Kho Lub Siab

Cov tshuaj antihypertensive rau hom 2 mob ntshav qab zib mellitus raug xaiv ib tus zuj zus, muab nws cov nyhuv rau kev ua haujlwm ntawm lub raum, thiab cov nyhuv ntawm cov metabolism ntawm fatty acids thiab carbohydrates. Arterial hypertension accompanies 80% ntawm cov neeg kev txom nyem los ntawm hyperglycemia. Cov kab mob sib xyaw ua rau kev ua haujlwm ntawm lub plab hnyuv siab raum, cuam tshuam rau kev ua haujlwm ntawm cov metabolism hauv lub cev.

Nta

Cov tshuaj ntawm cov tshuaj siab rau cov neeg mob ntshav qab zib yog qhov nyuaj los ntawm qhov tsis xav tau yam tsis txaus ntseeg, qhov kev cia siab uas tshwm sim los ntawm cov tshuaj tiv thaiv kab mob hauv lub cev.

Kev xaiv cov tshuaj rau kub siab nrog hyperglycemia yog raws li cov xwm txheej:

• Siab tshaj plaws, qhov kev cuam tshuam tsawg kawg,
• Cardio thiab nephroprotective effect (tiv thaiv lub plawv thiab lub raum),
• Tsis muaj dab tsi cuam tshuam rau kev mloog ntawm lipids thiab cov piam thaj hauv cov ntshav.

Ceev ua yeeb yam tshuaj

Yog tias koj nquag nquag dhia hauv ntshav siab, cov tshuaj uas haum rau cov ntshav qab zib mellitus yuav tsum nyob ntawm tes.

Yog tias xav tau kev pab thaum muaj xwm ceev, siv txhais tau tias nws cov txiaj ntsig ntawm lub cev kav ntev tsis tshaj 6 teev. Cov tshuaj muaj yees uas yog ib feem ntawm cov npe lag luam tshuaj:

Cov tshuaj kho rau siv kaw lus

Tus nyeem tas mus li sab saud 130/80 hli Hg. Kos duab. rau cov mob ntshav qab zib yog fraught nrog microvascular cov teeb meem, kev txhim kho ntawm atherosclerosis, qhov muaj tshwm sim ntawm cov mob ntshav qab zib angiopathies. Hauv qhov no, kev siv tshuaj tsis tu ncua tau pom zoo, thaum tib lub sijhawm ua raws li cov zaub mov noj ntsev thiab carbohydrate. Qhov cuam tshuam ntawm cov tshuaj tiv thaiv siab rau ntshav qab zib yuav tsum du. Kev poob rau hauv cov ntshav siab tom qab los ntawm kev dhia tawm yog ua kev puas tsuaj txawm tias cov kab mob plawv ntawm tus neeg noj qab haus huv.

ACE inhibitors

Rau cov kev kawm tiav ncua zuj zus ntawm kev nthuav qhia kev mob ntshav siab, tshuaj thaiv angiotensin-hloov pauv enzyme (ACE) yog siv, uas ua rau cov synthesis ntawm angiotensin. Los ntawm kev txo qis ntawm cov tshuaj angiotensin, cov qog adrenal ua cov tshuaj hormones tsawg dua aldosterone, uas khaws cov ntsev thiab dej hauv lub cev. Vasodilation tshwm sim, kev ua kua ntau dhau thiab ua kom qab ntsev yog dhau los, cov nyhuv hypotonic yog manifested.

Yam tshuaj uas thaiv ACE:

• Enalapril
• Perindopril,
• Quinapril,
• Fosinopril
• Thrandolapril,
• Ramipril.

Qhov tsis zoo ntawm cov tshuaj tiv thaiv yog qhov muaj peev xwm ncua cov poov tshuaj tsis txaus thiab ua kom qeeb ntev. Qhov cuam tshuam hauv daim ntawv thov raug soj ntsuam tsis muaj ntxov tshaj ob lub lim tiam tom qab tau teem tseg.

Angiotensin Receptor Blockers (ARBs)

Lawv thaiv cov kev sib txuas ntawm cov renin, uas ua rau muaj qhov hloov pauv ntawm angiotensin, uas ua rau kom txoj kev ntshav ntawm lub phab ntsa kom tsawg. ARBs raug tshuaj yog tias tsis haum rau ACE inhibitors yog tsim los. Tus txheej txheem ntawm lawv cov kev siv tshuaj biochemical sib txawv, tab sis lub hom phiaj yog zoo ib yam - kom txo tau cov kev cuam tshuam ntawm angiotensin thiab aldosterone.

Cov pab pawg hu ua sartans ntawm qhov kawg ntawm cov npe ntawm cov tshuaj nquag:

Cov tshuaj kho ntshav qab zib muaj cov nyhuv hypotonic me me, yog raug kho tshwj xeeb hauv kev sib koom ua ke siv lwm yam tshuaj rau cov ntshav qab zib.

1. Voj diuretics (furosemide, lasex) ua ke zoo nrog ACE inhibitors, tsis txhob cuam tshuam rau theem ntawm cov piam thaj, lipids, thiab tsim nyog rau kev tswj hwm mus sij hawm luv luv kom tshem tawm qhov mob hnyav ntawm cov ntaub so ntswg. Kev tswj tsis siv siv provokes nrawm tshem tawm cov poov tshuaj, uas tuaj yeem ua rau kev nce hauv hypokalemia thiab mob plawv dhia tsis xwm yeem.
2. Vim tias cov nyhuv diuretic me me, thiazide-zoo li diuretics (indapamide) tsis mob siab qhov sib npaug ntawm cov piam thaj, rog rog, qib potassium, thiab tsis cuam tshuam rau lub cev ua haujlwm ntawm lub raum.
3. Thiazide diuretics (hypothiazide) hauv kev noj tshuaj txhua hnub ntau dua 50 mg tuaj yeem nce siab ntxiv thiab qib roj. Lawv tau txais kev ceeb toom nrog ceev faj hauv kev txhaj tshuaj tsawg kawg vim tias qhov tshwm sim ntawm qhov tsis zoo lub raum tsis ua haujlwm thiab mob gout.
4. Cov poov tshuaj-sparing tshuaj (Veroshpiron) tsis pom zoo siv rau hauv hom 2 mob ntshav qab zib mellitus, nrog los ntawm kev ua haujlwm tsis zoo hauv lub raum.

