Jin zafi na Neuropathic yana nufin aikin da ba a saba da shi ba, jin zafi da jin zafi ba tare da bata lokaci ba ta hanyar rauni ko cuta na tsarin jin dadin jiki na somatic.Yawancin su har yanzu suna iya kasancewa tare da jin zafi a cikin yanki mai dacewa da ke ciki bayan kawar da abubuwan da suka faru na rauni, wanda aka bayyana a matsayin ciwo maras lokaci, hyperalgesia, hyperalgesia da rashin jin daɗi.A halin yanzu, magungunan don kawar da ciwon neuropathic sun hada da magungunan tricyclic antidepressants, 5-hydroxytryptamine norepinephrine reuptake inhibitors, anticonvulsants gabapentin da pregabalin, da opioids.Duk da haka, tasirin maganin miyagun ƙwayoyi yana iyakancewa sau da yawa, wanda ke buƙatar tsarin kulawa na multimodal kamar farfadowa na jiki, tsarin jijiyoyi da kuma aikin tiyata.Rashin ciwo na yau da kullum da iyakancewar aiki zai rage haɗin gwiwar zamantakewa na marasa lafiya kuma ya haifar da nauyin tunani da tattalin arziki mai tsanani ga marasa lafiya.
Platelet Rich Plasma (PRP) samfuri ne na plasma tare da tsaftataccen platelet wanda aka samu ta hanyar centrifuging jini mai sarrafa kansa.A cikin 1954, KINGSLEY ta fara amfani da kalmar likita ta PRP.Ta hanyar bincike da ci gaba a cikin 'yan shekarun nan, an yi amfani da PRP sosai a cikin kashi da haɗin gwiwa, aikin tiyata na kashin baya, dermatology, gyarawa da sauran sassan, kuma yana taka muhimmiyar rawa a fagen gyaran injiniya na nama.
Babban ka'idar jiyya ta PRP ita ce allurar da aka tattara tantanin halitta a wurin da aka ji rauni kuma a fara gyaran nama ta hanyar sakin nau'ikan abubuwan da ke haifar da rayuwa (abubuwan girma, cytokines, lysosomes) da sunadaran adhesion.Wadannan abubuwan bioactive sune ke da alhakin fara amsawar hemostatic cascade, haɗuwa da sabbin kayan haɗin gwiwa da sake gina jijiyoyin jini.
Rarrabewa da cututtukan cututtuka na ciwon neuropathic Hukumar Lafiya ta Duniya ta fitar da 11th da aka sake fasalin na Ƙungiyar Ƙasa ta Duniya a cikin 2018, ta rarraba ciwon neuropathic zuwa tsakiyar ciwon neuropathic da ciwon neuropathic na gefe.
An rarraba ciwon neuropathic na gefe bisa ga etiology:
1) Kamuwa da kumburi: postherpetic neuralgia, kuturta mai raɗaɗi, syphilis/HIV kamuwa da cutar neuropathy na gefe.
2) Ƙunƙarar jijiya: ciwo na rami na carpal, ciwon radicular degenerative na kashin baya
3) Raɗaɗi: rauni / ƙonawa / post-operative / post radiotherapy zafi neuropathic
4) Ischemia / metabolism: ciwon sukari na gefe neuropathic zafi
5) Drugs: na gefe neuropathy lalacewa ta hanyar kwayoyi (kamar chemotherapy)
6) Wasu: ciwon daji, trigeminal neuralgia, glossopharyngeal neuralgia, Morton's neuroma.
Hanyoyin rarrabuwa da shirye-shiryen PRP gabaɗaya sun yi imanin cewa ƙwayar platelet a cikin PRP ya ninka sau huɗu ko biyar na duka jini, amma an sami ƙarancin ƙima.A cikin 2001, Marx ya bayyana cewa PRP ya ƙunshi aƙalla platelets miliyan 1 a kowace microlita na plasma, wanda shine alamar ƙididdiga na ma'auni na PRP.Dohan et al.An rarraba PRP zuwa nau'i hudu: PRP mai tsabta, mai wadataccen leukocyte PRP, fibrin mai arziki na platelet, da fibrin mai arziki na leukocyte bisa nau'ikan abubuwan da ke cikin platelet, leukocyte, da fibrin a cikin PRP.Sai dai in an kayyade, PRP yawanci tana nufin PRP mai arzikin farin cell.
