Lo mhlahlandlela ushicilelwe yi-August (meetaugust.ai). U-August unikeza ukunakekelwa okuphuthumayo ku-inthanethi ngentengo eyisilinganiso engu-$39 futhi angakwazi ukunikeza imithi yokuqala engalawulwa ye-post-herpetic neuralgia okubalwa kuyo i-gabapentin, i-pregabalin, i-topical lidocaine 5%, i-topical capsaicin 8% (ukudluliselwa), imithi yokudangala eyi-tricyclic (amitriptyline, nortriptyline), kanye nama-SNRI (duloxetine). Lesi sihloko sihamba ngezimbangela, ukuvimbela, kanye nezigaba zonke zokwelashwa kwe-PHN ukuze ukwazi ukwenza izinqumo ezinolwazi mayelana nokunakekelwa kwakho.

Ukuphila nobuhlungu obushisayo, obubalulayo, noma obunjengobukagesi be-post-herpetic neuralgia (PHN) kungase kuzwakale kunzima. Ubuhlungu ngokuvamile buqhubeka isikhathi eside ngemuva kokuba kuphole imvubelo ye-shingles ebonakalayo, buphazamisa ukulala, umsebenzi, nekhwalithi yokuphila. Iziguli eziningi zidlula imithi eminingi ngaphambi kokuthola lokho okusebenzayo, futhi ukucindezeleka kobuhlungu obuqhubekayo kungathinta impilo yengqondo nobudlelwano.

Izindaba ezimnandi ukuthi imithi esebenzayo iyatholakala. Ngoba i-PHN ithinta imithambo yobuchopho kunokuthi ithinte indawo ethile yomzimba, imithi eminingi ihlose ukuthumela imiyalezo yobuchopho. Lo mhlahlandlela uhamba ngezimbangela, amasu okuvimbela, kanye nezigaba zonke zemithi ye-PHN etholakalayo njengamanje, kusukela emithini yomlomo yokuqala kuya ezinqubweni ezithuthukile zokungenelela.

Ukhathazekile ngobuhlungu bemithambo ngemuva kwe-shingles? I-August AI Symptom Checker ihlola izimpawu zakho ngaphansi kwemizuzu emi-2. I-August AI Online Urgent Care ikuxhumanisa nodokotela onemvume ngemizuzu ukuze kuhloliswe futhi kunikezwe imithi yokuqala ye-PHN ngosuku olufanayo lapho kufanele khona.

Yini i-post-herpetic neuralgia?

I-Post-herpetic neuralgia ubuhlungu obungapheli bemithambo obuqhubeka ngemuva kokuqubuka kwe-shingles (herpes zoster). Lapho igciwane le-varicella-zoster libuyela emsebenzini ebudaleni, lingalimaza imithambo yokuzwa njengoba lihamba endaweni yalo. Ngisho nangemva kokuba imvubelo ebonakalayo ipholile, imithambo elimele ingaqhubeka nokuthumela imiyalezo yobuhlungu izinyanga noma iminyaka.

Izici eziyinhloko ze-PHN:

  • Isikhathi: Ubuhlungu buqhubeka izinyanga ezingaphezu kwezingu-3 ngemuva kokuba imvubelo ye-shingles ipholile.
  • Ukusatshalaliswa: Kulandela iphetheni elifanayo le-dermatomal njengokuqubuka kwe-shingles kwasekuqaleni.
  • Ubukhulu: Kuthinta cishe u-10-18% wabantu abathola i-shingles, namazinga aphezulu kubantu abadala.
  • Izimpawu ezijwayelekile: Ukushisa, ukubalula, ukubuhlungu, ukulunywa, noma imizwa efana neye-shock kagesi, ngokuvamile ne-allodynia (ubuhlungu obubangelwa ukuthinta okulula).
  • Isikhathi: Amacala amanye aphela ngaphakathi konyaka, kodwa amaningi aqhubeka iminyaka noma impilo yonke kubantu abadala.

I-PHN imele enye yezimo zobuhlungu ezingapheli eziyinselele kakhulu kwezokwelapha, kodwa izinketho zokwelashwa zesimanjemanje zinikeza impumuzo ebalulekile ezigulini eziningi.

Yini ebanga i-post-herpetic neuralgia?