Beta blockers

Tus nab npawb ntawm cov tshuaj uas thaiv kev tsim kho ntawm adrenoreceptors los ntawm adrenaline thiab norepinephrine tau raug kho feem ntau rau kev kho mob ischemia, cardiosclerosis, lub plawv tsis ua haujlwm. Nrog hyperglycemia, ntsiav tshuaj rau kub siab yog xaiv nrog cov nyhuv ntxiv vasodilating:

Calcium antagonists

Cov calcium calcium blockers - ib pawg tshuaj uas txo cov tshuaj calcium calcium ions. So kom txaus thiab nthuav cov phab ntsa hauv cov hlab ntsha, cov hlab ntsha, cov leeg nqaij muaj pob. Conditionally muab faib ua pab pawg:

1. Verapamil, diltiazem. Cuam tshuam kev ua haujlwm ntawm myocardium thiab lub plawv mob hlwb, txo qis kev mob plawv. Ib txhij siv nrog beta-blockers yog contraindicated.
2. Cov khoom siv ntawm dihydropyridine - nifedipine, verapamil, nimodipine, amlodipine. Lawv so lub phab ntsa ntawm cov leeg hlwb txhim kho, ua kom lub plawv dhia.

Cov calcium antagonists tsis cuam tshuam nrog cov khoom noj carbohydrate, lipid metabolism. Thaum siv los ua tshuaj rau tswj siab, hom ntshav qab zib hom 2 txaus siab, tab sis muaj tus lej ntawm contraindications. Nifedipine yog contraindicated hauv angina pectoris, lub siab thiab lub raum tsis ua haujlwm, haum rau ib qho kev daws teeb meem ntawm kev nyuaj. Amlodipine yuav txhawb o. Verapamil muaj qhov ua tau zoo rau kev ua haujlwm ntawm lub raum, tab sis nws tuaj yeem ua rau bronchodilators.

Cov tshuaj tiv thaiv ib leeg

Antihypertensive tshuaj tau ua ke nrog txhua lwm yam, xaiv noj rau hauv tus account concomitant kab mob, tshuaj noj. Tawg ntshav, nrog ntshav qab zib ua txhaum cai ntawm cov metabolism hauv plab, ua rau muaj kev tsis haum tshuaj ntau yam.

Ua ntej siv, koj yuav tsum kawm cov npe ntawm cov kev mob tshwm sim, cov hau kev ntawm kev tshem tawm lawv.

Thaum noj, lub zog ntawm cov ntshav siab yog pom. Nyob rau tib lub sijhawm, qib ntawm glycated hemoglobin, cov roj cholesterol, triglycerides, yoo cov kua nplaum thiab tom qab noj tau soj qab. Undesirable deviations los ntawm qib txais yuav tsum tau hloov ntawm cov tshuaj.

Cov tshuaj ntsuab twg yuav pab tau cov ntshav qab zib?

Ib tus neeg uas ntsib thawj hom kabmob ntshav qab zib tau ploj, vim hais tias nrog tus kabmob no koj yuav tsum rov tsim kho koj txoj kev ua neej, hloov menus thiab kev coj ua. Ntshav qab zib Hom 2 tuaj yeem ua rau lub neej muaj sia, koj tsuas yog yuav tsum ua raws li qee txoj cai. Tshuaj ntsuab los tseem yuav pab ua lub neej yooj yim, xaiv tshuaj ntsuab zoo rau ntshav qab zib yeej tsis nyuaj.

Cov tshuaj ntsuab yuav pab tau li cas?

Nroj tsuag niaj hnub pab ib tus neeg thaum lub sijhawm nyuaj. Lawv pab tshem tawm cov kabmob thiab tuaj yeem siv ua khoom noj thiab txuj lom. Hauv qhov no, xwm tau muab cov neeg muaj nyiaj tiag tiag. Mob ntshav qab zib, tshuaj ntsuab tshuaj ntsuab yog conventionally muab faib ua ob pawg:

• Qab zib-qis. Lawv muaj cov tshuaj insulin zoo li tebchaw, ua tsaug uas nws muaj peev xwm tswj hwm qib hauv qabzib hauv tus neeg mob lub cev.
• Lwm tus. Cov uas pab lub cev ua haujlwm sib raug zoo, ntxuav nws ntawm cov co toxins thiab co toxins, ntxiv dag zog rau kev tiv thaiv kab mob thiab txhawb kev ua haujlwm ntawm tus kheej cov plab hnyuv siab raum thiab cov tshuab ua haujlwm (lub raum, siab, ntshav hlab ntsha).

Cov nroj tsuag tshuaj los ntawm thawj pab pawg tuaj yeem ua lub hauv paus rau kev kho mob ntawm hom 2 mob ntshav qab zib mellitus, tshwj xeeb tshaj yog yog siv nrog kev noj haus tshwj xeeb thiab kev siv dag zog. Yog tias muaj mob pes tsawg, lawv raug pom zoo kom coj los ua ntxiv rau kev npaj tshuaj insulin. Hmoov tsis zoo, lawv yuav tsis pab hom 1 ntshav qab zib.

Tshuaj ntsuab los ntawm pab pawg ntawm "lwm tus" pab tswj cov kev puas tsuaj ntawm tus kab mob no, lawv txhim kho lub luag haujlwm ntawm lub plab zom mov, ntxiv dag zog rau cov hlab ntsha, thiab pab txo cov txheej txheem ua mob.Cov nroj no muaj txiaj ntsig zoo rau cov ntshav qab zib thiab hom 1 thiab 2. Coj lawv tsis tu ncua lossis hauv cov chav kawm. Thiab koj tuaj yeem siv tsis tsuas yog decoctions thiab infusions. Qee qhov nqi tau siv ua compresses los pab cov qhov mob zoo sai dua, txij li cov neeg mob ntshav qab zib, tsim dua tshiab qeeb qeeb.

Qhov twg yuav coj thiab haus haus?