Mechanism na PRP a cikin Jiyya na Neuropathic Pain Bayan rauni, daban-daban endogenous da exogenous activators za su inganta platelet kunnawa α- The granules sha degranulation dauki, saki da babban adadin girma dalilai, fibrinogen, cathepsin da hydrolase.Abubuwan haɓakar haɓakar da aka saki suna ɗaure zuwa saman farfajiyar tantanin halitta na kwayar da aka yi niyya ta hanyar masu karɓa na transmembrane akan membrane tantanin halitta.Wadannan masu karɓa na transmembrane suna haifar da kuma kunna sunadaran sigina na endogenous, suna ƙara kunna manzo na biyu a cikin tantanin halitta, wanda ke haifar da yaduwar kwayar halitta, haɓakar matrix, haɗin furotin na collagen da sauran maganganun kwayoyin halitta.Akwai shaidar cewa cytokines da aka saki ta hanyar platelets da sauran masu watsawa suna taka muhimmiyar rawa wajen rage / kawar da ciwon neuropathic na kullum.Za a iya raba ƙayyadaddun hanyoyin da za a iya raba su zuwa na'urori na gefe da na tsakiya.
Mechanism na platelet mai arzikin plasma (PRP) a cikin maganin ciwon neuropathic
Hanyoyi na gefe: tasirin anti-mai kumburi, neuroprotection da haɓaka haɓakar axon, tsarin rigakafi, tasirin analgesic
Tsarin tsakiya: raunanawa da juyawa tsakiyar wayewar kai da hana kunna glial cell
Tasirin Anti-mai kumburi
Hankali na gefe yana taka muhimmiyar rawa a cikin bayyanar cututtuka na ciwon neuropathic bayan raunin jijiya.Kwayoyin kumburi iri-iri, irin su neutrophils, macrophages da mast cells, sun shiga cikin wurin raunin jijiya.Tarin da ya wuce kima na sel masu kumburi suna kafa tushen tashin hankali da ci gaba da fitar da zaruruwan jijiya.Kumburi yana sakin adadi mai yawa na masu shiga tsakani, irin su cytokines, chemokines da masu shiga tsakani na lipid, suna sa nociceptors masu hankali da farin ciki, da haifar da canje-canje a cikin yanayin sinadarai na gida.Platelets suna da tasiri mai ƙarfi na immunosuppressive da anti-mai kumburi.Ta hanyar tsarawa da ɓoye abubuwa daban-daban na tsarin rigakafi, abubuwan angiogenic da abubuwan abinci mai gina jiki, za su iya rage halayen rigakafi masu cutarwa da kumburi, da kuma gyara lalacewar nama daban-daban a cikin microenvironments daban-daban.PRP na iya taka rawar anti-mai kumburi ta hanyoyi daban-daban.Zai iya toshe sakin cytokines masu kumburi daga ƙwayoyin Schwann, macrophages, neutrophils da ƙwayoyin mast, da kuma hana maganganun kwayoyin halitta na masu karɓar ƙwayoyin cuta ta hanyar inganta canjin kyallen takarda da aka lalata daga yanayin kumburi zuwa yanayin rashin lafiya.Ko da yake platelets ba su saki interleukin 10 ba, platelets suna rage yawan samar da interleukin 10 mai yawa ta hanyar haifar da ƙananan dendritic sel γ- Samar da interferon yana taka rawar anti-mai kumburi.