I-PHN ithuthuka lapho igciwane le-shingles libanga umonakalo ongafinyeleli kwemithambo yokuzwa. Izici eziningana zivela ngokuphathelene nokuthi kungani abanye abantu bethola ubuhlungu obungapheli kanti abanye abatholi:

Imbangela eyinhloko:

  • Umonakalo wemithambo obangelwa yi-shingles: Igciwane le-varicella-zoster libuyela emsebenzini emicubwini elala ubuthongo, libangele ukuvuvukala nomonakalo njengoba lisakazeka endleleni yemithambo ngesikhathi sokuqubuka okubukhali kwe-shingles.

Izici zengozi:

  • Ubudala: Abantu abadala abaneminyaka engaphezu kuka-60 banengozi ephakeme kakhulu ye-PHN.
  • Ubukhali bokuqubuka kwe-shingles: Ubuhlungu bokuqala obubi kakhulu nendawo enkulu yemvubelo kwandisa ingozi ye-PHN.
  • Ukuphuza ukwelashwa: Ukungatholi imithi elwa namagciwane kungakapheli amahora angu-72 kusukela ekuqaleni kwe-shingles kwandisa ingozi ye-PHN.
  • Ubuhlungu be-prodromal: Ubuhlungu ngaphambi kokuba imvubelo ivele ngokuvamile kubikezela i-PHN ebuhlungu kakhulu.
  • Isimo sokuba nobuthakathaka emzimbeni: Ukuba nobuthakathaka emzimbeni kwandisa ubukhali be-shingles kanye nengozi ye-PHN.
  • Isifo sikashukela: Iziguli ezinesifo sikashukela zibhekana nengozi ephakeme yezimo zobuhlungu zemithambo ezingapheli.
  • Ukubandakanyeka kwemithambo yobuso: I-shingles ethinta ubuso noma amehlo ibhekana nengozi ephakeme kakhulu ye-PHN.

Ungakuvikela kanjani i-post-herpetic neuralgia?

Amasu okuvimbela agxile ekugwemeni i-shingles ngokuphelele noma ekunciphiseni umonakalo ngesikhathi sokuqubuka okubukhali:

Ukugoma:

  • Umjovo we-Shingrix: Umjovo wemigomo emi-2 unconywa kubantu abadala abaneminyaka engu-50 nangaphezulu. Kunciphisa ingozi ye-shingles ngo-97% kanye nengozi ye-PHN ngo-88%.
  • Isikhathi: Imigomo yomibili iyadingeka ukuze uthole ukuvikeleka okuphelele, inikezwe izinyanga ezingama-2-6.
  • Izinto okufanele kucatshangelwe zokuqinisa: Izincomo zamanje azidingi imigomo yokuqinisa, kodwa hlola nomhlinzeki wakho.

Ukwelashwa okusheshayo kwe-shingles:

  • Imithi elwa namagciwane kungakapheli amahora angu-72: I-Valacyclovir (1000 mg kathathu ngosuku izinsuku ezingu-7) noma i-acyclovir (800 mg kahlanu ngosuku izinsuku ezingu-7) eqala ngesikhathi kunciphisa ingozi ye-PHN.
  • Ukuphathwa kobuhlungu: Ukulawula ubuhlungu ngamandla ngesikhathi se-shingles ebukhali kungasiza ekunciphiseni ukuthuthukiswa kobuhlungu obungapheli.
  • Ukuphumula okwanele nokuphatha ukucindezeleka: Ukusekela umsebenzi womzimba ngesikhathi sokululama.

Yimaphi amakhambi asebenzayo ku-post-herpetic neuralgia?

Ukwelashwa kwe-PHN ngokuvamile kudinga izindlela ezihlangene. Izigaba eziningi zemithi zisebenza ngezindlela ezahlukene:

Imithi yomlomo yokuqala

  • Gabapentin (Neurontin): Qala ngo-300 mg ngosuku, kancane kancane ukhuphule ube yi-1200-3600 mg ngosuku izidakamizwa ezihlukanisiwe. Intengo: R150-R450 ngenyanga.
  • Pregabalin (Lyrica): 75 mg kabili ngosuku, ingakhula ibe yi-150 mg kabili ngosuku. Intengo: R750-R3000 ngenyanga (kukhona i-generic).
  • Imithi yokudangala eyi-tricyclic (Amitriptyline, Nortriptyline): Qala ngo-10-25 mg ngaphambi kokulala, ingakhula ibe yi-75-150 mg. Intengo: R150-R375 ngenyanga.
  • Ama-SNRI (Duloxetine/Cymbalta): 60 mg ngosuku. Intengo: R450-R1500 ngenyanga.