Pom kev sib sau nyom tsis yog ib qho teeb meem tam sim no, tab sis tsis tas yuav muaj kev lav paub tias txhua yam tshuaj ntsuab sau rau hauv qhov chaw huv. Yog li, siv tshuaj ntsuab los kho ntshav qab zib, yuav tsum ua raws li cov cai hauv qab no:

• Yuav pib nrog, koj yuav tsum sab laj tsis yog nrog kws kho mob, tab sis kuj nrog koj tus kws kho mob, tau txais nws kev pom zoo thiab cov lus qhia.
• Nws raug nquahu mus yuav cov kev npaj tshuaj ntsuab hauv cov khw muag tshuaj lossis los ntawm cov neeg muaj kev ntseeg siab thiab tau koom nrog txoj haujlwm no ntev dua ib xyoos.
• Ua ntej yuav tshuaj ntsuab, koj yuav tsum them sai sai rau lub sijhawm thiab thaj chaw ntawm kev sau qoob. Kev khaws sau ntev yuav tsum tsis txhob ua, vim tias tsis yog txhua tsob ntoo muaj lub txee cev ib yam nkaus.
• Cov neeg uas xav tau ntawm nws tus kheej npaj tshuaj ntsuab yuav tsum paub thaum twg thiab yuav sau cov nroj tsuag, dab tsi feem ntawm nws yog siv. Chaw sau yuav tsum tsis txhob nyob hauv nroog thiab chaw lag luam hauv nroog. Qhov chaw tsim nyog tshaj sab nraum lub nroog, deb ntawm cov pa phem.
• Thoob plaws thaum kawm tag nrho kev kho mob, ib tus yuav tsum ua tib zoo saib xyuas cov qib ntawm cov piam thaj hauv cov ntshav, kev noj qab nyob zoo thiab lub cev kev teb rau tshuaj ntsuab.
• Thaum cov tsos mob qhia tias tsis pom zoo rau yeeb tshuaj, koj yuav tsum txo qhov ntau npaum li cas, yog tias qhov no tsis pab, koj yuav tsum xaiv lwm tsob nroj uas nyob ze hauv kev nqis tes ua.
• Nws raug nquahu kom siv cov nqi los ntawm ob peb hom tshuaj ntsuab. Nyob rau lub caij ntuj sov, npaj ua kua txiv thiab tinctures zoo tshaj yog muab tso rau hauv tub yees kom lawv tsis txhob ua kom tsis zoo.

Txhua yam ntawm txhais tau tias nws muaj nws tus kheej txoj kev ua noj ua haus. Kev kho tshuaj ntsuab tsis nrawm, nyob nruab nrab, ib chav kawm ntev li 1-2 lub hlis. Tom qab qhov no, so ntawm tsawg kawg 2 lub lis piam yog ua, tom qab ntawd, cov chav kawm tuaj yeem rov ua dua. Kuv tsis qhia kom siv ntau tus nqi hauv ib zaug, nws yog qhov zoo dua rau qhov ua tiav ib, ib hlis so, thiab tom qab ntawd lwm qhov.

Cov tshuaj ntsuab dab tsi tuaj yeem siv tau?

Ntau cov nroj tsuag tuaj yeem siv rau kev ua noj. Txhua yam tshuaj ntsuab tau nws cov nyhuv ntawm tib neeg lub cev. Hauv qab no yuav qhia cov npe ntawm cov nroj tsuag thiab qhov lawv siv rau. Feem ntau ntawm lawv tuaj yeem raug ntaus nqi rau ntau pawg, tab sis rau ntau qhov lawv tau tshwm sim qhov twg lawv tau sau tseg.

• Muaj cov tshuaj insulin-zoo li. Cov no suav nrog cov nroj tsuag xws li burdock, clover, taum taum, elecampane, blueberries, peony, Suav magnolia vine thiab oats.
• Kev ntxiv dag zog. Golden hauv paus, kev ntxias, eleutherococcus, ginseng.
• Kev tswj cov metabolism. Flax, plantain, linden, knotweed, nplej nyom creeping, bearberry, St. John lub wort.
• Muaj cov vitamins thiab organic acids - sawv hav zoov, lingonberry, roob tshauv.
• Cov qoob loo cog uas pab kom "saturate" lub cev nrog cov vitamins thiab cov kab kawm tseem ceeb. Liab beets, qej thiab dos, spinach thiab zaub xam lav, zaub qhwv thiab zaub kav, qus qej thiab carrots, barley thiab oats.

Siv phytotherapy kev kho mob rau hom 2 mob ntshav qab zib mellitus, nws yog ib qho tseem ceeb kom nco ntsoov tias tsis yog txhua yam nroj tsuag ua ke nrog ib leeg, yog li nws raug nquahu kom yuav cov nqi kho mob npaj thiab siv lawv.

Ntshav qab zib cov zaub mov txawv

Txhawm rau txo cov ntshav qab zib hauv ntshav qab zib hom 2 thiab txhawm rau txhim kho lub cev ua haujlwm, muaj ntau yam nqi. Koj tuaj yeem pom lawv npaj tau hauv lub tsev muag tshuaj lossis yuav txhua hom tshuaj ntsuab ib tus zuj zus, thiab tom qab ntawd sib tov ua ntej ua noj. Txhua tus xaiv rau leej twg thiab yooj yim npaum li cas. Tsis yog siv tas li; tsuas yog cov nroj tsuag qhuav tuaj yeem kho siv cov khoom xyaw tshiab.

Qhov sib xyaw yog npaj los ntawm cov khoom siv qhuav: cov noob taum dog dig 20g, rosehips 15g, bilberry nplooj 20g, chamomile paj 10g. Teb horsetail 15g, Aralia Manchurian cag 10g, St. John lub wort 10g. Lawv sib xyaw rau hauv lub khob ntim thiab them nrog lub hau kom tsis txhob tsub zuj zuj.Los npaj lub Txoj kev lis ntshav, koj xav tau 2 tbsp. sib xyaw. Nyob rau yav tsaus ntuj, nyom yog hliv rau hauv ib lub thermos thiab hliv 500 ml ntawm dej npau npau thiab npog nrog lub hau.

Thaum sawv ntxov, Txoj kev lis ntshav yog npaj txhij, nws yog lim thiab haus dej haus 1/3 khob ib nrab ib teev ua ntej noj mov. Lub chav kawm yog 21-28 hnub, tom qab ntawd so li tsawg kawg 2 lub lis piam thiab tuaj yeem rov ua dua. Hauv ib xyoos, nrog hom 2 mob ntshav qab zib mellitus, tuaj yeem kho 3-4 zaug.

