_White-Coat_01.png

Insight of Dr. Alex Jimenez

Izigulane zomsindo ezingapheliyo zinokuhlangabezana neemeko zempilo ezahlukahlukeneyo ngexesha elide, ngaphandle kweempawu zabo ezidityanisiweyo. Ngokomzekelo, abaninzi abantu baya kuba neengxaki zokulala ngenxa yeentlungu zabo, kodwa ngokubaluleke kakhulu, intlungu engapheliyo ingakhokelela kwimicimbi eyahlukeneyo yempilo yengqondo, kuquka ukuxhalaba nokuxinezeleka. Imiphumo enokuba neentlungu ezinokubakho kwiingqondo zingabonakala zinzima kakhulu kodwa ubungqina obukhulayo bubonisa ukuba utshintsho lwengqondo aluyiyo isigxina kwaye lunokuguqulwa xa izigulane ezingapheliyo zifumana unyango olufanelekileyo kwimicimbi yazo yezempilo. Ngokwalo nqaku, into ebomvu efumaneka kwintlungu engapheliyo ingabonakali umonakalo wengqondo, kodwa kunoko, isisiphumo esibuyiselwayo esiqhelekileyo xa intlungu iphathwa ngokufanelekileyo. Ngethamsanqa, iindlela ezahlukeneyo zonyango ziyafumaneka ukunceda ukuphucula iimpawu ezibuhlungu kunye nokubuyisela isakhiwo kunye nomsebenzi wengqondo.

 

ingxoxo

 

Ukubeka iliso kulwakhiwo lobuchopho ngokuhamba kwexesha, siqinisekisa kwaye sandisa idatha yolingo yethu epapashwe kutshanje [17]. Sifumene utshintsho kwimicimbi engwevu yengqondo kwizigulana ezine-hip osteoarthritis ephambili kwisifo esinganyangekiyo, esiguquka ngokuyinxenye xa ezi zigulana zingenazintlungu, kulandela utyando lwe-hip joint endoprosthetic. Ukonyuka okuthe ngcembe kwinto engwevu emva kotyando kuphantse kwaba kwindawo ezifanayo apho ukubonwa kwezinto ezingwevu kuye kwabonwa ngaphambi kotyando. Ukutsiba idatha yezigulana ezine-hip OA yasekhohlo (kwaye ke ukuqheleka kwicala leentlungu) kube nefuthe elincinci kwiziphumo kodwa kubonise ukwehla kwezinto ezingwevu kwi-Heschl s gyrus kunye ne-Precuneus esingakwaziyo ukuyichaza ngokulula kwaye, njengoko kungekho priori hypothesis ekhoyo, jonga ngononophelo olukhulu. Nangona kunjalo, umahluko obonwe phakathi kwezigulana kunye nolawulo olusempilweni lokuskena bendisajongwa kuhlalutyo lwecandelo lokuvavanywa kwe-IV. Ukonyuka kwesihlobo kwento engwevu ngokuhamba kwexesha kungoko kungacacanga, okt akufani ngokwaneleyo ukuba kube nefuthe kuhlalutyo lwecandelo, into esele ibonisiwe kwizifundo eziphanda ngamava eplastikhi exhomekeke kumava [30], [31]. Siyaqaphela ukuba inyani yokuba sibonisa iinxalenye ezithile zotshintsho lobuchopho ngenxa yeentlungu ezingapheliyo ukuba ziguquke azibandakanyi ukuba ezinye iindawo zolu tshintsho azinakuphikwa.

 

Kuyathakazelisa, sabona ukuba imbobo engcolileyo iyancipha kwi-ACC kwizigulane ezingapheliyo ngaphambi kokuba unyango lubonakale liqhubeka neveki ze-6 emva kokuhlinzwa (i-scan II) kwaye kwanda kuphela ukukhangela ii-III kunye ne-IV, mhlawumbi ngenxa yosizi lwe-post-surgery, okanye ukuncipha kwi-motor msebenzi. Oku kuhambelanayo nedatha yokuziphatha yesikhokelo sokuhamba ngomzimba esiqukelelwe kwi-NHP, leyo eyabonakalisiweyo emva kokusebenza engabonakali nayiphi na inguqu ephawulekayo kwixesha le-II kodwa ngokunyuka kakhulu kwandisa ukukhangela i-III ne-IV. Ingqalelo, izigulane zethu zichaze ukuba akukho buhlungu ebudeni emva kokuhlinzwa, kodwa iintlungu zentsebenzo emva kwenkqubo yokuhlinzwa, eziye zabonakala zihluke kakhulu kwizigulane. Nangona kunjalo, njengoko izigulane zisaxela ezinye iintlungu ezicatshungulwayo II, sahluke ngokutsha ukukhangela (ukuhlinzwa kwangaphambili) ngeesisombululo se-III + IV (emva kokuhlinzwa), sityhila ukwanda kwezinto ezimpunga kwi-cortex yangaphambili kunye ne-cortex. Siyaqaphela ukuba lo mlinganiso awuncinci ngenxa yokujonga ngaphantsi kwimeko (intlungu ngokungahambisani nentlungu). Xa siwunciphisa umyinge siphindaphinda oko sikufumene ngokusebenzisa u-I + II kunye no-III + IV.

 

Idatha yethu icebisa ukuba utshintsho lwezinto ezingwevu kwizigulana ezinganyangekiyo, ezihlala zifumaneka kwiindawo ezibandakanyeka ekusebenzeni kwe-supraspinal nociceptive process [4] azikho ngenxa ye-neuronal atrophy okanye ukonakala kwengqondo. Inyaniso yokuba olu tshintsho lubonwe kwimeko yentlungu engapheliyo aluguquki ngokupheleleyo lunokuchazwa ngexesha elifutshane lokujonga (unyaka omnye emva kokusebenza kuthelekiswa neminyaka esixhenxe yentlungu engapheliyo ngaphambi kokusebenza). Utshintsho lobuchopho be-Neuroplastic olunokuthi luphuhle kwiminyaka eliqela (njengesiphumo sokufakwa rhoqo kwe-nociceptive) kufuneka ixesha elininzi lokubuyela umva ngokupheleleyo. Enye into enokubangela ukuba ukwanda kwezinto ezingwevu kufumaneke kuphela kwidatha ye-longitudinal kodwa kungabi kwidatha enqamlezileyo (okt phakathi kwamaqela ngexesha le-IV) kukuba inani lezigulana (n? =? 20) lincinci kakhulu. Kufuneka kuboniswe ukuba umahluko phakathi kweengqondo zabantu abaliqela mkhulu kakhulu kwaye idatha ye-longitudinal inethuba lokuba umahluko mncinci njengoko iingqondo ezifanayo ziskenwa amatyeli aliqela. Ngenxa yoko, utshintsho olufihlakeleyo luya kufumaneka kuphela kwidatha ye-longitudinal [30], [31], [32]. Ewe asinakukhetha ngaphandle ukuba olu tshintsho ubuncinci alunakuphinda lubuyeke nangona oko kungenakulindeleka, kunikwe iziphumo zenkqubo ethile yolwakhiwo kunye nolungelelwaniso ngokutsha [4], [12], [30], [33], [34]. Ukuphendula lo mbuzo, izifundo ezizayo kufuneka ziphande abaguli kaninzi ngaphezulu kwamaxesha amade, kunokwenzeka iminyaka.

 

Siyabona ukuba sinokwenza izigqibo ezilinganiselweyo malunga nokuguqulwa kwengqondo yengqondo ngokutshintsha ixesha. Isizathu kukuba xa senze le ngxelo kwi-2007 kwaye sitshintshwe kwi-2008 kunye ne-2009, kwakungaziwa ukuba utshintsho lwezakhiwo luya kwenzeka nantoni na ngenxa yezizathu ezinokwenzeka zokukhetha iintsuku zokukhangela kunye nexesha elichazwe apha. Omnye unokuthetha ukuba inguqu ebomvu iguquka ngexesha, esiyichaza ngayo iqela lesigulane, mhlawumbi lenzeke kwiqela lolawulo kunye (umphumo wexesha). Nangona kunjalo, nayiphi na utshintsho ngenxa yokuguga, ukuba kukho konke, kulindeleke ukuba kuhla kwexabiso. Ukunikezelwa kweengcamango ze-priori, ngokusekelwe kwizifundo ezizimeleyo ze-9 kunye namaqabane abonisa ukwehla kwimiba ebomvu kwizigulane zentlungu ezingapheliyo [7], [8], [9], [15], [24], [25], [26], [27], [28], sigxile ekunyuseni kwengingqi kwixesha kwaye ngoko kukholelwa ukuba ukufumana kwethu kungabi yinto elula. Inqaku, asikwazi ukulawula ukuba imbali ebomvu iyancipha ngaphezu kwexesha esiyifumene kwiqela lethu lesigulane sinokuba ngenxa yempembelelo yexesha, njengoko singakhange sitshintshe iqela lethu lokulawula ngexesha elifanayo. Ukunikezelwa kweziphumo, iinjongo ezizayo kufuneka zijolise kwixesha elifutshane kunye nelifutshane, ngenxa yokuba utshintsho lwengqondo oluxhomekeke kwi-morphometric lungenzeka ngokukhawuleza emva kweveki ye1 [32], [33].

 

Ukongezelela kwimpembelelo yecalactifptive aspect of pain in question brain grey [17], [34] sabona ukuba utshintsho kwintsebenzo yemoto mhlawumbi lufaka isandla kwiinguqulelo zesakhiwo. Sifumane imoto kunye neendawo zangaphambili (indawo ye-6) ukwandisa ngaphezu kwexesha elide (Umfanekiso 3). Intuitively oku kungakho ngenxa yokuphucula umsebenzi wexesha elifanelekileyo njengoko izigulane zazingekho mfuneko yokuphila ubomi obuqhelekileyo. Ngokucacileyo asizange sigxininise ekusebenzeni kwemoto kodwa kuphuculwe kwimeko yamava, sinikezela umbuzo wethu wokuqala ukuphanda ukuba ukunciphisa kwaziwa ngokugqithiseleyo kwengqondo ebomvu kwizigulane ezingapheliyo kugqityiweyo. Ngenxa yoko, asizange sisebenzise izixhobo ezithile zokuphanda umsebenzi wemoto. Nangona kunjalo, (esebenzayo) i-motor cortex ukulungiswa kwezigulane ezineentlungu zesifo zibhalwe kakuhle [35], [36], [37], [38]. Ngaphezu koko, i-cortex yemoto iyona nto ijoliswe kwiindlela zokuthintela izigulane ezingenakunyangekiyo ezigulisa ingqondo (39], [40], i-transcranial ngokukhawuleza ngokukhuphayo [41], kunye nokuphindaphindiweyo kwe-magnetic stimulation [42], [43]. Iindlela ezichanekileyo zokumodareyithwa (ukulungelelaniswa kunye nokuphazamiseka, okanye ukuphazamiseka nje kwiintanethi ezinxulumene nentlungu) azange zichazwe [40]. Uphando olutshanje lubonise ukuba isipiliyoni semoto esithile singatshintsha isakhiwo sengqondo [13]. I-Synaptogenesis, ukulungiswa kwakhona kwemibonakalo yokunyakaza kunye ne-angiogenesis kwisixhobo se-cortex sinokufuna iimfuno ezizodwa zomsebenzi wemoto. Tsao et al. wabonisa ukulungiswa kwakhona kwi-motor cortex yezigulane ezineentlungu ezingapheliyo ezinqabileyo ezibonakala zibuhlungu ngokukhethekileyo [44] kunye nePuri et al. yabona ukunciphisa umgangatho wegridi wendawo engasese ekhohlo kwi-fibromyalgia abagulayo [45]. Isifundo sethu asizange senzelwe ukuphazamisa iinkalo ezahlukeneyo ezinokutshintsha ingqondo ebuhlungu obungapheliyo kodwa sichaza idatha yethu malunga nokuguquka kwempuphuko engabonakaliyo kuphela kwimiphumo yokufaka i-nociceptive input. Enyanisweni, uphando olutshanje kwizigulane zentlungu ye-neuropathic luchaza ukungaqhelekanga kwimiba yengqondo equka ukuqonda, ukuzimela, kunye neentlungu, nto leyo ebonisa ukuba badlala indima ebalulekileyo kwi-klinikhi yomfanekiso wentsholongwane engapheliyo [28].