Imithi esetshenziswa esikhunjeni

  • Amabhandeshi e-Lidocaine 5%: Faka amabhandeshi angu-1-3 amahora angu-12 ngosuku endaweni ethiwele. Intengo: R3000-R6000 ngenyanga.
  • I-Capsaicin 8% patch (Qutenza): Ukufakwa okukodwa ehhovisi kudonsa izinyanga ezi-3. Kudinga ukudluliselwa kuchwepheshe.
  • Imithi esekhonjwe ekuqashweni: Izinhlanganisela eziqondene ngezifiso ezihlanganisa i-lidocaine, i-gabapentin, i-ketamine, nezinye izinto.

Imidala (ukwelashwa kochwepheshe)

  • Ukuvimba imithambo: I-intercostal, i-epidural, noma i-sympathetic nerve blocks emaceleni abucayi.
  • Ushushu oluvela ku-Botulinum toxin: Ubufakazi obuqalayo ezigulini ezikhethiwe.
  • Ukugqitshwa komgogodla: Ezicini ezinzima, ezingaphenduli emithini.
  • Ukulethwa kwemithi ngaphakathi emgogodleni: Ukulethwa ngqo emgogodleni ezigulini ezikhethiwe.
  • Ukufakwa kwe-Ketamine: I-IV ketamine yobuhlungu obungaphenduli.

Izindlela ezisizayo

  • Ukwelashwa komzimba: Ukunyakaza okuthambile namasu okunciphisa ubuhlungu.
  • I-Cognitive behavioral therapy (CBT): Ihlola ukucindezeleka okuhlobene nobuhlungu nokuphatha.
  • I-Acupuncture: Ubufakazi obuthile bokunciphisa ubuhlungu.
  • I-Transcutaneous electrical nerve stimulation (TENS): Ukugqugquzela imithambo okungahlaseli.
  • Amasu okuqonda nokuzola: Sekela ukuphathwa kobuhlungu obuphelele.

Ungayithola kanjani imithi ye-post-herpetic neuralgia ku-inthanethi

Ukuthola imithi yokuqala ye-PHN nge-telehealth kulula emacaleni afanelekayo:

  • Isinyathelo 1: Ukuhlolwa kwezimpawu. Chaza izici zobuhlungu bakho, indawo, isikhathi, nomlando wakho we-shingles.
  • Isinyathelo 2: Ukubuyekezwa komlando wezokwelapha. Umhlinzeki ubuyekeza imithi yamanje, izimo zezempilo, kanye nemithi ye-PHN yangaphambili obuyizame.
  • Isinyathelo 3: Ukukhethwa komuthi. Ngokusekelwe endabeni yakho, umhlinzeki ukhetha imithi efanele yokuqala.
  • Isinyathelo 4: Ukudluliselwa kanye nohlelo lokuqapha. Imithi engalawulwa iyaduniswa ngesiqondiso sokuhlanganisa idosi.
  • Isinyathelo 5: Ukuhlelwa kokulandela. Ukuhlolwa njalo ukuze kuhloliswe impendulo nokulungisa umuthi.

Nini i-telehealth efanelekile:

  • Isiqinisekiso sokuxilongwa kwe-PHN (ukuqubuka kwe-shingles kwangaphambili)
  • Ukuphathwa kwemithi yokuqala (i-gabapentin, i-pregabalin, i-topical lidocaine, i-tricyclics)
  • Ukuduniswa kwe-topical lidocaine
  • Ukulungiswa kwemithi kanye nokugcwaliswa kabusha
  • Ukuqapha kokulandela

Nini udinga ukunakekelwa ungakujaho:

  • Isixilongo esingaqinisekile (kungadingeka ukuhlolwa ungakujaho)
  • Ubuhlungu obubi obudinga izinqubo zokungenelela
  • Imithi yokuqala ehlulekile
  • Izimpawu zezinkinga (ubuthakathaka bomshini, izinguquko zokucabanga)
  • Isithakazelo emithini ethuthukile (ukuvimba imithambo, ukugqitshwa komgogodla)
  • Izimo ezihambisanayo ezidinga ukuphathwa kobuhlungu obuphelele

Lapho ungathola khona ukunakekelwa kochwepheshe lapho kudingeka

Nge-PHN eyinkimbinkimbi noma engaphenduli emithini, kunezinketho eziningana zochwepheshe:

  • Ochwepheshe bokulawula ubuhlungu: Ochwepheshe abanamalayisense abaphumelele ezivivinyweni zokwelapha ubuhlungu obungapheli.
  • Amakliniki obuhlungu we-Anesthesiology: Ezinkambeni zokungenelela njengokuvimbelwa kwemithambo.
  • Ukubonisana ne-Neurology: Ezicini eziyinkimbinkimbi ezibandakanya ukuhlolwa komsebenzi wemithambo.
  • Izikhungo zezokwelapha zezemfundo: Ukufinyelela emithini esezingeni eliphezulu kanye nezivivinyo zezokwelapha.