Txhawm rau npaj cov ntawv sau no koj yuav xav tau: cov paj ntawm mullein ntawm skipper-zoo li 15g, nplooj ntawm qus strawberry (25g) thiab blueberries (40g), linden paj 20g. Npaj kom qhuav cov khoom tuaj yeem muab khaws cia rau hauv cov thawv ntawv thawv lossis lwm lub thawv. Txhawm rau npaj ib lub decoction, 2 tablespoons ntawm kev sau yog nchuav nrog 2 tsom iav ntawm dej npau thiab muab tso rau hauv dej da dej rau 15 feeb. Tom qab ntawd, hais txog ib nrab ib teev thiab lim. Nws yog ib qho tsim nyog los nqa lub ntim ntawm cov cawv rau nws cov qub, rau qhov no, cov dej rhaub tau ntxiv rau nws. Haus ib nrab ib khob 30 feeb ua ntej noj mov, 2-3 zaug ib hnub.

Bilberry nplooj thiab cov tub ntxhais hluas tua tau muab sib xyaw nrog dandelion keeb kwm thiab dioecious nettle nplooj ntxiv, txhua yam raug muab coj los sib npaug. Txhawm rau kho mob ntshav qab zib hom 2, noj ib tablespoon ntawm qhov sib tov tiav thiab hliv ib khob dej kub. Txheeb 8 teev thiab tom qab ntawd lim. Lub chav kawm ntawm kev kho mob yog 2 hlis, noj ½ khob ib teev ua ntej noj mov 3 zaug hauv ib hnub.

Siv tshuaj ntsuab rau ntshav qab zib tsis yog yooj yim xwb, tab sis kuj tseem cia koj rov qab kho thiab tswj lwm yam hauv nruab nrog cev. Hauv cov kab mob no, qhov no yog qhov tseem ceeb heev, vim tias yog tias koj tsis them sai sai rau cov ntshav qab zib hom 2, tom qab ntawd nws tuaj yeem nkag mus rau hauv 1, thiab qhov no twb tau mob loj dua.

Cov tshuaj kho ntshav qab zib kom ntshav qab zib

Diuretics rau ntshav qab zib mellitus (DM) feem ntau yog siv rau kev kho mob ntawm concomitant arterial hypertension (AH), lub plawv tsis ua haujlwm lossis tshem tawm ntawm pob txha caj dab. Nyob rau lub sijhawm tam sim no, muaj ntau yam tshuaj kho tau tuaj yeem ua rau kom diuresis (cov zis tso zis).

Txawm li cas los xij, nws yog qhov nyuaj hais qhov tsis txaus ntseeg twg ntawm lawv yog qhov zoo tshaj plaws. Txhua yam tshuaj kho tau nws tus kheej qhov ua tau zoo thiab tsis muaj zog thiab rau qee tus neeg mob nws yuav tau qhia lossis txwv.

Mob ntshav qab zib thiab diuretics

Txhua txoj kev kho mob rau lub zog ntawm lawv cov txiaj ntsig ntawm lub cev tuaj yeem faib ua:

1. Muaj Zog (Furosemide, Torasemide, Mannitol).
2. Nruab Nrab Qhov Zoo (Hypothiazide, Hydrochlorothiazide, Indapamide, Clopamide).
3. Tsis muaj zog (Diacarb, Dichlorfenamide, Spironolactone).

Thawj chav kawm ntawm cov tshuaj siv feem ntau yog siv rau kev txiav (kho) mob kab mob sai, xws li mob txha caj qaum los yog ascites. Pawg ob yog qhov zoo tsim nyog siv rau kev siv mus ntev rau kev kho mob ntawm tus mob ntev (ntshav siab, ntshav qab zib).

Cov nyiaj tom kawg yog feem ntau siv los kho kev kho mob hauv kev sib xyaw nrog lwm cov tshuaj diuretics, txhim kho lawv cov hauj lwm zoo.

Diuretic tshuaj rau ntshav qab zib: hom

Ua raws li cov txheej txheem ntawm kev txiav txim, cov tshuaj ntawm pawg hauv qab no tau cais:

1. Voj: Torasemide, Furosemide, Ethacrinic acid. Txhawb nqa kom sai thiab tsim nyog hauv cov zis. Lawv tuaj yeem tshem tawm cov dej tawm ntawm lub cev sai sai. Ua haujlwm hauv lub voj ntawm Henle nephron. Lawv muaj ntau qhov tshwm sim.
2. Thiazide: Hypothiazide, Dichlothiazide, Indapamide. Cov txheej txheem tshuaj rau ntshav qab zib tau suav hais tias yog "tus qauv kub" rau kev txo ntshav siab thiab tshem puffiness.
3. Osmotic: Mannitol, Urea, Potassium acetate. Cov cuab yeej muaj zog uas tuaj yeem tshem tawm qhov tso zis ntau hauv feeb. Lawv siv rau cov kab mob pathology. Tsis haum rau lub sijhawm siv ntev.
4. Poov tshuaj-sparing: Spironolactone, Triamteren. Lub ntsiab cuam tshuam loj ntawm txhua yam tshuaj uas tau piav saud yog poob ntawm sodium, potassium thiab magnesium. Pab pawg no tau tsim los tiv thaiv kev ntxhov siab hauv kev sib npaug ntawm electrolyte.

Cov tshuaj twg zoo dua?

Thiazide diuretics rau hom ntshav qab zib hom 2 feem ntau siv.

Kev siv cov tshuaj diuretics nyob rau hauv rooj plaub 1 ntawm tus kab mob raug pom tsawg dua vim tias qhov tsis muaj kev cuam tshuam txog kev mob ntshav siab hauv ntau qhov mob:

1. Indapamide. Tej zaum, txog cov tshuaj no, peb tuaj yeem hais tias nws yog qhov zoo tshaj plaws kho mob ntshav qab zib. Nws muaj cov txiaj ntsig ntawm nruab nrab lub zog. Cov cuab yeej tseem ceeb uas cov kws kho mob hlub nws yog nws qhov tsis zoo rau cov plhaus nkas thiab rog hauv lub cev. Indapamide tsis hloov pauv qhov piam thaj thiab cov cholesterol hauv cov ntshav. Muaj nyob hauv ntsiav tshuaj daim ntawv 1.5 mg. Nws yog tsim nyog yuav tau thov 1 tab. ib zaug thaum sawv ntxov tsis hais lub sijhawm noj mov. Hoob kawm ntawm kev kho yog tsim los ntawm tus kws khomob tuaj koom.
2. Kev Hypothiazide. Ib qho tshuaj zoo uas yog ib feem ntawm txoj kev kho mob ntshav qab zib thiab ntshav siab. Nws tau muaj qee yam haujlwm me dua piv rau tus sawv cev dhau los ntawm cov pab pawg. Lub ntsiab tsis zoo yog cov nyhuv ntawm cov piam thaj thiab cov roj metabolism hauv lub cev. Nrog kev siv lub caij nyoog ntev ntawm kev siv tshuaj tiv thaiv tsis txaus, qhov muaj mob ntawm cov mob qis thiab atherosclerosis yuav tshwm sim. Muag hauv cov ntsiav tshuaj ntawm 0.025 g. Siv 1 tab. thaum sawv ntxov ua ntej noj mov. Lub sijhawm siv sijhawm yog 3-7 hnub, tom qab ntawd so 4 hnub.
3. Hydrochlorothiazide. Zoo ib yam li cov tshuaj dhau los. Cov sib txawv hauv qhov ua tau zoo me ntsis thiab kev siv hom. Koj yuav tsum haus 1-4 ntsiav tshuaj. ib hnub tom qab noj tshais 2-3 zaug ib lub lim tiam. Tus kws kho mob tau sau tseg kev kho mob kiag, nyob ntawm qhov mob hnyav npaum li cas.

Tsis tas yuav piv qhov zoo ntawm cov tshuaj no. Koj tus kws kho mob yuav xaiv cov tshuaj zoo rau koj raws li koj lub cev kev paub tab.

Tshuaj Kho Mob Kom Zoo

Qhov piav qhia diuretics rau ntshav qab zib muaj peev xwm yaug poov tshuaj los ntawm lub cev. Txhawm rau tiv thaiv kev txhim kho ntawm cov kev mob tshwm sim los ntawm qhov tsis muaj qhov ntsuas electrolyte, potassium-sparing diuretics yuav tsum tau siv nyob rau hauv parallel.

Cov nyiam thiab hom tshaj plaws yog Spironolactone (Veroshpiron). Nws muaj cov nyhuv diuretic me me, tab sis tiv thaiv qhov poob ntawm ib qho tseem ceeb hauv qab taug. Nws yog ib feem ntawm cov tshuaj tsim nyog hauv kev kho kab mob ntshav siab thiab ntshav qab zib.

Cov ntsiav tshuaj ntawm cov tshuaj muaj 25 lossis 100 mg ntawm cov tshuaj nquag. Cov kev siv tshuaj rau ib hnub ib txwm yog 50-100 mg, nyob ntawm saib ntshav siab. Lub sij hawm ntawm kev kho yog tsawg kawg 2 lub lis piam.

Siv cov diuretics tsis tshua muaj neeg

Cov tshuaj xws li Mannit, Torasemide, Furosemide (Lasix), Urea muaj cov nyhuv sai thiab muaj zog diuretic. Txawm li cas los xij, lawv tsis zoo rau kev siv sijhawm ntev los ntawm cov neeg mob uas muaj "kab mob qab zib".

Cov laj thawj tseem muaj ntau qhov tshwm sim:

1. Ib qho poob hauv cov ntshav siab, myocardial ischemia, angina pectoris.
2. Xeev siab, ntuav, lub cev qhuav dej.
3. Arrhythmias, atrial fibrillation.
4. Kev mob plab zom mov.
5. Quincke's edema, urticaria, anaphylactic ceeb.

Ntxiv rau, lawv ua sai sai, tab sis cov nyhuv tsis dhau ntev, uas khi cov neeg mob kom coj lawv ntau zaus. Siv cov tshuaj no tso rau hauv tsev kho mob lub chaw teeb tsa.

Cov cim tseem ceeb yog:

• O o rau lub hlwb los yog lub ntsws
• Decompensated lub plawv lossis lub raum tsis ua haujlwm,
• Ascites
• Cov dej hauv lub cev tseem ceeb hauv qhov qis qis.

Kev siv cov tshuaj diuretics yuav tsum yog qhov tsis pom zoo nrog koj tus kws kho mob.

Tshuaj kho ntshav qab zib hom 2: ntshav qab zib tshuaj rau ntshav qab zib

Diuretics (tshuaj diuretic) tshwj xeeb cuam tshuam rau kev ua haujlwm ntawm lub raum, pab txhawb rau kev nthuav tawm ceev ntawm cov zis los ntawm lub cev. Lub tshuab kev ntawm kev ua ntawm cov nyiaj no yog ua raws li kev muaj peev xwm inhibit qhov rov qab nqus ntawm electrolytes hauv cov hlaus rov qab. Nrog rau qhov nce hauv qhov ntim ntawm electrolytes tso tawm, qee qhov nqi ntawm cov kua ua kua.

Thawj lub diuretic tshwm rov qab rau xyoo 19th, thaum nws paub txog cov tshuaj mercury, uas tau siv dav kho mob syphilis.Txawm li cas los xij, hauv kev kho tus kab mob no, cov tshuaj mercury tsis tau tshwm sim nws tus kheej hauv txhua txoj kev, tab sis pom qhov cuam tshuam diuretic rau tib neeg lub cev tau pom.

Tom qab qee lub sijhawm, kev npaj txhij txhua mercury tau hloov pauv los ntawm cov khoom tsis zoo thiab muaj tshuaj lom. Kev txhim kho ntxiv ntawm diuretics coj mus rau qhov tshwm sim ntawm cov tshuaj diuretic uas muaj zog.

Thaum kho nrog diuretics, nquag thiab txhawb kev kho yog cais. Nrog rau kev saib xyuas theem, diuretics raug coj tas li, nrog kev kho mob nquag, kev siv cov koob tshuaj ntawm cov tshuaj pleev ib ce muaj zog yog qhia.

Thaum muab tshuaj kho mob

Nws yuav tsum raug sau tseg tias diuretics ib leeg tsis muaj kev cuam tshuam zoo rau ntshav qab zib, vim li no lawv raug pom zoo kom noj nrog beta-blockers, ACE inhibitors.

Ua ntej tshaj plaws, nrog hom 2 ntshav qab zib, beta-blockers yog cov kws kho:

• xaiv thiab tsis xaiv
• lipophilic thiab hydrophilic,
• nrog kev ua sympathomimetic thiab tsis muaj nws.