 

Umfanekiso we-3 Statistical Parametric Maps

Umzobo 3: Iimephu zeenkcukacha-manani ezibonisa ukonyuka okubonakalayo kwengqondo engwevu kwimimandla yeemoto (indawo ye-6) kwizigulana ezine-coxarthrosis ngaphambi kokuthelekiswa nasemva kwe-THR (uhlalutyo olude, scan I Uqikelelo lothelekiso kwi-x? =? 19, y? = ?? 12, z? =? 70.

 

Izifundo ezimbini zokugqibela zamagosa ezijoliswe kwi-hip replacement therapy kwizigulane ze-osteoarthritis, i-syndrome kuphela yentsholongwane ehambayo ephilisa ngokupheleleyo [17], [46] kwaye le nkcukacha zixutywe ngophando olutshanje olwenziwe kwizigulane ezingapheliyo ezibuhlungu [ 47]. Ezi zifundo zimele zibonwe ekukhanyeni kwezifundo ezininzi eziphambili zophando lwama-neuronal plastic-dependence level in humans [level 30], [31] kwaye uphando olutshanje lwengqondo lusetshintsho kumavolontiya anempilo avuselelwa ngokuphindaphindiweyo (34] . Umyalezo oyintloko walezi zifundo kukuba umlinganiselo ophezulu kwisakhiwo sobuchopho phakathi kwezigulane zentlungu kunye nokulawula kunganciphisa xa intlungu iphiliswa. Nangona kunjalo, kufuneka kuthathelwe ingqalelo ukuba akucaci ukuba ngaba utshintsho kwizigulane zintlungu ezingapheliyo kuphela ngenxa yongeniso lwe-nociceptive okanye ngenxa yeziphumo zentlungu okanye zombini. Kukho okungakumbi ukuba ukuguquka kokuziphatha, njengokunciphisa okanye ukuphuculwa koqhagamshelwano loluntu, ubuchule, ukuqeqeshwa ngokomzimba kunye noshintsho lwesitayela somzimba kunelungelo lokwenza ubuchopho [6], [12], [28], [48]. Ukudandatheka ngokukodwa njengentsebenziswano yokubandezeleka okanye ngenxa yentlungu ngumviwa oyintloko ekuchazeni umahluko phakathi kwezigulane kunye nokulawula. Iqela elincinane lezigulane zethu ezine-OA zabonisa iimpawu ezidityanisiweyo ezize zithe zatshintsha ngexesha. Asizange sithole ukuguqulwa kwesakhiwo ukuba sibe ne-covary ngokubaluleka kakhulu kumanqaku eBDI kodwa umbuzo uphawula ukuba zingaphi ezinye iinguqu zokuziphatha ngenxa yokungabikho kweentlungu kunye nokuphucula imoto kunokufaka isandla kwiziphumo kunye nokuba zithini. Ezi zinguqu zendlela yokuziphatha zingaphathisa umba wegrey wehla kwiintlungu ezingapheliyo kunye nokunyuka kwengqondo xa kuvela intlungu.

 

Enye into ebalulekileyo enokuyichaphazela ukutolika kwethu kweziphumo kukuba phantse zonke izigulane ezineentlungu ezingapheliyo zithatha imithi kwiintlungu, eziye zayeka xa zintlungu. Omnye unokuxela ukuba ii-NSAID ezifana ne-diclofenac okanye ibuprofen zinemiphumo ethile kwiinkqubo ze-neural kwaye zifana ne-opioids, i-antiepileptics kunye ne-anti-depressants, imichiza edlalwa rhoqo kwiyeza zonyango. Impembelelo yababulali kunye namanye amayeza kwiingqinisiso ze-morphometric ingabaluleka (48). Akukho sifundo okwangoku siye sabonisa imiphumo yesifo sengqondo kwi-brain morphology kodwa amaphepha amaninzi afumene ukuba utshintsho kwisakhiwo sobuchopho kwizigulane ezingapheliyo zichazwe kuphela ngeentlungu ezibangelwa ukungasebenzi [15], okanye ngamachiza ensizi [7], [9], [49]. Nangona kunjalo, uphando oluthile lusekho. Uphando olongezelelweyo kufuneka lujolise kwiinguqu ezixhomekeke kumava kwi-cortical plasticity, enokuba nefuthe elikhulu kwiinkliniki zokunyanga iintlungu.

 

Siphinde safumana ukuhla kwezinto ezimpunga ekuhlalutyweni kwexesha elide, mhlawumbi ngenxa yeenkqubo ezilungelelaniswayo ezihamba kunye neenguqu kwizinto zokusebenza kunye nentlungu yokuqonda. Kukho ulwazi oluncinci olukhoyo malunga noshintsho olude kwimeko yengqondo ebomvu kwiimeko ezibuhlungu, ngenxa yesi sizathu asinayo ingcamango yento ebomvu eyancipha kule mimandla emva kokusebenza. Teutsch et al. [25] wathola ukunyuka kwengqondo ebomvu kwingqungquthela ye-somatosensory kunye ne-midcingulate kwiivolontiya ezinempilo ezafumana ukuvuselela okubuhlungu kwimihla ngemihla yeentsuku ezilandelelanayo ezilandelelanayo. Ukufunyanwa kwezinto ezimpunga kwandele emva kwenkalo yokuhlola isicatshulwa esilungelelanisa ngokwemvelo kwinqanaba elithile kunye nokuncipha kwengqondo ebomvu kulolu cwaningo kwizigulana eziphilisiweyo zintlungu engapheliyo. Oku kuthetha ukuba i-nociceptive input kwiivolontiya eziphilileyo iholele ekutshintsheni umsebenzi oxhomekeke kwisigxina, njengokuba kunokwenzeka kwizigulane ezinentlungu engapheliyo, kwaye ukuba ezi zinguqu ziphendulela kumavolontiya anempilo xa i-nociceptive input iyeka. Ngenxa yoko, ukwehla kwengxaki ebomvu kule mimandla ebonwe kwizigulane ezine-OA kunokutshilwa ukulandela inkqubo efanayo efanayo: ukutshintshelwa koxhomekeke kwimeko yengqondo (50]. Njengendlela engeyiyo inomdla, uM MR Morphometry yilona ilungileyo lokufuna ukufumana izifo eziphathekayo zezifo, ukwandisa ukuqonda kwethu ubudlelwane phakathi kwesakhiwo sobuchopho kunye nomsebenzi, kwanokubeka iliso ukungenelela kwindlela yokwelapha. Enye yemingeni emikhulu kwixesha elizayo kukuzilungelelanisa esi sixhobo esinamandla semilingo emininzi kunye neyonyango lwezilonda ezingapheliyo.

 

Imida yale Sifundo

 

Nangona olu phononongo lulwandiso lwesifundo sethu sangaphambili sokwandisa idatha yokulandela ukuya kwiinyanga ze-12 kwaye siphanda abaguli ngakumbi, umgaqo wethu wokufumanisa ukuba ingqondo ye-morphometric iyatshintsha kwiintlungu ezingapheliyo ziyahlengahlengiswa kunokuba kungangqalanga. Iziphumo zesayizi zincinci (jonga apha ngasentla) kwaye iziphumo ziqhutywa kukuncitshiswa okungaphezulu komthamo wengwevu yengqondo yengingqi ngexesha lesikena. Xa singabandakanyi idatha kwiskena 2 (ngqo emva kotyando) kubalulekile ukwanda kwemeko engwevu yengqondo yemoto yecortex kunye necortex yangaphambili iphila kumda we-p <2 engalunganga (Itheyibhile 0.001).

 

Itafile 3 Data Longitudinal Data

 

isiphelo

 

Akunakwenzeka ukwahlula ukuba kungakanani ukuguqulwa kwesakhiwo esikubonayo ngenxa yeenguqu kwii-nociceptive input, utshintsho kwimisebenzi yemoto okanye ukusetyenziswa kwamachiza okanye utshintsho kwimpilo enjalo. Ukumisa iqela elihlukeyo lokuqala kunye nokugqibela lokutshintshana omnye nomnye kubonakalisa ukungalingani kangako kunokuba kulindeleke. Ngokuqinisekileyo, ukuguqulwa kwengqondo ngenxa yokubuhlungu okungapheliyo yonke imiphumo kuphuhliswa ngaphezu kwexesha elide kwaye kunokufuna ixesha lokubuyisela. Nangona kunjalo, ezi ziphumo zibonakalisa iinkqubo zokulungiswa kwakhona, zibonisa ukuba ingongoma engapheliyo ye-nociceptive ne-motor impairment kulezi zi gulane ikhokelela ekutshintshisweni kwimihlaba ye-cortical kwaye ngenxa yoko iinguqu zengqondo zengqungquthela ezisemgangathweni.

 

Imibulelo

 

Siyabulela onke amavolontiya ngokuthatha inxaxheba kulolu phofu kunye neChysics kunye neNkqubo zeNdlela kwi-NeuroImage Nord e-Hamburg. Isifundo sanikezwa imvume yecandelo lekomiti yoLungileyo kunye nemvume ebhaliweyo enolwazi yafunyanwa kubo bonke abathathi-nxaxheba phambi kokuba bahlolwe.

 

Ingxelo Yenkxaso

 

Lo msebenzi wawuxhaswa yimalikelo evela kwi-DFG (i-German Research Foundation) (i-MA 1862 / 2-3) kunye ne-BMBF (i-Federal Ministry of Education and Research) (371 57 01 ne-NeuroImage Nord). Abaxhasi babenalo nxaxheba kwiplani yokufunda, ukuqokelela idatha kunye nokuhlalutya, isigqibo sokupapasha, okanye ukulungiswa kweso siqendu.

 

I-Endocannabinoid System | El Paso, TX I-Chiropractor

 

Inkqubo ye-Endocannabinoid: Inkqubo eyiNtloko ongazange wayiva

 

Ukuba awuzange uve nge-endocannabinoid system, okanye i-ECS, akukho sidingo sokuba uhlazeke. Emuva kwi-1960, abaphandi ababenomdla kwi-bioactivity ye-Cannabis ekugqibeleni baninzi amaninzi eekhemikhali zawo ezisebenzayo. Kwathatha enye i-30 iminyaka, nangona kunjalo, kubaphandi bafunda iifom zezilwanyana ukuze bafumane i-receptor yezi khemikhali ze-ECS kwiibhokhwe zamagundane, ukufumanisa okuvulwe umhlaba wonke uphando kwi-ECS i-receptors ikhona kunye nokuba yintoni injongo yabo yokuphila.

 

Ngoku siyazi ukuba ininzi iilwanyana, kwiintlanzi ukuya kwiinyoni ziya kuba ne-endocannabinoid, kwaye siyazi ukuba abantu abagcini nje ngokwenza i-cannabinoids yabo enxulumene nale nkqubo, kodwa sivelisa nezinye iimveliso ezidibanisa ne-ECS, ezo ezibonakala kwizityalo ezininzi kunye nokutya, ngaphaya kweentlobo ze-Cannabis.

 

Njengendlela yokusebenza komzimba womntu, i-ECS ayiyona ndawo yesikhokelo esicacileyo njengendlela ye-nervous system okanye ye-cardiovascular system. Esikhundleni salo, i-ECS yiseti yama-receptors esasazwa ngokubanzi kuwo wonke umzimba osebenze ngokusetyenzwa kweelandi esaziwa ngokubanzi njenge-endocannabinoids, okanye i-endogannabinoid endogenous. Zomibini eziqinisekisiweyo zokufumana i-CB1 kunye ne-CB2, nangona kukho ezinye ezicetywayo. Iipalati ze-PPAR ne-TRP zidibanisa neminye imisebenzi. Ngokufanayo, uya kufumana kuphela i-endocannabinoids emibini egcinwe kakuhle: i-anadamide ne-2-arachidonoyl glycerol, okanye i-2-AG.