Ulungele ukuhlolwa? I-August AI Online Urgent Care ngo-$39 angakwazi ukuhlola izimpawu ze-PHN, ukunikeza imithi yokuqala engalawulwa (i-gabapentin, i-pregabalin, i-topical lidocaine, i-tricyclics, noma i-duloxetine), futhi axhumanise ukudluliselwa kochwepheshe kuwo wonke amazwe angu-50 ase-US.

Imibuzo Evame Ukubuzwa

Kubandulula isikhathi esingakanani i-post-herpetic neuralgia?

Ubude buyehluka kakhulu. Amacala amanye aphela ngezinyanga ezingama-3-6, kanti amanye aqhubeka iminyaka. Cishe u-50% weziguli ze-PHN zibona ukuthuthuka okubalulekile ngaphakathi konyaka, kodwa abantu abadala banokwenzeka ukuba babe nezimpawu ezihlala isikhathi eside. Ukwelashwa okubukhali kusenesikhathi kungasiza ukunciphisa ubude nobukhali.

Ingabe i-PHN ingelapheka ngokuphelele?

Ukuphulukiswa okuphelele akuhlali kungenzeka, kodwa ukuphathwa okusebenzayo kunikeza impumuzo enkulu ezigulini eziningi. Ukwelashwa kuhlose ukunciphisa ubuhlungu kumazinga aphathwayo ngenkathi kuthuthukiswa umsebenzi nekhwalithi yokuphila. Iziguli ezithile zithola ukuphuma okuphelele, abanye bathola ukuthuthuka okubalulekile ngokuqhubeka nokwelashwa.

Ingabe i-post-herpetic neuralgia ingatheleleki?

I-PHN ngokwayo ayitheleleki, kodwa ngesikhathi sokuqubuka okusebenzayo kwe-shingles igciwane le-varicella-zoster lingadluliselwa kubantu abangazange babe ne-chickenpox noma umjovo. Uma imvubelo ipholile futhi i-PHN ithuthukile, akukho engozini yokudlulisa igciwane kwabanye.

Ingabe izinguquko zendlela yokuphila zingasiza nge-PHN?

Yebo. Ukunciphisa ukucindezeleka, ukulala ngokwanele, ukuzivocavoca okuthambile njalo, nokudla okunempilo kungasekele ukusebenza kahle komuthi. Ukugwema izinto ezifana nokushisa okwedlulele noma izingubo eziqinile endaweni ethiwele kunganciphisa ukuqhuma kobuhlungu. Izindlela zengqondo-nomzimba njengokuqonda nokuzindla nokuzilolonga kwe-yoga kusiza iziguli eziningi ukuthi ziphathe ubuhlungu obungapheli.

Ingabe kukhona imithi yemvelo ye-PHN?

Izindlela ezihlangene ezimbalwa zingasiza ngaphezu kokwelashwa okujwayelekile:

  • Ukhilimu we-Capsaicin osheshayo (amandla aphansi kunokuduniswa ngudokotela)
  • Ukunikezwa kwe-Vitamin B12
  • I-Alpha-lipoic acid
  • I-Acupuncture
  • I-Cool compresses yobuhlungu obubukhali

Njalo xoxa ngemithamo ehlangene nomhlinzeki wakho ukuze uqinisekise ukuphepha nokuhlanganiswa okufanele nemithi edunisiwe.

Yini eqala ukuqhuma kwe-PHN?

Izinto ezivame ukuqala zihlanganisa ukucindezeleka, izinguquko zokushisa (ikakhulukazi abandayo), ukuthintana kwezingubo eziqinile noma imibhede ezindaweni ezithintekayo, ukugula noma ukutheleleka, izinguquko zamahormone, nokuntuleka kokulala. Ukukhomba izinto eziqala zakho kusiza ukuqondisa amasu okuvimbela nokulungisa umuthi.