Txhais tau tias cov pab pawg no tseem ceeb heev rau cov neeg mob ntshav qab zib, uas muaj keeb kwm ntawm lub plawv tsis ua haujlwm, mob plawv, thaum lub sijhawm rov qab kis mob.

Ntawm cov ntshav qab zib, tshuaj diuretics feem ntau pom zoo kom txo cov tsos mob ntawm kev kub siab thiab tshem tawm kev o. Nws yuav tsum coj mus rau hauv tus account tias tsis yog txhua tus diuretic tso cai rau siv rau cov teeb meem nrog insulin, yog li kev kho tus kheej yuav ua rau muaj kev puas tsuaj rau kev noj qab haus huv.

Qhov ua kom cov pa oxygen tsawg dua ntawm cov mob plawv thaum kho nrog diuretics yog piav qhia los ntawm kev ntxhov siab los ntawm myocardial cell, thauj khoom ntawm sab laug ventricle, txhim kho microcirculation hauv lub raum, thiab txo cov platelet adhesion.

Coob tus neeg mob ntshav mob tawm los yog tawm thiazide diuretics ntev, tab sis lawv ua rau sodium poob loj. Nyob rau tib lub sijhawm:

1. triglycerides, roj (cholesterol) thiab ntshav qab zib cov ntshav nce siab
2. nws muaj kev txwv ntawm kev siv ntawm diuretics.

Tab sis kev tshawb fawb txog kev kho mob tsis ntev los no tau pom tias kev siv tshuaj diuretics hauv ntshav qab zib ua rau muaj kev tsis zoo rau lub cev tshwj xeeb thaum siv ntau qhov ntau.

Thaum noj cov thiazide diuretics, nws yog ib qho tseem ceeb rau cov neeg mob ntshav qab zib kom haus cov zaub thiab txiv hmab txiv ntoo txaus, uas yuav pab them rau cov dej qab ntsev, potassium thiab magnesium. Koj kuj yuav tsum nco ntsoov qhov zoo li ntawm qhov txo qis hauv kev nkag siab ntawm cov hlwb rau cov tshuaj insulin. Thaum lub sijhawm kev kho mob, nws yog ib qho tsim nyog los tswj cov kev saib xyuas ntawm cov ntshav qab zib, thiab yog tias tsim nyog, nce cov diuretic ntau ntxiv.

Txog rau cov ceg tawv nqaij txhawm rau mob ntshav qab zib hom 2, tus kws kho mob yuav sau ntawv rau Indapamide lossis nws cov keeb neeg Arifon. Ob qho tshuaj tsis tuaj yeem cuam tshuam rau cov metabolism hauv cov metabolism, uas yog qhov tseem ceeb tshaj plaws rau teeb meem rau cov piam thaj. Lwm qhov ntxiv ntawm kev kho mob nrog cov diuretics yog qhov txiaj ntsig zoo tsis nyob ntawm qhov kev lees txais ntawm cov tshuaj, yog li koj tuaj yeem noj tsuas yog ib ntsiav tshuaj ib hnub.

Lwm txoj kev siv tshuaj tso ntshav muaj tsawg dua li hom ntshav qab zib hom 2, yog li koj tuaj yeem nqa:

• npaj cov voj (tshwj xeeb rau kev ceev nrawm ntawm lub siab),
• kev koom ua ke ntawm cov tshuaj potassium ntxiv, ua ke thiazide (kom paub tseeb tias yuav txo cov potassium ntau).

Ntawm cov ntshav qab zib 2, kev siv cov tshuaj diuretic tuaj yeem tsim cov txiaj ntsig uas tsis xav tau xws li txo qis hauv insulin rhiab heev. Xws li cov tshuaj tiv thaiv kab mob tuaj yeem pom txawm tias tsis muaj kev kho mob ntev ntev ntawm txoj kev mob ntshav siab.

Cov neeg sawv cev txuas ntxiv, uas muab cov nyhuv diuretic, siv ntau tsawg dua, tsuas yog thaum qee yam mob.

Cov ntaub ntawv dav dav

Diuretic diuretics raug kho thaum kho mob ntshav siab hauv ntshav qab zib mellitus, nrog kev txhim kho ntawm lub siab ua haujlwm thiab lub siab. Kev xaiv ntawm diuretics rau kev kho yuav tsum tau xaiv tus kheej los ntawm tus kws kho mob.Nrog ntshav siab, tshuaj diuretics ntawm thiazide pawg yog kho. Lawv ua kom tshem tawm cov ntsev ntawm lub cev, tab sis tib lub sijhawm nce triglycerides, piam thaj thiab roj cholesterol. Kev txhaj tshuaj siab dua ua rau cov txheej txheem no thiab ua rau muaj kev phom sij rau lub cev. Nws yog ib qho tsim nyog los tswj cov qib ntawm cov piam thaj hauv kev kho kab mob nrog kev pab ntawm diuretics.

Rov qab rau cov lus txheej txheem

Vim li cas siv tshuaj diuretics

Tus kws kho mob sau ntawv tso cai tshuaj diuretics nrog rau cov kev kuaj mob no:

• ntshav siab (tawg, ntshav siab),
• lub raum tsis ua hauj lwm zoo,
• ascites
• lub raum tsis ua hauj lwm
• txha txha caj qaum
• Liddle's mob siab
• mob ntsws
• mob plawv o
• mob ntsws.

Nrog kev ua haujlwm tsis zoo ntawm ob lub raum, cov tshuaj kho lub voj ntawm cov pab pawg tau txais, uas cuam tshuam rau lub raum. Nrog rau cov hlab ntsha txhaws, thiazide diuretics tsis ua rau muaj kev phom sij rau lub cev, txo kev pheej hmoo ntawm mob hlab ntsha tawg.

Cov koob tshuaj siab tuaj yeem ua rau kev loj hlob ntawm hypokalemia, yog li koj yuav tsum siv lawv kom zoo thiab tsuas yog kev pom zoo ntawm kws kho mob, nruj me ntsis ua raws nws cov tshuaj noj.

Rov qab rau cov lus txheej txheem

Kub siab mob ntshav qab zib

Lub luag haujlwm tseem ceeb yog txo cov ntshav qab zib kom ntau.