 

Ngaphezu koko, isisiseko kwinkqubo yokugcina i-endocannabinoid yi-enzymes edibanisa kwaye iphule i-endocannabinoids. I-Endocannabinoids ikholelwa ukuba ihlanganiswe kwisiseko esifanelekileyo. Ama-enzymes ephambili abandakanyekayo yi-diacylglycerol lipase kunye ne-N-acyl-phosphatidylethanolamine-phospholipase D, elandelana ngokulandelelana nge-2-AG kunye ne-anandamide. Ezi zimbini zi-enzyme ezihlaziyileyo zi-fatty acid amide hydrolase, okanye i-FAAH, ephula i-anandamide, kunye ne-monoacylglycerol lipase, okanye i-MAGL, ephula i-2-AG. Ukulawulwa kwezi zimbini ze-enzyme kunokwandisa okanye kunciphise umodyuli we-ECS.

 

Iyintoni umsebenzi we-ECS?

 

I-ECS yinkqubo eyintloko yokulawula i-homeostatic yomzimba. Inokuthi ibonwe ngokukhawuleza njengenkqubo ye-adaptogenic yangaphakathi, rhoqo isebenza ukugcina umlinganiselo wemisebenzi eyahlukeneyo. I-Endocannabinoids isebenze ngokubanzi njenge-neuromodulators kwaye, njengaloo ndlela, ilawula uluhlu olubanzi lweenkqubo zomzimba, ukusuka kwenzalo ukuya kwintlungu. Eminye yale mi sebenzi eyaziwayo e-ECS yile ndlela ilandelayo:

 

System nervous

 

Ukususela kwinkqubo yomnatha, okanye i-CNS, ukuvuselelwa ngokubanzi kwe-CB1 receptors kuyakuvimba ukukhululwa kwe-glutamate kunye ne-GABA. Kwi-CNS, i-ECS inendima ekwakheni imemori nokufunda, ikhuthaza i-neurogenesis kwi-hippocampus, iphinda ilawule ukunyaniseka kwe-neuronal. I-ECS nayo idlala inxaxheba kwindlela iingqondo eziza kusabela ngayo xa zilimala kunye nokuvuvukala. Ukususela kumgca womgudu, i-ECS ihlengahlengisa intlungu kwaye isondeza i-analgesia yemvelo. Kwinkqubo yenzwa ye-peripheral, apho i-CB2 i-receptors ilawula, i-ECS isebenza ngokusisiseko kwinkqubo yeentlonelo zentlungu ukulawula imisebenzi yamaphepheni emathumbu emathumbu, emanzini kunye nokuzala.

 

Ukuxinezeleka kunye neMood

 

I-ECS ineempembelelo ezininzi kwiimpendulo zoxinzelelo kunye nokulawulwa ngokomzwelo, njengokuqaliswa kwezimpendulo zomzimba kwiimeko ezixinzelelekileyo kunye nokulungelelanisa ngexesha elide kwiimvakalelo zangexesha elide, njengokwesaba nokuxhalabisa. Inkqubo yokugcina i-endocannabinoid esebenzayo ibaluleke kakhulu kwindlela abantu abahamba ngayo phakathi kweqondo eliyanelisayo lokuvuthwa xa kuthelekiswa nezinga eligqithisileyo nelingathandekiyo. I-ECS nayo inendima ekwakheni imemori kwaye mhlawumbi ngokukodwa kwindlela apho ubuchopho bukhumbuza khona izikhumbuzo zengcinezelo okanye ukulimala. Ngenxa yokuba i-ECS ihlengahlengisa ukukhululwa kwe-dopamine, i-noradrenaline, i-serotonin kunye ne-cortisol, nayo inokuchaphazela kakhulu iimpendulo zemoya kunye nokuziphatha.

 

System Digestive

 

I-tractes tract ehlala kwi-CB1 kunye ne-CB2 receptors ezilawula iinkalo ezibalulekileyo zezempilo ze-GI. Kucingelwa ukuba i-ECS ingaba "ikhonkco elahlekileyo" ekuchazeni isiqhagamshelo se-gut-brain-immune edlala indima ebalulekileyo kwimpilo esebenzayo yendlela yokutya. I-ECS ngumlawuli we-immune immunity, mhlawumbi ngokunciphisa umzimba wokuzikhusela ekubhubhiseni imifuno ephilileyo, kunye nokutyunjwa kwe-cytokine. I-ECS imodareyitha impendulo yokuvuvukala kwendalo kwindlela yokutya, eneempembelelo ezibalulekileyo kwimibandela ephakamileyo yempilo. I-Gastric kunye ne-GI motility ebonakalayo ibonakala ilawulwa yi-ECS.

 

Ukutya kunye neMetabolism

 

I-ECS, ngokukodwa i-CB1 receptors, idlala inxalenye yesondlo, i-metabolism, kunye nokulawulwa kwamathambo omzimba. Ukukhuthazwa kwama-receptor ye-CB1 kuphakamisa ukuziphatha kokufuna ukudla, kuphucula ulwazi lokunuka, kukwazisa ukulinganisela kwamandla. Zomibini izilwanyana kunye nabantu abagqithisileyo banokugqithiseleka kwe-ECS engakhokelela kule nkqubo ukuba ibe yingozi, egalela ekudleni kunye nokunciphisa inkcitho yamandla. Amanqanaba omjikelezo we-anandamide kunye ne-2-AG abonakaliswe ukuba aphakanyiswe ekunyanyeni, oko kunokuthi ube yinxalenye ngenxa yokunciphisa umveliso we-FAAH enzyme ehlazolayo.

 

Impilo ye-Immune kunye nokuphendula okuvuthayo

 

Iiseli kunye namalungu omzimba omzimba atyebile ngeempendulo ze-endocannabinoid. Iimvumi ze-Cannabinoid zibonakaliswe kwi-thymus gland, i-tleen, i-toni, kunye nomnatha wethambo, kunye ne-T- kunye ne-B-lymphocytes, i-macrophages, iiseli zesigxina, i-neutrophils, kunye neeseli zokubulala zendalo. I-ECS ithathwa njengomqhubi oyintloko wokuhlaziywa kwe-immune system kunye ne-homeostasis. Nangona kungekho yonke imisebenzi ye-ECS kwi-immune system eqondakalayo, i-ECS ibonakala ilawula ukuveliswa kwe-cytokine kunye nokuba negalelo ekukhuseleni ukungasebenzi komzimba kwi-immune system. Ukuvutha kuyingxenye yendalo yempendulo yomzimba, kwaye idlala indima eqhelekileyo ekuhlaselweni okusemzimbeni, kuquka ukulimala kunye nezifo; Nangona kunjalo, xa ingagcinwanga ingqwalasela ingaba yinto engapheliyo kwaye igalelo ekukhuselweni kweengxaki zempilo ezimbi, ezifana nentlungu engapheliyo. Ngokugcina iimpendulo zokuzivikela ngomzimba, i-ECS inceda ukugcina impendulo enokulinganisela emzimbeni.

 

Ezinye iindawo zempilo ezilawulwa yi-ECS:

 

  • Impilo yeThambo
  • Ukhula
  • Impilo yengqondo
  • I-Arterial and respiratory health
  • Ukulala kunye nesigqi

 

Indlela engcono yokuxhasa i-ECS enempilo ngumbuzo abaninzi abaphandi abazama ukuphendula. Hlalani nilungelelanisa ngolwazi olungakumbi malunga nesi sihloko esikhulayo.

 

Ukuququmbela,Intlungu ye-ronicchronic idibene neenguqu zengqondo, kubandakanywa nokunciphisa into ebomvu. Nangona kunjalo, inqaku elingentla libonise ukuba iintlungu ezingapheliyo zinokutshintsha ubume kunye nokusebenza kwengqondo. Nangona iintlungu ezingapheliyo zinokukhokelela koku, phakathi kweminye imicimbi yezempilo, unyango olululo lweempawu zesigulana ezinokubuyisa utshintsho lwengqondo kunye nokulawula imvi. Ukongezelela, uphando olwenziweyo kunye nolunye uphando luye lwavela emva kokubaluleka kwenkqubo ye-endocannabinoid kwaye isebenza ekulawuleni nasekulawuleni ubuhlungu obungapheliyo kunye neminye imiba yezempilo. Ulwazi olukhankanyiweyo kwiZiko leSizwe loLwazi lweBiotechnology (NCBI) .Ububanzi bolwazi lwethu bunqunyelwe kwi-chiropractic kunye nakulimala komqolo kunye neemeko. Ukuxoxa ngomxholo, nceda ukhululeke ukubuza uGqirha Jimenez okanye unxibelelane nathi ku915-850-0900 .

 

Ikhutshwe nguDkt. Alex Jimenez

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

Imixholo eyongezelelweyo: Ubunzima bokubuyisela

Umqolo obuhlungu enye yezona zizathu ezibangeleko zokukhubazeka kunye neentsuku eziphosakeleyo emhlabeni wonke. Njengokuba kunjalo, iintlungu zenziwa emva kweyona sibini isizathu esivakalayo sokutyelela iofisi yee-dkt. Ngokumalunga neepesenti ze-80 zabemi ziya kuba nolunye uhlobo lweentlungu zentlungu ubuncinane kanye kanye ebomini babo. Umgudu uyisakhiwo esiyinkimbinkimbi esakhiwa ngamathambo, amajoyina, iigaments kunye nezihlunu, phakathi kwezinye iifomthi ezithambileyo. Ngenxa yoko, ukulimala kunye / okanye iimeko ezihlaziyiweyo, ezifana disni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.

 

 

 

umfanekiso webhlogi weendaba eziphambili zephepha lephepha

 

ISIHLOKO ESIBALULEKILEYO: Ulawulo oluPhantsi lwePain Pain

 

IINKCUKACHA NGOKUGQITHISILEYO: UKONGEZA KWEZINTLOKO: PainUbuhlungu obungapheliyo kunye nonyango

 

Ngenanto
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Vala i-Accordion
Biochemistry Of Pain

Biochemistry Of Pain

I-Biochemistry of Pain:Zonke iisyndromes zentlungu zineprofayile yokukrala. Iprofayili yokuvuvukala ingahluka ukusuka kumntu ukuya emntwini kwaye inokwahluka kumntu omnye ngamaxesha ahlukeneyo. Unyango lwee-syndromes zentlungu kukuqonda iprofayile yokuvuvukala. Iintlungu ze-syndromes zinyangwa ngokwamayeza, ngokuhlinzwa okanye zombini. Injongo kukuthintela / ukucinezela ukuveliswa kwabalamli abanokudumba. Kwaye isiphumo esiphumeleleyo sesinye esikhokelela kukudumba okuncinci kwaye kunjalo iintlungu zingaphantsi.

Biochemistry Of Pain

Iinjongo:

  • Ngubani abadlali abalulekileyo
  • Ziziphi iinkqubo ze-biochemical?
  • Ziziphi i ziphumo?

Uhlolo lokuvuvukala:

Abadlali key

i-biochemistry yintlungu el paso tx.

i-biochemistry yintlungu el paso tx.

i-biochemistry yintlungu el paso tx.

i-biochemistry yintlungu el paso tx.Kutheni Igxalaba Lam Libuhlungu? Ukuphononongwa kwe-Neuroanatomical & Biochemical Basis of Pain Shoulder

KWI-ABSTRACT

Ukuba isigulana sibuza ukuba "kutheni igxalaba lam libuhlungu?" Incoko iyakuthi iphethuke iye kwithiyori kwaye ngamanye amaxesha ingqibelelo engaqinisekiswanga. Rhoqo, ugqirha uyayiqonda imida yesiseko senzululwazi yenkcazo yabo, ebonisa ukungaphelelanga kokuqonda kwethu imeko yentlungu egxalabeni. Olu hlaziyo luthatha indlela emiselweyo yokunceda ukuphendula imibuzo esisiseko enxulumene nentlungu egxalabeni, ngenjongo yokubonelela ngolwazi kuphando lwexesha elizayo kunye neendlela ezintsha zokunyanga iintlungu zamagxa. Siza kuphonononga iindima ze (1) ii-peripheral receptors, (2) ukuqhutywa kwentlungu okanye i- nociception , (3) intambo yomqolo, (4) ingqondo, (5) indawo ezamkela kuyo igxalaba kunye (6) i-neural anatomy yegxalaba. Sikwathathela ingqalelo ukuba ezi zinto zinokuba negalelo njani kuguquko kwinkcazo yeklinikhi, isifo kunye nonyango lweentlungu. Ngale ndlela sijolise ekunikezeleni isishwankathelo samacandelo enkqubo yokubona iintlungu kunye neenkqubo zokulungisa iintlungu ezisezintlungwini ezinxibelelana ukuvelisa iintlungu zeklinikhi.