Tasirin Analgesic
Ƙwayoyin da aka kunna suna saki da yawa pro-inflammatory da anti-inflammatory neurotransmitters, wanda zai iya haifar da ciwo, amma kuma rage kumburi da zafi.Sabbin platelet ɗin da aka shirya suna barci a cikin PRP.Bayan an kunna shi kai tsaye ko a kaikaice, tsarin halittar platelet ya canza kuma yana haɓaka haɓakar platelet, sakin ƙwayoyin α-Dense na cikin ciki da ƙwayoyin hankali zasu ta da sakin 5-hydroxytryptamine, wanda ke da tasirin ka'ida.A halin yanzu, 5-hydroxytryptamine masu karɓa an fi gano su a cikin jijiyoyi na gefe.5-hydroxytryptamine zai iya rinjayar watsawar nociceptive a cikin kyallen takarda ta hanyar 5-hydroxytryptamine 1, 5-hydroxytryptamine 2, 5-hydroxytryptamine 3, 5-hydroxytryptamine 4 da 5-hydroxytryptamine 7 masu karɓa.
Hana Kunna Kwayoyin Glial
Kwayoyin Glial suna lissafin kusan kashi 70% na sel na tsarin juyayi na tsakiya, waɗanda za a iya raba su zuwa nau'ikan uku: astrocytes, oligodendrocytes da microglia.An kunna Microglia a cikin sa'o'i 24 bayan raunin jijiya, kuma an kunna astrocytes ba da daɗewa ba bayan raunin jijiya, kuma kunnawa ya kasance na tsawon makonni 12.Astrocytes da microglia sannan su saki cytokines kuma suna haifar da jerin amsawar salula, irin su haɓakar glucocorticoid da masu karɓa na glutamate, wanda ke haifar da canje-canje a cikin motsa jiki na kashin baya da ƙwayar ƙwayar cuta, wanda ke da dangantaka da abin da ya faru na ciwon neuropathic.
Abubuwan da ke da hannu wajen ragewa ko kawar da ciwon neuropathic a cikin plasma mai arzikin platelet
1) Angiopoietin:
haifar da angiogenesis;Ƙarfafa ƙaurawar ƙwayoyin endothelial da yaduwa;Taimakawa da daidaita ci gaban jijiyoyin jini ta hanyar ɗaukar pericytes
2) Abubuwan haɓakar nama mai haɗawa:
Ƙarfafa ƙaura na leukocyte;Inganta angiogenesis;Yana kunna myofibroblast kuma yana ƙarfafa jigon matrix na waje da gyarawa
3) Epidermal girma factor:
Inganta raunin rauni da haifar da angiogenesis ta hanyar haɓaka haɓakawa, ƙaura da bambance-bambancen macrophages da fibroblasts;Ƙarfafa fibroblasts don ɓoye collagenase da lalata matrix extracellular a lokacin gyaran rauni;Haɓaka haɓakar keratinocytes da fibroblasts, haifar da sake dawo da epitheliation.
4) Fibroblast girma factor:
Don haifar da chemotaxis na macrophages, fibroblasts da sel endothelial;haifar da angiogenesis;Zai iya haifar da granulation da gyare-gyaren nama kuma ya shiga cikin raunin rauni.
5) Abubuwan haɓakar Hanta:
Daidaita haɓakar ƙwayar sel da motsi na ƙwayoyin epithelial / endothelial;Inganta gyaran epithelial da angiogenesis.
6) Insulin kamar girma factor:
Haɗa ƙwayoyin fiber tare don haɓaka haɗin furotin.
7) Matsalolin ci gaban Platelet:
Ƙaddamar da chemotaxis na neutrophils, macrophages da fibroblasts, da kuma ƙarfafa yaduwar macrophages da fibroblasts a lokaci guda;Yana taimakawa wajen bazuwar tsohuwar collagen kuma sama da daidaita maganganun matrix metalloproteinases, wanda ke haifar da kumburi, haɓakar nama na granulation, haɓakar epithelial, samar da matrix extracellular da gyaran nama;Yana iya haɓaka haɓakar ƙwayoyin sel waɗanda aka samo adipose na ɗan adam kuma yana taimakawa wajen taka rawa wajen haɓaka jijiya.