Nrog kev kuaj mob ntshav qab zib, cov teeb meem tawg yuav txawv. Nws feem ntau tshwm sim nrog tus mob metabolic syndrome, uas tshwm sim ua ntej pib ntawm tus mob ntshav qab zib hom 2. Qee zaum tus kws kho mob tsis tuaj yeem nrhiav lub hauv paus ntawm qhov tshwm sim ntawm cov ntshav siab. Cov laj thawj uas ua rau muaj kub siab tuaj yeem yog:

• magnesium tsis muaj zog
• kev nyuaj siab tas li thiab lub siab ntxhov siab,
• kev lom lossis nkag mus rau hauv lub cev tshwm sim los ntawm tus neeg ntawm cawv muaj ceem, cadmium lossis taug txhuas,
• arteriosclerosis ntawm cov hlab ntsha.

Kev puas tsuaj rau lub raum provokes tawg vim tsis ua haujlwm zoo los ntawm sodium los ntawm tus neeg mob lub cev. Lub voj voos txaus ntshai raug tsim: lub raum tsis muaj zog yog los ntawm kev mob ntshav siab, uas nce hauv lub raum glomeruli. Qhov no ua rau tuag ntawm glomeruli vim lub caij nyoog siab ntsig txog qhov siab. Mob raum tsis ua haujlwm. Yog tias kev kho mob tau pib thaum ntxov ntawm tus mob ntshav qab zib nephrosis, tus kab mob yeej kho tau. Lub luag haujlwm tseem ceeb yog txo cov ntshav qab zib kom tsawg.

Rov qab rau cov lus txheej txheem

Cov Hom Tshuaj Diuretics

Txhua tus kab mob yuav tsum tau kho nrog ib hom tshuaj tshwj xeeb uas ua ncaj qha rau tus ua kom muaj tus mob. Diuretic tshuaj muaj cov txheej txheem sib txawv ntawm kev ua. Raws li kev faib tawm no, txhua tus diuretic belongs rau qee pawg:

Tsis tas li, tag nrho cov tshuaj tso tawm tau faib ua pawg raws li kev ua tau zoo ntawm sodium excretion:

• nrog kev ua tau zoo los ntawm 15% thiab ntau dua,
• nrog tus txiaj ntsig nruab nrab ntawm 5-10%,
• qhov ua tau zoo tshem tawm 5% lossis tsawg dua ntawm lub cev.

Txhua lub diuretic nws muaj nws lub hom phiaj tshwj xeeb. Diuretics nrog kev ua tsis tau zoo txhawb lub cev kom sib xyaw nrog lwm cov tshuaj. Hauv kev tshawb fawb, nws pom tias qib siab ntawm cov protein ntau hauv cov zis, qhov siab yuav ua rau nrog tawg. Cov tshuaj zoo heev feem ntau yog siv yog tias tsim nyog rau lub sijhawm luv.

Rov qab rau cov lus txheej txheem

Diuretic pawg

Diuretics tau muab faib ua pab pawg raws li cov txheej txheem ntawm lawv cov kev coj ua ntawm lub cev:

1. Loopback - zoo tshem tawm cov kua dej ntau dhau hauv lub sijhawm luv. Cov no suav nrog: "Furosemide", "Ethacrylic acid" thiab lwm yam.
2. Thiazide diuretics - feem ntau siv rau cov ntshav qab zib thiab raug suav hais tias yog ib qho ntawm cov tshuaj siv tau zoo tshaj plaws. Sai sai txo qhov siab thiab pab daws o. Cov no suav nrog: "Hypothiazide", "Indapamide", "Dichlothiazide".
3. Osmotic diuretics - tshem cov kua hauv lub sijhawm luv heev. Siv thaum muaj xwm ceev. Kev Txwv tsis pub siv ntev. Cov no suav nrog: Urea, Mannitol, Potassium Acetate.
4. Potassium-sparing diuretics tiv thaiv kev puas tsuaj rau cov ntshav hluav taws xob tshuav nyiaj, pab txhawb rau kev nthuav tawm ntawm cov poov tshuaj thiab sodium los ntawm lub cev. Cov no suav nrog: Triamteren, Spironolactone.

Cov kev mob tshwm sim los ntawm kev siv tshuaj diuretics kho mob ntshav qab zib tau ntev. Yog li, txhawm rau kom siv cov tshuaj kom zoo nrog kev ua haujlwm siab tshaj plaws, tus kws kho mob yuav tsum sau nws tom qab txhua yam kev tshuaj ntsuam thiab kev kuaj mob tau ua tiav. Kev noj tshuaj rau tus kheej tuaj yeem ua rau muaj mob hnyav, vim li ntawd nws yog txwv tsis pub cuam tshuam nrog nws.

Rov qab rau cov lus txheej txheem

Dab tsi tshuaj rau siv rau ntshav qab zib?

Ib qho diuretic yog siv dav hauv kev kho mob ntshav qab zib, uas zwm rau ntawm thiazide lossis thiazoid pawg. Diuretics uas yog rau thiazide sawv daws yuav (Dichlothiazide, Poithiazide) thiab raug coj mus rau ntshav siab nrog hom 1 mob ntshav qab zib mellitus ua tau zoo tshaj rau kev txhaj tshuaj me me. Ib qho tshuaj tau zoo tshaj plaws yog Indapamide. Nws muaj qhov nruab nrab ntawm kev ua tau zoo, tab sis cov khoom tseem ceeb uas tau sau tseg los ntawm cov kws kho mob yog qhov tsis muaj kev cuam tshuam ntawm cov rog thiab cov roj carbohydrates.

Feem ntau, cov diuretics siv tau nrog rau lwm cov tshuaj.

Ib qho diuretic xws li Hypothiazide feem ntau siv rau hauv txoj kev kho mob ntshav qab zib mellitus thiab ntshav siab. Ib qho ntawm cov cwj pwm tsis zoo yog cov yam ntxwv ntawm cov tshuaj, uas cuam tshuam rau kev sib pauv ntawm cov piam thaj thiab roj cholesterol. Kev tswj tsis tau kho ua rau mob atherosclerosis thiab ua rau mob hnyav dua. Lub hydrochlorodiazide diuretic muaj cov teebmeem zoo ib yam nrog hypothiazide.