INTSHAYELELO: INKQUBO YOKUPHILA KWENKQUBO YOMSEBENZI WESAYENSI OKUBALULEKILEYO KWIIKLINICI

Uhlobo lwentlungu, ngokubanzi, ibingumba ophikisanayo kakhulu kwinkulungwane edlulileyo. Kwinkulungwane ye-17th Descartes theory1 yacebisa ukuba ubunzima beentlungu buhambelana ngqo nenqanaba lokulimala kwezicubu kunye nokuba iintlungu zalungiswa ngendlela enye eyahlukileyo. Iithiyori ezininzi zangaphambili zazixhomekeke kule nto ibizwa ngokuba yi- dualist Descartian bulumko, ibona iintlungu njengesiphumo sokuvuselelwa kwe- specific peripheral pain receptor kwingqondo. Kwinkulungwane yama-20 idabi lobunzululwazi elaliphakathi kweembono ezimbini eziphikisanayo ezalandelayo, ezizezi ithiyori ekhethekileyo kunye nethiyori yomzekelo. I-Descartian specityity theory yabona iintlungu njengendlela ethile eyahlukileyo yokufaka uluvo kunye nezixhobo zayo, ngelixa i-theory aziva ukuba iintlungu zibangelwe kukuvuseleleka okungamkelekanga kwee-receptors.2 Kwi-1965, Wall kunye neMelzack s 3 Ithiyori yesango lentlungu ibonelele ubungqina bemodeli apho iintlungu zokuqonda zalungiswa khona ngempendulo yeemvakalelo kunye nenkqubo ye-nervous system. Enye inkqubela phambili enkulu kwithiyori yentlungu ngaxeshanye yabona ukufunyanwa kwendlela ethile yezenzo ze-opioids.4 Emva koko, inkqubela phambili yamva nje ye-neuroimaging kunye neyeza lemolekyuli ikwandisile ngokubanzi ukuqonda kwethu kwentlungu.

Ke oku kunxulumana njani neentlungu zamagxa?�Intlungu yentlungu yinkinga eqhelekileyo yeklinikhi, kunye nokuqonda okunamandla kwendlela iintlungu ezenziwa ngayo ngumzimba kubalulekile ekuchongeni nasekunyangeni iintlungu zesigulana. Ukuqhubela phambili kulwazi lwethu lokulungisa iintlungu kuthembisa ukungahambelani phakathi kwesifo kunye nembono yeentlungu, zinokusinceda ukuba sichaze ukuba kutheni izigulana zisilela ukuphendula kunyango oluthile.

UKUQALA AMASEBENZI OKUSEBENZA

Iipheripheral sensory receptors: umatshini we-mechanoreceptor kunye ne-ocnociceptor

Zininzi iintlobo zeepheripheral sensory receptors ezikhoyo kwinkqubo yemisipha yomntu. 5 Banokuhlelwa ngokusekwe kwimisebenzi yabo (njengee-mechanoreceptors, i-thermoreceptors okanye i-nociceptors) okanye i-morphology (iziphelo zamahala ezikhululekileyo okanye iintlobo ezahlukeneyo ze-receptors) .5 Iindidi ezahlukeneyo ze-receptor emva koko zinokuxhaswa ngakumbi ngokusekwe ubukho babamakishi abathile beekhemikhali. Kukho ukugqabhuka okubalulekileyo phakathi kweeklasi ezahlukeneyo zomsebenzi we-receptor, umzekelo

Ukuqhubekeka kobuhlungu bePheripher: ocNociception

Ukulimala kwezicubu kubandakanya iintlobo zabalamli abanokudumba abakhutshwa ziiseli ezonakalisiweyo kubandakanya i-bradykinin, i-histamine, i-5-hydroxytryptamine, i-ATP, i-nitric oxide kunye nee-ions ezithile (K + kunye ne-H +). Ukusebenza kwendlela ye-arachidonic acid kukhokelela kwimveliso ye-prostaglandins, i-thromboxanes kunye ne-leuko- trienes. IiCytokines, kubandakanya ii-interleukins kunye ne-tumor necrosis factor? I-endothelin-15) ikwanyanzelisiwe kwimpendulo ebukhali yokuvuvukala.1 16 Ezinye zezi arhente zinokusebenzisa ngokuthe ngqo ii-nociceptors, ngelixa ezinye zizisa ukuqeshwa kwezinye iiseli ezithi emva koko zikhulule ezinye iiarhente zokuququzelela.17 Le nkqubo yendawo ibangela ukwanda kokuphendula yee-nociceptive neurons kwigalelo lazo eliqhelekileyo kunye / okanye ukugaywa kwempendulo kwigalelo lesiqhelo kubizwa ngokuba yi-ipipheral sensitization . Umzobo 18 ushwankathela ezinye zeendlela eziphambili ezichaphazelekayo.

i-biochemistry yintlungu el paso tx.I-NGF kunye ne-receptor yexeshana enokubakho ye-cation ye-subfamily V ilungu le-1 (TRPV1) receptor banobudlelwane be-symbiotic xa kufikwa kukuvuvukala kunye ne-nociceptor sensitization. Ii-cytokines eziveliswe kwizicwili ezitshisiweyo zikhokelela kukonyuka kwemveliso ye-NGF.19 NGF ivuselela ukukhutshwa kwe-histamine kunye ne-serotonin (5-HT3) ziiseli zemasti, kwaye ikwazisa ii-nociceptors, ezinokuthi zitshintshe iipropathi ze-A? iifayibha ezinje ukuba uninzi lwazo luba yi-nociceptive. I-receptor ye-TRPV1 ikho kugqithiso lweefayibha eziphambili kwaye yenziwe yasebenza yi-capsaicin, ubushushu kunye neeproton. I-receptor ye-TRPV1 idityanisiwe kumzimba weseli wefayibha ehambelanayo, kwaye ithuthelwa kuzo zombini iipheripherali kunye neendawo eziphakathi, apho inegalelo kubuntununtunu bezinto ezinxulumene nociceptive. Ukudumba kuphumela kwimveliso ye-NGF ngokungagungqiyo ethi emva koko ibophele kwi-tyrosine kinase receptor uhlobo lwe-1 receptor kwii-terminals ze-nociceptor, i-NGF emva koko ihanjiswa iye emzimbeni weseli apho ikhokelela kulawulo oluphezulu lokukhutshelwa kwe-TRPV1 kwaye ngenxa yoko yonyusa ubuntununtunu be-nociceptor. 19 20 NGF kunye Abanye abalamli abavuthayo baphinde bancedise i-TRPV1 ngokusebenzisa iindlela ezahlukeneyo zesithunywa. Uninzi lwezinye ii-receptors kubandakanya ii-cholinergic receptors,? -Aminobutyric acid (GABA) receptors kunye ne-somatostatin receptors zikwacingelwa ukuba ziyabandakanyeka kubuzaza be-nociceptor sensitivity.

Inani elikhulu labalamli abanokudumba liye lachaphazeleka ngokuthe ngqo kwintlungu yamahlombe kunye nesifo se-rotator cuff.21 25 Ngelixa abanye abalamli bemichiza basebenza ngokuthe ngqo kwii-nociceptors, uninzi lukhokelela kutshintsho kwi-neuron ye-sensory uqobo kunokuba luyenze ngqo. Olu tshintsho lunokubakho kwangoko emva kokuguqulelwa okanye ukulibaziseka ukuxhomekeka kokukhutshelwa. Imizekelo yezinto zangaphambili ziinguqu kwi-receptor ye-TRPV1 okanye kwii-ion-chated ion channels ezibangelwa yi-phosphorylation ye-protein-bound bound-protein. Imizekelo yamva ibandakanya ukonyuswa kwe-NGF kwimveliso yejelo le-TRV1 kunye nokusebenza kwe-calcium okubangelwa kukukhutshelwa kwangaphakathi.

Iindlela zeMelecular Of Nociception

Uvakalelo lwentlungu lusilumkisa ngokwenzakala okwenyani okanye okuzayo kwaye kubangele iimpendulo ezifanelekileyo zokukhusela. Ngelishwa, iintlungu zihlala zikhumbula ukuba luncedo njengenkqubo yokulumkisa kwaye endaweni yoko ziye zingapheli kwaye zenze buthathaka. Olu tshintsho kwisigaba esinganyangekiyo lubandakanya utshintsho ngaphakathi kwethambo lomqolo kunye nengqondo, kodwa kukwakho ukumodareyitha okumangalisayo apho imiyalezo yeentlungu iqaliswa- kwinqanaba le-neuron ye-sensory ephambili. Imizamo yokufumanisa indlela ezi-neurons ezifumanisa ngayo ukuba zivelisa iintlungu zomoya oshushu, oomatshini okanye weekhemikhali zityhile iindlela ezintsha zokubonisa kwaye zasisondeza ekuqondeni iziganeko zeemolekyuli eziququzelela utshintsho olusuka kwintlungu ukuya kwintlungu eqhubekayo.

i-biochemistry yintlungu el paso tx.I-Neurochemistry Of Nociceptors

I-Glutamate yi-neurotransmitter eyinhloko ye-excitatory kuwo onke ama-nociceptors. Ucwaningo lwengqondo ye-DRG yabantu abadala, nangona kunjalo, ibonakalisa iiklasi ezimbini ezibanzi ze-C fiber ezingabonakaliyo.

Iimpawu zeThimpeki zeMichiza ukwenzela ukuba ubuhlungu bube nzima

Njengoko kuchazwe ngasentla, ukulimala kuphakamisa amava ethu entlungu ngokunyusa uvelwano lwama-nociceptors ukuya kumathambo angama-thermally and mechanical stimuli. Ezi ziphumo, kwinqanaba, ukusuka kwimveliso kunye nokukhululwa kwabalamli beekhemikhali ukusuka kwisigxina sokuqala kunye neseli ezingenalo ne-neural (umzekelo, ii-fibroblasts, i-cell mast, i-neutrophils kunye neeplatelet) kwimeko yendawo36 (umzekeliso 3). Ezinye izixhobo zesobho esivuthayo (umzekelo, i-proton, i-ATP, i-serotonin okanye i-lipids) inokutshintsha i-neuronal ngokukhawuleza ngokubambisana neziteshi ze-ion kummandla we-nociceptor, kanti abanye (umzekelo, i-bradykinin kunye ne-NGF) babophelela kwiimceivers ze-metabotropic kunye ukudibanisa imiphumo yabo ngokusebenzisa isalathisi yesibini ukubonakalisa i-cascades11. Inkqubela ebonakalayo eyenziwe ekuqondeni isiseko se-biochemistry yezixhobo zokumodareyitha.

Iiprotoni ezongezelelweyo kunye neTissue Acidosis

I-tissue acidosis iyimpendulo ebonakalayo yokuzilimaza, kwaye ubukhulu bentlungu okanye intlungu ehambelana nayo ihambelana kakhulu nobukhulu be-acidification37. Ukusetyenziswa kwe-asidi (i-pH 5) kwesikhumba kuvelisa ukukhutshwa okuqhubekayo kwisithathu okanye ngaphezulu kwee-nociceptors zepolymod ezingenasigxina kwintsimi ye-20.

i-biochemistry yintlungu el paso tx.Iindlela zeselfowuni kunye neMolekyuli zobuhlungu

Abstract

Inkqubo yenzwa iyaphawula kwaye iguqulela uluhlu olubanzi lwezinto ezishukumisayo kunye nezomatshini kunye nokukhuseleka kwemvelo kunye nokuphela kweemichiza. Xa kunzima, ezi zinto zivelisa ubuhlungu obukhulu, kwaye kwimeko yokulimala okuqhubekayo, zombini kwiprogram kunye nendawo ye-nervous system yendlela yokudlulisa intlungu ibonisa iplastiki enkulu, ukuphucula iintlungu kunye nokuvelisa i-hypersensitivity. Xa i-plasticity ikhuthaza i-reflexes yokukhusela, inokuba luncedo, kodwa xa utshintsho oluqhubekayo, imeko yesifo esingapheliyo ingabangela. I-Genetic, i-electrophysiological, kunye nezifundo ze-pharmacological zicacisa iindlela zee molecular ezithobela ukubonwa, ukudibanisa kunye nokumodareyitha kwezinto ezixhalabisa ezenza intlungu.