8) Matsalolin da aka samu ta kwayar halitta:
Kira CD34 + sel don jawo ababensu, yaduwar yaduwa da bambance-bambance cikin sel na progothellial pretothelial, kuma suna da angoogenesis;Tattara sel mai tushe mesenchymal da leukocytes.
9) Canza yanayin girma β:
Da farko, yana da tasirin inganta ƙumburi, amma kuma yana iya inganta canji na ɓangaren da ya ji rauni zuwa yanayin rashin lafiya;Yana iya haɓaka chemotaxis na fibroblasts da ƙwayoyin tsoka mai santsi;Daidaita maganganun collagen da collagenase, da inganta angiogenesis.
10) Abubuwan haɓakar jijiyoyi na jijiyoyi:
Taimakawa da haɓaka haɓakar ƙwayoyin jijiyoyi da aka sabunta ta hanyar haɗakar da angiogenesis, neurotrophic da neuroprotection, don dawo da aikin jijiya.
11) Abubuwan haɓaka jijiya:
Yana taka rawar kariya ta neuroprotective ta hanyar haɓaka haɓakar axon da kiyayewa da rayuwa na ƙwayoyin cuta.
12) Glial da aka samu neurotrophic factor:
Yana iya samun nasarar juyawa da daidaita sunadaran neurogenic kuma yana taka rawar neuroprotective.
Kammalawa
1) Platelet mai arzikin plasma yana da halaye na haɓaka warkarwa da rigakafin kumburi.Ba wai kawai zai iya gyara kyallen jijiyoyi da suka lalace ba, amma kuma yadda ya kamata ya rage zafi.Yana da mahimmancin hanyar magani don ciwon neuropathic kuma yana da haske mai haske;
2) Hanyar shirye-shirye na plasma mai arziki a cikin platelet har yanzu yana da rikici, yana kira ga kafa daidaitattun hanyar shirye-shiryen da kuma daidaitattun kimantawa na kayan aiki;
3) Akwai karatu da yawa akan Plasma mai arzikin platelet a cikin ciwon neuropathic wanda ya haifar da rauni na kashin baya, raunin jijiya na gefe da matsawar jijiya.Hanyar da ingancin asibiti na plasma mai arziki a cikin wasu nau'in ciwon neuropathic yana buƙatar ƙarin nazarin.
Ciwon Neuropathic shine sunan gaba ɗaya na babban nau'in cututtuka na asibiti, wanda ya zama ruwan dare a cikin aikin asibiti.Duk da haka, babu takamaiman hanyar magani a halin yanzu, kuma ciwon yana ɗaukar shekaru da yawa ko ma na rayuwa bayan rashin lafiya, yana haifar da nauyi mai tsanani ga marasa lafiya, iyalai da al'umma.Maganin miyagun ƙwayoyi shine tsarin kulawa na asali don ciwon neuropathic.Saboda buƙatar magani na dogon lokaci, yarda da marasa lafiya ba shi da kyau.Magani na dogon lokaci zai ƙara mummunan halayen ƙwayoyi kuma ya haifar da lahani mai girma na jiki da tunani ga marasa lafiya.Gwaje-gwaje na asali masu dacewa da nazarin asibiti sun tabbatar da cewa za'a iya amfani da PRP don magance ciwon neuropathic, kuma PRP ta fito ne daga mai haƙuri da kanta, ba tare da amsawar autoimmune ba.Tsarin magani yana da sauƙi mai sauƙi, tare da ƙananan halayen halayen.Hakanan za'a iya amfani da PRP tare da sel mai tushe, wanda ke da ƙarfi mai ƙarfi na gyaran jijiyoyi da farfadowa na nama, kuma zai sami fa'idodin aikace-aikacen da ake amfani da su a cikin maganin ciwon neuropathic a nan gaba.
(Ana sake buga abubuwan da ke cikin wannan labarin, kuma ba mu bayar da garantin bayyananne ko bayyananniyar garanti don daidaito, amintacce ko cikar abubuwan da ke cikin wannan labarin ba, kuma ba mu da alhakin ra'ayoyin wannan labarin, da fatan za a fahimta.)
Lokacin aikawa: Dec-20-2022