Isingeniso: Ngokubhekiselele kwintlungu eqhubekayo

i-biochemistry yintlungu el paso tx.

i-biochemistry yintlungu el paso tx.Umzobo 5. Umgca woMgcini (iPhakathi) Ukwazisa

  1. Ukwazisa ukuthotyelwa kwe-Glutamate / NMDA.�Ukulandela uvuselelo olumandla okanye ukwenzakala okuzingileyo, iC kunye no-A zivuliwe? i-nociceptors ikhulula iindidi ze-neurotransmitters ezibandakanya i-dlutamate, i-substance P, i-calcitonin-gene ehlobene ne-peptide (CGRP), kunye ne-ATP, kwi-neurons ephumayo kwi-lamina I yophondo lwe-dorsal olungaphezulu (obomvu). Ngenxa yoko, i-NMDA glutamate receptors eqhelekileyo ethuleyo ebekwe kwi-postsynaptic neuron inokubonisa ngoku, inyuse i-intracellular calcium, kwaye ivule i-calcium exhomekeke kwiindlela zokubonisa kunye nezithunywa zesibini ezibandakanya i-mitogen-activated protein kinase (MAPK), protein kinase C (PKC) , iprotein kinase A (PKA) kunye ne-Src. Le cascade yeziganeko iya kwandisa i-excitability ye-neuron ephumayo kwaye iququzelele ukuhanjiswa kwemiyalezo yeentlungu kwingqondo.
  2. Ukukhubaza.�Phantsi kweemeko eziqhelekileyo, i-interneurons ye-inhibitory (eluhlaza okwesibhakabhaka) ikhulula ngokuqhubekayo i-GABA kunye / okanye i-glycine (Gly) ukunciphisa i-excitability ye-lamina I-output neurons kunye nokulungelelanisa ukuhanjiswa kweentlungu (ithoni yokuvimbela). Nangona kunjalo, kwimeko yokulimala, oku kuthintela kungalahleka, kubangele i-hyperalgesia. Ukongeza, i-disinhibition inokwenza i-non-nociceptive myelinated A? i-primary afferents ukubandakanya ukuhanjiswa kweentlungu zesekethe ezinje ukuba izivuseleli ezingenabungozi ngoku zibonwa njengentlungu. Oku kwenzeka, ngokuyinxenye, ngokukhutshwa kwe-PKC evuselelayo? ukuvakalisa i-interneurons kwi-lamina yangaphakathi II.
  3. Ukusebenza kwe Microglial.�Ukulimala kwemithambo yeperipheral kukhuthaza ukukhululwa kwe-ATP kunye ne-chemokine fractalkine eya kuvuselela iiseli ze-microglial. Ngokukodwa, ukusetyenziswa kwe-purinergic, i-CX3CR1, kunye ne-Toll-like receptors kwi-microglia (purple) iphumela ekukhululweni kwe-brain-derived neurotrophic factor (BDNF), ethi ngokusebenzisa i-activation ye-TrkB i-receptors echazwe yi-lamina I-output neurons, ikhuthaza ukwanda kwe-excitability kwaye intlungu eyongeziweyo ekuphenduleni kokubili ukuvuselela okunobungozi kunye nokungenabungozi (oko kukuthi, i-hyperalgesia kunye ne-allodynia). I-microglia esebenzayo ikwakhupha inkitha yee-cytokines, ezifana ne-tumor necrosis factor? (TNF?), i-interleukin-1? kunye ne-6 (IL-1?, IL-6), kunye nezinye izinto ezifaka isandla kwi-central sensitization.

I-Chemical Milieu Of Inflammation

Uvakalelo lomda ngakumbi kwiziphumo ezivela kutshintsho olunxulumene nokuvuvukala kwimeko yemichiza yefayibha yentsimbi (McMahon et al., 2008). Ke ngoko, ukonakala kwethishu kuhlala kuhamba nokuqokelelwa kwezinto ezingapheliyo ezikhutshwe kwii-nociceptors okanye iiseli ezingezizo ezomzimba ezihlala ngaphakathi okanye zingene kwindawo eyonzakeleyo (kubandakanya iiseli zemasti, ii-basophils, iiplatelets, ii-macrophages, i-neutrophils, iiseli zokuphela kwexesha, i-keratinocytes, kunye iifibroblast). Ngokudibeneyo. ezi zinto, zibizwa ngokuba yi- inflammatory soup , zimele uluhlu lweemolekyuli zokubonisa, kubandakanya ii-neurotransmitters, ii-peptides (iziyobisi P, CGRP, bradykinin), ii-eicosinoids kunye ne-lipids ezinxulumene noko (prostaglandins, thromboxanes, leukotrienes, endocannabinoids), ii-neurotrophins, ii-cytokines , kunye neekhemokines, kunye neeprotease zangaphandle kunye neeproton. Ngokumangalisayo, ii-nociceptors zivakalisa enye okanye nangaphezulu iiseli ezamkela indawo ezikwaziyo ukuphendula kunye nokuphendula nganye yezi arhente zepro-inflammatory okanye pro-algesic agents (Umzobo 4). Ukudibana okunjalo kukonyusa ukonwaba kwefiber ye-nerve, ngaloo ndlela iphakamisa ubuntununtunu bayo kubushushu okanye ukubamba.

Indlela engavumelekanga ngayo indlela yokunciphisa intlungu evuzayo iquka ukuvimbela ukuhlanganiswa okanye ukuqokelela kweengxenye zesobho esivuthayo. Le nto iboniswe ngokugqithiseleyo ngamachiza angenayo i-steroidal anti-inflammatory, efana ne-aspirin okanye ibuprofen, eyanciphisa intlungu yokuvuvukala kunye ne-hyperalgesia ngokuvimbela i-cyclooxygenases (i-Cox-1 kunye ne-Cox-2) ebandakanyekayo kwi-prophyglandin synthesis. Indlela yesibini kukuthintela izenzo ze-arhente ezivuthayo kwi-nociceptor. Apha, sikhankanya imizekelo esinika ingqiqo entsha kwiindlela zeselula zokukhuthaza ukuphazamiseka komzimba, okanye ukuba yintoni isiseko seendlela ezintsha zokuphulukisa intlungu.

I-NGF mhlawumbi iyayaziwa kakhulu ngendima yayo njengengxaki ye-neurotrophic efunekayo ekusindeni nasekuphuhliseni i-neurons ye-sensory ngexesha le-embryogenesis, kodwa kumntu omdala, i-NGF iphinda ikhiqizwe kwimeko yokulimala komzimba kwaye ibe yinto ebalulekileyo yesobho sokuvutha (Ritner et al., 2009). Phakathi kwezinye iithagethi zamaselula, i-NGF isebenza ngokuthe ngqo kwi-peptidergic C fiber nociceptors, ebonisa ukuxhamla kwe-NGF receptor tyrosine kinase, i-TrkA, kunye ne-faxtrophin receptor, i-P75 (i-Chao, i-2003; i-Snider noMcMahon, i-1998). I-NGF ikhiqiza ukuxhomekeka okukhulu ekutshiseni nasekukhuselweni kweendlela ngeendlela ezimbini ezahlukileyo. Ekuqaleni, ukusebenzisana kwe-NGF-TrkA kuvula iindlela ezibonakaliswe ngaphantsi kwamanzi, kuquka i-phospholipase C (PLC), i-proogen activated kinase (MAPK) kunye ne-phosphoinositide 3-kinase (PI3K). Oku kubangela ukuxhotyiswa komsebenzi weeprotheyini ezijoliswe kwi-terminal ye-nociceptor, ngokugqithiseleyo i-TRPV1, ekhokelela ekutshintsheni ngokukhawuleza kwintsebenziswano yokufudumala kwesibindi se-cellular nokuziphatha (Chuang et al., 2001).

Kungakhathaliseki ukuba zeziphi iindlela zabo ze-pro-nociceptive, ukuphazamisa i-neurotrophin okanye i-cytokine ukubonakaliswa kuye kwaba sisicwangciso esikhulu sokulawula isifo esivuthayo okanye intlungu ebangelwayo. Eyona ndlela iphambili ibandakanya ukuvala i-NGF okanye i-TNF-? isenzo nge-antibody ethomalalisayo. Kwimeko ye-TNF-?, oku kuye kwasebenza ngokuphawulekayo kunyango lwezifo ezininzi ezizimelayo, ezibandakanya i-rheumatoid arthritis, ekhokelela ekunciphiseni okumangalisayo kuzo zombini ukutshatyalaliswa kwezicubu kunye nokuhamba ne-hyperalgesia (Atzeni et al., 2005). Ngenxa yokuba izenzo eziphambili ze-NGF kwi-nociceptor yabantu abadala zenzeka kwindawo yokuvuvukala, inzuzo yale ndlela kukuba i-hyperalgesia iya kuncipha ngaphandle kokuchaphazela. qwa lasela intlungu. Enyanisweni, iintsholongwane ze-NGF zangoku zivavanyo zonyango ekwenzeni unyango oluvuthayo lwe-syndromes (Hefti et al., 2006).

I-Glutamate / i-NMDA I-Receiver-Mediated Sensitization

Intlungu ebuhlungu ibonakaliswa ngokukhululwa kwe-glutamate ukusuka kwiimitha eziphambili zee-nociceptors, ezivelisa i-currents after-synaptic currents (EPSCs) kwinqanaba le-second order. Oku kwenzeka ngokukodwa ngokusebenzisa i-postsynaptic AMPA kunye ne-kainate subtypes ye-ionotropic receptors ionotropic. Ukuqulunqwa kwe-EPSC yesigxina kwi-neuron ye-postsynaptic ekugqibeleni kuya kubangela isenzo esingabalekayo nokuhambisa isigidimi sobuhlungu kwi-neurons ephezulu.

Ezinye iziphumo zibonisa ukuba utshintsho kwi-neuron, ngokwalo, lunegalelo kwinkqubo yokukhubaza. Ngokomzekelo, ukulimala kwentsholongwane yechungechunge kumgangatho ophantsi-ulawula i-K + - Cl-co-transporter i-KCC2, ebalulekileyo ekugcineni ii-K + kunye neeClass eziqhelekileyo kwi-membrane ye-plasma (i-Coull et al., I-2003). Ukurhoxisa i-KCC2, ebonakaliswa ku-lamina I i-neurons yokubonisa, iphumela ekutshintsheni kwi-Cl-gradient, enjengokuthi ukusebenza kwe-GABA-A i-receptors iphoxisa, kunokuxhomekeka kwe-lamina I i-neurons ye-projection. Oku kuya kuthi, kukhulise ukukhutshulwa nokunyusa intlungu. Enyanisweni, ukuvinjwa kwemithi ye-pharmacy okanye i-rRNA-mediated downregulation ye-KCC2 kwi-rat yenza i-allodynia engumatshini.

Yabelana ngeEbook

Imithombo:

Kutheni ihlombe lam libuhlungu? Ukuhlaziywa kwe-neuroanatomical and biochemical basis of pain

UBenjan John Floyd Dean, uStephen Edward Gwilym, uAndrew Jonathan Carr

Iindlela kunye neendlela zeMolcular of Pain

UAllan I. Basbaum1, uDiana M. Bautista2, uGreory uGory Scherrer1, kunye noDavid Julius3

1Dafa ye-Anatomy, iYunivesithi yaseCalifornia, iSan Francisco 94158

I-2Department of Biology and Cell Biology, iYunivesithi yaseCalifornia, eBerkeley CA 94720 3Department of Physiology, iYunivesithi yaseCalifornia, iSan Francisco 94158

Iinkqubo ze-molecular of nociception

UDavid Julius * kunye noAllan I. Basbaum

*ISebe leSellular kunye ne-Molecular Pharmacology, kunye �ISebe le-Anatomy nePhysiology kunye ne-WM Keck Foundation ye-Integrative Neuroscience, kwiYunivesithi yaseCalifornia eSan Francisco, eSan Francisco, eCalifornia 94143, e-USA (i-imeyile: julius@socrates.ucsf.edu)

Ubume bePathophysiology ye-Pauropathic Pain

Ubume bePathophysiology ye-Pauropathic Pain

Iintlungu ze-Neuropathic ziimeko ezinzima, ezingapheliyo zentlungu zihlala zihamba kunye nokulimala kwezicubu ezithambileyo. Intlungu ye-Neuropathic ixhaphake kuqhelaniso lweklinikhi kwaye ikwabangela ucelomngeni kwizigulana nakwabahlengikazi ngokufanayo. Ngeentlungu ze-neuropathic, imithambo ngokwayo inokuba yonakele, ingasebenzi okanye ilimele. Intlungu ye-Neuropathic sisiphumo somonakalo ovela kwintlungu yesifo okanye kwisifo ukuya kwipripalal or central system system, apho lesion inokuthi ivele nakweyiphi na indawo. Ngenxa yoko, le micu ye-nerve eyonakalisiweyo ingathumela imiqondiso engalunganga kwamanye amaziko entlungu. Iziphumo zokulimala kwentsinga ye-nerve kubandakanya ukutshintsha kokusebenza kwe-neural, zombini kwindawo yokulimala kunye nokujikeleza ukulimala. Iimpawu zeklinikhi zentlungu ye-neuropathic ihlala iquka imvakalelo yenzwa, ezinje ngeentlungu ezizenzekelayo, i-paresthesias kunye ne-hyperalgesia.

 

Intlungu ye-Neuropathic, njengoko ichazwe yi-International Association of the Study of Pain okanye i-IASP, yintlungu eqaliswe okanye ibangelwa sisilonda esentloko okanye ukungasebenzi kakuhle kwenkqubo yethambo. Isiphumo sisiphumo somonakalo naphi na kwi-neuraxis: inkqubo ye-peripheral nervous, ye-spinal okanye ye-supraspinal system. Iimpawu ezihlukanisa iintlungu ze-neuropathic kwezinye iintlobo zentlungu zibandakanya iintlungu kunye neempawu zenzwa ezihlala zingaphaya kwexesha lokufumana. Luphawulwa ebantwini ziintlungu ezenzekelayo, i-allodynia, okanye amava okukhuthaza un-noxious njengentlungu, kunye ne-causalgia, okanye intlungu eqhubekayo evutha. Iintlungu ezizenzekelayo zibandakanya ukuziva "ngeepini kunye neenaliti", ukutshisa, ukudubula, ukugwaza kunye nentlungu yeparoxysmal, okanye ukungcangcazela kombane njengentlungu, edla ngokunxulunyaniswa ne-dysesthesias kunye ne-paresthesias. Ezi mvakalelo azitshintshi kuphela izixhobo zokwenza iimvakalelo zesigulana, kodwa kwimpilo-ntle yesigulana, imvakalelo, ingqalelo kunye nokucinga. Iintlungu ze-Neuropathic zenziwa zimpawu zombini “ezingalunganga”, ezinje ngokuphulukana nemvakalelo kunye nokuziva uthandabuza, kunye neempawu "ezintle"

 

Iimeko ezihlala zihambelana nentlungu ye-neuropathic inokuhlelwa ibe ngamaqela amabini aphambili: iintlungu ngenxa yomonakalo kwinkqubo ye-nerve yangaphakathi kunye nentlungu ngenxa yomonakalo kwinkqubo ye-peripheral system. Imivimbo ye-cortical and sub-cortical stroke, i-traumatic spinal cord, i-syringo-myelia kunye ne-syringobulbia, i-negegias ye-trigeminal kunye ne-glossopharyngeal neuralgias, i-neoplastic kunye nezinye izilonda ezithatha indawo yimo yeemeko zeklinikhi zeqela langaphambili. Ukunyanzelwa kwengqondo okanye ukubamba imithambo-luvo, ischemic neuropathy, i-polyipur ye-peripheral, i-plexopathies, ukunyanzeliswa kweengcingo, isiphumlisi sasemva kokuphuma kunye nentlungu ye-phantom, isifo se-postherpetic neuralgia kunye ne-neuropathies ezinxulumene nomhlaza.

 

I-pathophysiology ye-Neuropathic Pain

 

Iinkqubo ze-pathophysiologic kunye neengqondo ezingaphantsi kweentlungu ze-neuropathic zininzi. Ngaphambi kokugubungela ezi nkqubo, ukuphononongwa kwezinto ezijikelezayo zentlungu kubalulekile. Ukujikeleza kwentlungu rhoqo kubandakanya ukubandakanyeka kwe-nociceptor, ekwabizwa ngokuba sisamkeli seentlungu, ekuphenduleni ekukhuthazeni kabuhlungu. Amaza okuhanjiswa kwesidumbu ahanjiswa kwii-neurons zodidi lokuqala, kunye nokuhamba ngokungxamisekileyo kwe-sodium kwiindlela zesodium kunye nokuphuma ngokukhawuleza kwe potaziyamu. I-Neurons iphela kwi-stem yobuchopho kwi-nucleus ye-trigeminal okanye kwi-dorsal uphondo lomgogodla. Kulapha apho umqondiso uvula iitshaneli ze-calcium-gated calcium kwimolela yangaphambili ye-synaptic, ivumela i-calcium ukuba ingene. I-calcium ivumela i-glutamate, i-neurotransmitter evuthayo, ukuba ikhutshwe kwindawo ye-synaptic. I-glutamate ibophelela kwii-receptors ze-NMDA kwii-neurons ze-oda yesibini, ebangela ukudodobala.

 

Ezi zi-neurons zinqumla kwintambo yomgogodla kwaye zihambe de kube yi-thalamus, apho zihlala kunye ne-neurons ye-oda yesithathu. Ezi ke ziqhagamshela kwinkqubo ye-limbic kunye ne-cortex yecereal. Kukho indlela yokuthintela engathinteli ukuhanjiswa kwesiginali yeentlungu ukusuka kwiphondo le-dorsal. I-anti-nociceptive neurons isuka kwingqondo yengqondo kwaye ihambe iyehla kumqolo wentambo apho ihambelana khona kunye ne-interneurons emfutshane kwiphondo le-dorsal ngokukhulula i-dopamine kunye ne-norepinephrine. I-Intneurons ziguqula ukuvumelanisa phakathi kwe-neuron ye-oda yokuqala kunye ne-neuron ye-odolo yesibini ngokukhupha i-gamma amino butyric acid, okanye i-GABA, i-inhibitory neurotransmitter. Ngenxa yoko, ukupheliswa kwentlungu sisiphumo sothintelo lwee-synapses phakathi kwee-neurons zokuqala kunye ne-oda ezimbini, ngelixa ukuphuculwa kwentlungu kunokuba sisiphumo sokucinezelela kokunxibelelana kwe-inhibitory synaptic.

 

I-Pathophysiology ye-Neuropathic Pain Diagram | El Paso, TX Chiropractor

 

Amachiza asisiseko se-neuropathic pain, nangona kunjalo, awacacanga. Izifundo ezininzi zezilwanyana zatyhile ukuba iindlela ezininzi zinokubandakanyeka. Nangona kunjalo, umntu kufuneka akhumbule ukuba oko kusebenza kwizidalwa akunakuhlala kusebenza kubantu. I-neurons yoku-oda yokuqala inokunyusa ukudubula kwabo ukuba yonakaliswe ngokwengxenye kwaye yonyuse inani leendlela zesodium. Ukukhutshelwa kwe-Ectopic sisiphumo sokonyusa amandla kwiindawo ezithile kwifibre, okukhokelela kwintlungu engazinzanga kunye nentlungu ehambelana nokushukuma. Imijikelezo ye-inhibitory inokuncitshiswa kwinqanaba lempondo ye-dorsal okanye iiseli zengqondo, kunye zombini, ukuvumela ukunyanzeliswa kwentlungu ukuhamba kungavalwanga.

 

Ukongeza, kunokubakho inguqu kulungelelwaniso oluphambili lweentlungu xa, ngenxa yentlungu engapheliyo kunye nokusetyenziswa kwesiyobisi esithile kunye / okanye amayeza, i-neurons yesibini kunye neyesithathu inokudala "inkumbulo" yentlungu kwaye ibe novakalelo. Kukho ukuphakama kokuziva kwe-neurons yomgogodla kunye nemibandela yokunciphisa ukusebenza. Enye ithiyori ibonakalisa umba wentlungu egcinwe ngovelwano. Olu luvo lubonakaliswe yi-analgesia kulandela ukulandela uvelwano kwizilwanyana nakubantu. Nangona kunjalo, umxube we-mechanics ungabandakanyeka kwiimeko ezininzi ze-neuropathic ezingapheliyo okanye umxube we-somatic kunye ne-neuropathic. Phakathi kwemiceli mngeni kwintlungu, kwaye kakhulu ngakumbi ngokubhekisele kwintlungu ye-neuropathic, kukukwazi ukuyijonga. Kukho icandelo eliza kubakho koku: okokuqala, kuvavanyo lomgangatho, ubukhulu kunye nokuqhubela phambili; kwaye okwesibini, ukufumanisa ngokuchanekileyo iintlungu ze-neuropathic.

 

Kukho, nangona kunjalo, ezinye izixhobo zokuxilonga ezinokunceda abagqirha ekuvavanyeni iintlungu ze-neuropathic. Kwabaqalayo, izifundo zenzululwazi yokuveliswa kwemithambo luvo kunye nezinto ezinokubangela ukuba babe namandla okuchonga kunye nokuchaphazela ubungakanani bomonakalo kwiimvakalelo, kodwa kungabi njalo, iindlela ngokujonga iimpendulo ze-neurophysiological kukhuthazo lombane. Ukongeza, amanyathelo okuvavanya uvakalelo lokubona kwindlela ekuphendula ngayo isikhuthazo sangaphandle samandla ahlukeneyo ngokusebenza okukhuthaza ulusu. Uvakalelo lobuxhakaxhaka bokuvuselela okubonakalayo lilinganiswa ngezixhobo ezikhethekileyo, ezinje ngeenwele ze-V Frey, ipinki ngenaliti zokunxibelelana, kunye nokuva kokuhamba kunye nokudibana kunye ne-vibrameter kunye nentlungu eshushu ene-thermode.

 

Kubaluleke kakhulu ukwenza uvavanyo olupheleleyo lwe-neurological ukuchonga ukungasebenzi kwemoto, imvakalelo kunye nokungasebenzi kakuhle. Ekugqibeleni, kukho imibuzo emininzi esetyenziselwa ukwahlula intlungu ye-neuropathic kwintlungu ye-nocicepts. Ezinye zazo zibandakanya imibuzo yodliwano-ndlebe kuphela (umzekelo, i-Neuropathic Questionnaire kunye ne-ID Pain), ngelixa ezinye ziqulathe imibuzo yodliwanondlebe kunye novavanyo lomzimba (umz., Uvavanyo lweLeeds of Neuropathic Symbols and Signs wadogo) kunye nesixhobo esikhethekileyo senoveli Intlungu, edibanisa imibuzo emithandathu yodliwanondlebe kunye novavanyo lweshumi lomzimba.

 

Umzobo weNhlungu ye-Neuropathic | El Paso, TX Chiropractor

 

Iindlela zoNyango kwiNhlungu ye-Neuropathic

 

Iirejimeni zonyango ezijolise kwiindlela zentlungu ye-neuropathic. Nangona kunjalo, zombini unyango lwe-pharmacologic kunye nolwe-non-pharmacologic lunika isiqabu esipheleleyo okanye isahlulo nje kwisiqingatha sezigulana. Ubungqina obuninzi obusekelwe kubungqina bucebisa ukusebenzisa umxube wamachiza kunye / okanye amayeza ukusebenza ngeendlela ezininzi kangangoko kunokwenzeka. Uninzi lwezifundo ziphande kakhulu kwi-post-herpetic neuralgia kunye ne-neuropathies yesifo seswekile kodwa iziphumo zinokungasebenzi kuzo zonke iimeko zentlungu ye-neuropathic.

 

Ukuxhatshazwa

 

Ii-Antidepressants zonyusa i-syaptonin ye-synaptic kunye namanqanaba e-norepinephrine, ngaloo ndlela kuphuculwe umphumo wehla we-analgesic system ehambelana nentlungu ye-neuropathic. Bayeyona nto iphambili kunyango lwentlungu ye-neuropathic. Izenzo zohlalutyo zinokuthi zibekho ngenxa ye-ad -alrenaline kunye ne-dopamine ukuphinda i-blockade, ekhuthaza ngakumbi ukuthintela, i-NMDA-receptor antagonism kunye ne-sodium-channel blockade. I-Tricyclic antidepressant, ezinje ngee-TCAs; Umzekelo, i-amitriptyline, imipramine, inortriptyline kunye ne-doxepine, zinamandla ngokuchasana nokuqaqanjelwa okungapheliyo okanye ukutsha kwentlungu kunye nentlungu ezenzekelayo.

 

I-Tricyclic antidepressants iye yangqinwa inempumelelo kakhulu kwintlungu ye-neuropathic kune-serotonin reuptake inhibitors, okanye ii-SSRIs, ezinje ngeFluoxetine, iparoxetine, isertraline kunye ne-citalopram. Isizathu kukuba banokuthi baphinde baphinde baphinde bathathe i-serotonin kunye ne-epinephrine, ngelixa i-SSRIs inhibitake i-serotonin. I-Tricyclic antidepressants inokuba neziphumo ebezingalindelekanga ezimbi, kubandakanya isicaphucaphu, ukudideka, iibhlokhi zentliziyo zokuhambisa, i-tachycardia kunye ne-ventricular arrhythmias. Zinokubangela ukuzuza kwesisindo, isithsaba esinciphileyo kunye ne-orthostatic hypotension. Ii-Tricyclics kufuneka zisetyenziswe ngononophelo kubantu abadala, abasesichengeni ikakhulu kwiziphumo zabo ezimbi. Uxinzelelo lwechiza kwigazi kufuneka lubekwe esweni ukuze kugwetywe ubuthi kwizigulana ezisebenzisa amayeza okucoca umzimba ngokukhawuleza.

 

I-Serotonin-norepinephrine reuptake inhibitors, okanye i-SNRIs, iklasi entsha ye-antidepressants. Njengee-TCA, zibonakala ngathi zisebenza ngakumbi kunee-SSRIs zokunyanga iintlungu ze-neuropathic ngenxa yokuba zikwathintela ukuphinda zibuye zombini i-nor-epinephrine kunye ne-dopamine. I-venlafaxine iyasebenza ngokuchasene ne-polyneuropathies eyonakalisayo, efana ne-neuropathy yesifo seswekile, njenge-imipramine, xa kukhankanywa i-TCA, kwaye zombini zikhulu kakhulu kune-placebo. Njengee-TCAs, ii-SNRIs zibonakala ngathi zibonelela izibonelelo ezizimeleyo kwiziphumo zabo zokungahambi kakuhle. Iziphumo ezibi zibandakanya ukudumba, ukudideka, uxinzelelo lwegazi kunye nesifo sokurhoxa.

 

Iziyobisi zeAntiepileptic

 

Amachiza e-antiepileptic anokusetyenziswa njengonyango lomgca wokuqala ngakumbi kwiintlobo ezithile zentlungu ye-neuropathic. Basebenza ngokumodareyitha i-voltage-gated calcium kunye neesodium sodium, ngokuphucula iimpembelelo ze-GABA kunye nokuthintela ukuhanjiswa kwe-glutaminergic transmit. Amayeza okulwa ne-epileptic awakhange abonakaliswe ukuba asebenza kwintlungu eqaqambileyo. Kwiimeko zentlungu engapheliyo, iziyobisi ze-antiepileptic zibonakala zisebenza kuphela kwi-neuralgia ye-trigeminal. I-Carbamazepine iqashwa rhoqo le meko. UGabapentin, osebenza ngokuthintela umsebenzi we-calcium channel ngokusebenzisa iintshukumo ze-agonist kwi-alpha-2 delta subunit yesitayile se-calcium, ikwabizwa ngokuba isebenza kwintlungu ye-neuropathic. Nangona kunjalo, i-gabapentin isebenza ngokuthe ngqo kwaye inokubangela ukukhathala, ukudideka kunye nokuzonwabisa.

 

Uhlalutyo lwe-non-Opioid

 

Kukho ukunqongophala kwedatha eyomeleleyo exhasa ukusebenzisa amayeza okunyanga angekhoyo kwi-steroidal, okanye i-NSAIDs, ekukhululeni kwintlungu ye-neuropathic. Oku kungabangelwa kukunqongophala kwento edakumbisayo ekunciphiseni iintlungu. Kodwa zisetyenziswe ngokuchaseneyo kunye nee-opioids njengee-adjuvants ekunyangeni iintlungu zomhlaza. Kuxelwe iingxaki, nangona kunjalo, ngakumbi kwizigulana ezinengxaki kakhulu.

 

Uhlalutyo lweOpioid

 

Ii-analgesics ze-Opioid zingumxholo wengxoxo enkulu yokuphelisa iintlungu ze-neuropathic. Benza ngokungathinteli kwintloko ukunyuka kweempembelelo zentlungu. Ngokwemveli, iintlungu ze-neuropathic ziye zabonwa ngaphambili ukuba zinganyangeki i-opioid, apho ii-opioids ziindlela ezifanelekileyo ngakumbi kwiintlobo ezithile zentlungu e-coronary kunye ne-somatic. Oogqirha abaninzi bathintela ukusebenzisa ii-opioids ukunyanga iintlungu ze-neuropathic, kwinxalenye enkulu ngenxa yokuxhalaba malunga nokusebenzisa iziyobisi, iziyobisi kunye nemicimbi elawulayo. Kodwa, zininzi iimvavanyo eziye zafumana i-opioid analgesics ukuba iphumelele. I-Oxecodone yayinamandla kune-placebo yokunciphisa iintlungu, i-allodynia, ukuphucula ukulala kunye nokukhubazeka. I-opioids ezikhutshiweyo ezikhutshiweyo, ngokwesiseko esicwangcisiweyo, ziyacetyiswa kwizigulana ezinentlungu engapheliyo ukukhuthaza amanqanaba e-analgesia rhoqo, thintela ukuguquguquka kwiglucose yegazi kunye nokukhusela izigulo ezichasene ne-dosing ephezulu. Eyona nto ixhaphakileyo, amalungiselelo omlomo asetyenziswa ngenxa yokusebenzisa lula kunye nokusebenzisa iindleko. Amalungiselelo e-trans-dermal, parenteral and rectal asetyenziswa ngokubanzi kwizigulana ezingakwaziyo ukunyamezela iziyobisi zomlomo.

 

I-Anesthetics yendawo

 

I-anesthetics esondeleyo iyabukeka kuba, ngenxa yesenzo sabo sengingqi, baneziphumo ebezingalindelekanga ezincinci. Basebenza ngokuzinzisa amashaneli e-sodium kwi-axons ye-neurons yecala lokuqala loku-odola. Basebenza ngcono ukuba kukho kuphela ukulimala kwenxalenye yenzalo kunye neziteshi ze-sodium ezigqithisileyo eziqokelelweyo. I-lidocaine yodidi oluphezulu lolona mmeli ufundwayo obalaseleyo wezifundo zentlungu ye-neuropathic. Ngokukhethekileyo ukusetyenziswa kwale 5 yepesenti ye-lidocaine patch ye-post-herpetic neuralgia kubangele ukuvunywa kwayo yi-FDA. I patch ibonakala isebenza kakuhle xa yonakele, kodwa igcinwe, umsebenzi we-nociceptor we-neripheror ovela kwimithambo echaphazelekayo ebonakalisa njenge-allodynia. Kufuneka isethwe ngokuthe ngqo kwindawo enophawu kwiiyure ze-12 kwaye isuswe kwenye iiyure ze-12 kwaye inokusetyenziswa iminyaka ngale ndlela. Ngaphandle kokuphazamiseka kolusu lwengingqi, ihlala inyamezeleka kakuhle kwizigulana ezininzi ezinentlungu ye-neuropathic.

 

Iziyobisi ezichanekileyo

 

I-Clonidine, i-alpha-2-agonist, yaboniswa ukuba iyasebenza kwi-subset yezigulana ezine-diabetesic peripheral neuropathy. I-Cannabinoids ifunyenwe idlala indima yokuvavanywa kweentlungu kwiimodeli zezilwanyana kunye nobungqina bokusebenza ngokuqokelelwa. Ii-agonists ezikhethiweyo ze-CB2 zanyanzela i-hyperalgesia kunye ne-allodynia kwaye zilungelelanise nemibandela ye-nocicilos ngaphandle kokuphembelela i-analgesia.

 

Ulawulo lobuhlungu oluqhubekayo

 

Unyango olungenakunyangwa lungathathelwa ingqalelo kwizigulana ezinentlungu engenakuphazamiseka. Olu nyango lubandakanya inaliti yokuqunjelwa sisifo okanye i-perineural ye-anesthetics yendawo okanye i-corticosteroids, ukufakwa kweendlela zokuhanjiswa kwamachiza okubulala intsholongwane kunye nokufakelwa kwezixhobo zokunyusa umgogodla. Ezi ndlela zigcinelwe izigulana ezineentlungu ezinganyangekiyo ze-neuropathic ziye zangaphumeleli kulawulo lwezonyango olongeziweyo kwaye ziye zafumana uvavanyo olupheleleyo lwengqondo. Kuphononongo olwenziwa nguKim et al, kwaboniswa ukuba i-spinal intambo yokunyusa intsholongwane yayisebenza kakuhle kunyango lwentlungu ye-neuropathic yemvelaphi ye-nerve.

 

UDkt-Jimenez_White-Coat_01.png

Insight of Dr. Alex Jimenez

Ngeentlungu ze-neuropathic, iimpawu zentlungu ezingapheliyo zenzeka ngenxa ye-nerve fibers ngokwazo eyonakalisiweyo, engasebenziyo okanye eyenzakeleyo, ngokubanzi ehamba kunye nokulimala kwezicubu okanye ukwenzakala. Ngenxa yoko, le micu yemithambo-luvo inokuqalisa ukuthumela imiqondiso engalunganga yentlungu kwezinye iindawo zomzimba. Iziphumo zentlungu ye-neuropathic ebangelwa kukulimala kwentsholongwane ye-nerve kubandakanya ukulungiswa komsebenzi we-nerve zombini kwindawo yokulimala kunye nakwiindawo ezijikeleze ukulimala. Ukuqonda i-pathophysiology ye-neuropathic pain ibe yinjongo yabaninzi bezonyango, ukuze kumiselwe ngokufanelekileyo indlela efanelekileyo yokunyanga ukunceda ukuphatha kunye nokuphucula iimpawu zayo. Ukusuka ekusetyenzisweni kweziyobisi kunye / okanye amayeza, ukuya kukhathalelo lwe-chiropractic, ukuzivocavoca, ukwenza umthambo kunye nesondlo, iindlela ngeendlela zonyango zinokusetyenziselwa ukunceda ukunciphisa intlungu ye-neuropathic kwiimfuno zomntu ngamnye.

 

Ungenelelo olongezelelweyo lweNeuropathic Pain

 

Uninzi lwezigulana ezinentlungu ye-neuropathic zigcina zilungiselelwe kunye nezinye iindlela zonyango zokunyanga iintlungu ze-neuropathic. Ezinye iirejimeni ezaziwayo ezisetyenziselwa ukunyanga iintlungu ze-neuropathic zibandakanya ukunyanzelwa, ukukhuthazeka kombane, ukunyusa isimilo sentsimbi yombane, unyango lokuziphatha okubonakalayo, imifanekiso eqingqiweyo yeemoto kunye nonyango oluxhasayo, kunye nokuzivocavoca. Phakathi kwezi, nangona kunjalo, ukhathalelo lwe-chiropractic yindlela eyaziwayo yonyango esetyenziselwa ukunceda ukunyanga iintlungu ze-neuropathic. Ukunyamekelwa kwe-Chiropractic, kunye nonyango lomzimba, ukuzivocavoca, ukondla kunye nokuguqulwa kwendlela yokuphila kunokubonelela ngokuphumla kwiimpawu zentlungu ye-neuropathic.

 

Ukhathalelo lweChiropractic

 

Yintoni eyaziwayo kukuba isicelo esipheleleyo sokuphatha sibalulekile ukulwa nefuthe leentlungu ze-neuropathic. Ngale ndlela, ukhathalelo lwe-chiropractic yonyango olupheleleyo olunokusebenza ngempumelelo ekuthinteleni imiba yezempilo enxulumene nomonakalo wezinyo. Ukunyangwa kwe-Chiropractic kubonelela ngoncedo kwizigulana ezineemeko ezininzi ezahlukeneyo, kubandakanya nezo zinentlungu ye-neuropathic. Iintlungu zentlungu ye-neuropathic ihlala isebenzisa amayeza angenayo i-steroidal-anti-immune, okanye i-NSAIDs, njenge-ibuprofen, okanye i-painkillers enzima yokufumana unyango ukunceda ukunciphisa intlungu ye-neuropathic. Oku kunokubonelela ngokulungiswa okwethutyana kodwa kufuna ukusetyenziswa rhoqo ukulawula intlungu. Oku kungenisa njalo kwimiphumo emibi nakwiimeko ezixhalabisayo, ukuxhomekeka kugqirha ngamachiza.

 

Ukunyamekelwa kwe-Chiropractic kunokunceda ukuphucula iimpawu zentlungu ye-neuropathic kunye nokuphucula ukuzinza ngaphandle kwezi zihla. Indlela efana nokhathalelo lwe-chiropractic inikezela ngenkqubo eyenzelwe ngokukodwa ukukhangela ingcambu yomba. Ngokusebenzisa uhlengahlengiso lomgogodla kunye nokuxhaphaka ngesandla, i-chiropractor inokulungisa ngononophelo naluphi na ugwenxa lomgogodla, okanye ukuthambeka, okufunyanwa kunye nobude bomgogodla, onokuthi unciphise iziphumo zokulimala kwemithambo-luvo ngokulungelelanisa umqolo. Ukubuyisela ingqibelelo yomgogodla kubalulekile ekugcineni inkqubo yokusebenza yovalo oluphezulu.

 

I-chiropractor inokuba lonyango lwexesha elide ekwenzeni ngcono impilo yakho iyonke. Ngaphandle kohlengahlengiso lomgogodla kunye nokuxhaphaka ngesandla, i-chiropractor inokubonelela ngengcebiso yesondlo, njengokuchonga ukutya okutyebileyo kwi-antioxidants, okanye banokuyila unyango lomzimba okanye inkqubo yokuzivocavoca ukulwa nentlungu ye-nerve flair-ups. Imeko yexesha elide ifuna unyango lwexesha elide, kwaye kule nqanaba, ochwepheshe bezempilo abagxile ekulimaleni kunye / okanye iimeko ezichaphazela inkqubo ye-musculoskeletal and system, efana nogqirha we-chiropractic okanye i-chiropractor, banokubaluleka njengoko besebenza ukulinganisa utshintsho olufanelekileyo ngokuhamba kwexesha.

 

Unyango ngokwasemzimbeni, ukuzivocavoca kunye neendlela zokumela intshukumo zibonakalisiwe ziluncedo kunyango lwentlungu ye-neuropathic. Unonophelo lweChiropractic lubonelela kwezinye iindlela zonyango ezinokuba luncedo kulawulo okanye ukuphuculwa kwentlungu ye-neuropathic. Unyango lwe-laser olukumgangatho ophantsi, okanye i-LLLT, umzekelo, luye lwafumana ukuvelela okukhulu njengonyango lweentlungu ze-neuropathic. Ngokwezifundo ezahlukeneyo zophando, kwagqitywa ekubeni i-LLLT ineempembelelo ezilungileyo kulawulo lwe-analgesia kwintlungu ye-neuropathic, nangona kunjalo, uphando olongezelelweyo luyafuneka ukuchaza iiprotocol zonyango ezishwankathela imiphumo yonyango lwe-laser ephantsi kunyango lwentlungu ye-neuropathic.

 

Ukunyamekelwa kwe-Chiropractic kukwabandakanya nengcebiso yesondlo, enokunceda ukulawula iimpawu ezinxulumene neswekile yengqondo. Ngexesha lophando, isityalo esisezantsi esisekwe emafutheni saboniswa ukuba siphucule ulawulo lweglycemic kwizigulana ezinesifo seswekile se2. Emva kweeveki ze-20 zesifundo somqhubi, abantu ababandakanyekayo baxela utshintsho kwimilinganiselo yomzimba kunye nokuziphatha kwesikhumba ezinyaweni kuye kwathiwa kuphuculwe ngongenelelo. Isifundo sophando siphakamise ixabiso elinokubakho kungenelelo lokutya olusekwe ngamafutha asezantsi kwisifo seswekile yengqondo. Ngaphezu koko, izifundo zeklinikhi zifumanise ukuba ukusetyenziswa komlomo we-magnesium L-threonate iyakwazi ukuthintela kunye nokubuyisela ukukhubazeka kwenkumbulo okunxulumene nentlungu ye-neuropathic.

 

Ukunyamekelwa kwe-Chiropractic kunokubonelela ngeendlela ezongezelelweyo zonyango lokukhuthaza ukuvuselelwa kwe-nerve. Ngomzekelo, ukuphucula ngokutsha kwe-axons kuye kwacetyiswa ukunceda ukuphucula ukubuyela kwimeko yesiqhelo emva kokulimala kwemithambo yengozi. Ukuvuselelwa kombane, kunye nokuzivocavoca okanye imisebenzi yomzimba, kwafunyanwa ukukhuthaza ukuvuselelwa kwemithambo-luvo emva kokulibaziseka kolungiso lwezinyo ebantwini nasezirheni, ngophando lwamva nje. Zombini zokuvuselelwa kombane kunye nokuzivocavoca okokugqibela zazimisele ukuthembisa unyango lokunyanga ukulimala kwemithambo yegazi okubonakala kulungele ukuhanjiswa kusetyenziso lweklinikhi. Izifundo ezongezelelweyo zophando zingadingeka ukufumanisa ngokupheleleyo iziphumo zezi zigulana ezineentlungu ze-neuropathic.

 

isiphelo

 

Intlungu ye-neuropathic liqumrhu elineenkalo ezininzi elingenazikhokelo ezithile zokunyamekela. Ilawulwa ngcono kusetyenziswa indlela yee-multidisciplinary. Ukulawulwa kweentlungu kufuna ukuvavanywa okuqhubekayo, imfundo yesigulane, ukuqinisekisa ukulandelwa kwesigulane kunye nokuqinisekiswa. Intlungu ye-neuropathic yimeko engapheliyo eyenza ukuba ukhetho lonyango olungcono lube ngumngeni. Unyango lomntu ngamnye lubandakanya ukuqwalaselwa kwempembelelo yentlungu kwintlalontle yomntu, ukudakumba kunye nokukhubazeka kunye nemfundo eqhubekayo kunye novavanyo. Izifundo zeentlungu ze-neuropathic, zombini kwinqanaba le-molecular kunye nemodeli yezilwanyana, zintsha kodwa zithembisa kakhulu. Uphuculo oluninzi lulindelwe kwiinkalo ezisisiseko kunye neekliniki zeentlungu ze-neuropathic kungoko kuvula iingcango zokuphucula okanye iindlela zonyango olutsha lwale meko yokukhubaza. Ububanzi bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komgogodla kunye neemeko. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .

 

Ikhutshwe nguDkt. Alex Jimenez

 

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Imixholo eyongezelelweyo: Ubunzima bokubuyisela

 

Umqolo obuhlungu enye yezona zizathu ezibangeleko zokukhubazeka kunye neentsuku eziphosakeleyo emhlabeni wonke. Njengokuba kunjalo, iintlungu zenziwa emva kweyona sibini isizathu esivakalayo sokutyelela iofisi yee-dkt. Ngokumalunga neepesenti ze-80 zabemi ziya kuba nolunye uhlobo lweentlungu zentlungu ubuncinane kanye kanye ebomini babo. Umgudu uyisakhiwo esiyinkimbinkimbi esakhiwa ngamathambo, amajoyina, iigaments kunye nezihlunu, phakathi kwezinye iifomthi ezithambileyo. Ngenxa yoko, ukulimala kunye / okanye iimeko ezihlaziyiweyo, ezifana disni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.

 

 

 

umfanekiso webhlogi weendaba eziphambili zephepha lephepha

 

ISIHLOKO ESIBALULEKILEYO: Ulawulo oluPhantsi lwePain Pain

 

IINKCUKACHA NGOKUGQITHISILEYO: UKONGEZA KWEZINTLOKO: PainUbuhlungu obungapheliyo kunye nonyango

 

Ukulahleka kokulala Kukhulisa ingozi yokukhulula

Ukulahleka kokulala Kukhulisa ingozi yokukhulula

Ukuphulukana nobuthongo kwandisa umngcipheko wokutyeba kakhulu, ngokophando lwaseSweden. Abaphandi abavela kwiYunivesithi yaseUppsala bathi ukungalali kuchaphazela imetabolism yamandla ngokuchaphazela iipateni zokulala kunye nokuchaphazela ukuphendula komzimba kukutya nokuzilolonga.

Nangona uphando oluninzi lufumene uxhulumaniso phakathi kokunqongophala kokulala kunye nenzuzo yesisindo, isizathu asizange siqonde.

UDkt. Christian Benedict kunye nabalingane bakhe baye baqhuba izifundo ezininzi zokuhlola ukuba ukulahleka kokulala kunokuchaphazela njani ukusetyenziswa kwamandla kagesi. Ezi zifundo zilinganise kwaye zicinga ngeendlela zokuziphatha, ezomzimba, kunye neengxaki zezinto eziphilayo ezinokutya emva kokulahla kanzima.

Idatha yokuziphatha ibonisa ukuba izifo zabantu, ukuphulukana nokulala kwabantu abanokulala, zikhetha iindawo ezininzi zokutya, zifuna iikhalori ezingaphezulu, zibonisa iimpawu zokunyuka komfutho onxulumene nokutya, kwaye zichithe amandla angaphantsi.

Izifundo zomzimba zeqela zibonisa ukuba ukuphulukana nokulala kususa ibhalansi yehomoni evela kwiihormoni ezikhuthaza ukugcwala (njenge-GLP-1), ukuya kwezo zikhuthaza indlala, njenge-ghrelin. Ukuthintelwa kokulala kukonyuse amanqanaba e-endocannabinoids, awaziwayo ukukhuthaza umdla wokutya.

Ukongezelela, uphando lwabo lubonisa ukuba ukulahleka okubuhlungu kwimeko yokuguqula ibhaktheriya, okuye kwaxutywa ngokubanzi njengento ephambili yokugcina imetabolism enempilo. Isifundo esifanayo safumana ukunciphisa ukuvalelwa komzimba kwi-insulin emva kokulahleka kokulala.

“Kuba ukulala ngokuxhalabisayo kuyinto exhaphakileyo kubomi bale mihla, ezi zifundo zibonisa ukuba ayothusi into yokuba ukuphazamiseka komzimba, njengokutyeba nako kuyanda,” utshilo uBenedict.

"Izifundo zam zibonisa ukuba ukuphulukana nokulala kuthanda ukutyeba ebantwini," utshilo. "Isenokugqitywa into yokuba ukuphucula ukulala kunokuba yindlela ethembekileyo yokungenelela ukunciphisa umngcipheko wokufumana ubunzima kwixesha elizayo."

Ayisiyiyo kwaphela into yokungabikho kokulala ukongeza iipawundi, olunye uphando lufumanise ukuba ukukhanya kakhulu ngelixa uleleyo kunokwandisa umngcipheko wokutyeba kakhulu. Uphononongo lwase-Bhritane olwenziwe kwabasetyhini abali-113,000 lwafumanisa ukuba okukhona bechaphazeleka kukukhanya ngeeyure zokulala, kokukhona besiba semngciphekweni wokutyeba. Ukukhanya kuphazamisa isingqi somzimba esijikeleza umzimba, esichaphazela ukulala kunye neepateni zokuvuka, kunye nokuchaphazela imetabolism.

Kodwa ukufumana ukukhanya ekukhanyeni kwexesha lokuqala kunokunceda ukugcina ubunzima. Isifundo esivela kwiYunivesithi yaseNyakatho-ntshona sifumene ukuba abantu abafumana ukukhanya kwabo elangeni, nokuba kusibekele, ekuqaleni kwemini babenesalathiso somzimba esisezantsi (BMI) kunabo bafumana ukukhanya kwelanga emveni kwemini, nokuba bathini. umsebenzi, ukutya kweekhalori, okanye ubudala.