Rov qab rau cov lus txheej txheem

Tshuaj ntshav qab zib hom ntshav qab zib hom 2

Tshuaj diuretics rau cov ntshav qab zib hom 2 tsis pom zoo nyob rau hauv ntau. Diuretics uas zwm rau hauv thiazide pawg muaj cov khoom ntiag tug uas cuam tshuam nrog cov tshuaj insulin thiab nce qib ntau ntxiv. Nws yog txwv tsis pub noj cov tshuaj no ntawm koj tus kheej. Ib qho osmotic diuretic tuaj yeem ua ib qho kev tiv thaiv kab mob xws li hyperosmolar coma nrog kev siv tsis tau tswj.

Tsis pub siv cov tshuaj diuretic rau cov ntshav qab zib, zwm rau hauv cov potassium-sparing los yog loop pawg, tsis pom zoo. Qhov kev zam yog kev tswj hwm ib-zaug rau kev coj ua haujlwm tam sim thaum muaj xwm ceev. Nrog rau kev kub siab, uas yog nrog tus mob ntshav qab zib hom 2, tshuaj diuretic yog siv nrog ceev faj.

Rov qab rau cov lus txheej txheem

Concurrently muab tshuaj rau cov ntshav qab zib

Diuretic tshuaj rau ntshav qab zib yog tshuaj nrog lwm cov tshuaj uas yuav tsum tau coj los tshem tawm qhov kev pheej hmoo ntawm kev tsis zoo ntawm kev kho. Txhua qhov kev tso tshuaj rau ntau dua lossis tsawg dua ntxuav cov poov tshuaj tawm hauv lub cev. Tsis muaj cov poov tshuaj ua rau tsis muaj kev cuam tshuam. Yog li ntawd, nyob rau hauv parallel nrog rau kev nqus ntawm diuretics, potassium-sparing diuretics yog coj. Cov no suav nrog cov tshuaj "Spironolactone." Cov ntsiab lus ntawm nws cov pes tsawg leeg tiv thaiv kev xaum cov poov tshuaj. Tus kws kho mob tau sau ntawv rau cov tshuaj no yam tsis poob thaum kho mob ntshav hauv ntshav qab zib mellitus.

Diuretics (tshuaj diuretic) tshwj xeeb cuam tshuam rau kev ua haujlwm ntawm lub raum, pab txhawb rau kev nthuav tawm ceev ntawm cov zis los ntawm lub cev. Lub tshuab kev ntawm kev ua ntawm cov nyiaj no yog ua raws li kev muaj peev xwm inhibit qhov rov qab nqus ntawm electrolytes hauv cov hlaus rov qab. Nrog rau qhov nce hauv qhov ntim ntawm electrolytes tso tawm, qee qhov nqi ntawm cov kua ua kua.

Thawj lub diuretic tshwm rov qab rau xyoo 19th, thaum nws paub txog cov tshuaj mercury, uas tau siv dav kho mob syphilis. Txawm li cas los xij, hauv kev kho tus kab mob no, cov tshuaj mercury tsis tau tshwm sim nws tus kheej hauv txhua txoj kev, tab sis pom qhov cuam tshuam diuretic rau tib neeg lub cev tau pom.

Tom qab qee lub sijhawm, kev npaj txhij txhua mercury tau hloov pauv los ntawm cov khoom tsis zoo thiab muaj tshuaj lom.Kev txhim kho ntxiv ntawm diuretics coj mus rau qhov tshwm sim ntawm cov tshuaj diuretic uas muaj zog.

Thaum kho nrog diuretics, nquag thiab txhawb kev kho yog cais. Nrog rau kev saib xyuas theem, diuretics raug coj tas li, nrog kev kho mob nquag, kev siv cov koob tshuaj ntawm cov tshuaj pleev ib ce muaj zog yog qhia.

Kev tshwm sim tsis zoo ntawm cov tshuaj diuretics

Qhia qhov koj muaj piam thaj lossis xaiv poj niam txiv neej rau cov lus pom zoo

Tshuaj kho ntshav qab zib hom ntshav qab zib hom 2 qee zaum nce uric acid rau hauv cov hlab ntshav. Yog li, cov neeg mob uas tseem tau pom tias muaj mob caj dab gouty tuaj yeem pom pom kev tsis zoo hauv kev noj qab haus huv.

Cov neeg sawv cev ntawm cov pab pawg thiazide, piv txwv li, cov ntsiav tshuaj Hypothiazide, Hydrochlorothiazide, tuaj yeem ua rau cov kev xav tsis zoo, uas tau tshwm sim los ntawm mob taub hau, tsis muaj zog, raws plab, bouts ntawm xeev siab, ib qho kev xav ntawm dryness hauv qhov ncauj kab noj hniav.

Nrog ib qho tsis txaus ntawm ions tshwm sim:

1. txo qis libido rau cov txiv neej,
2. arrhythmia,
3. leeg tsis muaj zog
4. ua pob ua xua,
5. spasms hauv cov leeg pob txha.

Kev siv cov diuretic Furosemide yuav txo qhov kev nyeem ntawm magnesium, calcium, potassium, thiab tso zis ib zaug. Tus mob no, nyeg, coj mus rau qhov txo qis hauv lub rooj sib hais, paresthesia.

Aldosterone antagonists yuav ua rau mob taub hau, ua kom qaug dab peg, ntuav, raws plab, tawv nqaij ua pob khaus, gynecomastia. Hauv cov pojniam muaj ntshav qab zib, nrog rau kev noj tshuaj tsis txaus, kev coj khaub ncaws cuam tshuam lub cev, tus mob hirsutism tuaj yeem pom tau.

Cov tshuaj Dibicor

Dibicor yog cov tshuaj tshiab rau kev txhim kho cov metabolism hauv cov ntaub so ntswg, uas tseem muaj cov nyhuv diuretic. Muaj ib ntsiav tshuaj:

• taurine
• microcrystalline cellulose,
• hmoov txhuv nplej siab
• lwm cov tshuaj ntxiv.

Cov lus qhia rau kev siv qhia tau tias, nrog rau siv sijhawm ntev, cov ntshav qab zib sau ib qho kev txhim kho tseem ceeb hauv nws txoj kev mob, nws cov ntshav ncig hauv cov khoom hauv lub qhov muag pom sai sai.

Dibicor hauv kev txhaj tshuaj me me yuav pab txo qis qhov tsis zoo uas tshwm sim thaum siv lwm cov tshuaj rau thaiv cov calcium calcium. Tsis tas li ntawd, muaj qhov txo qis rhiab heev ntawm lub siab rau cov neeg ua haujlwm tiv thaiv kab mob.

Rau cov neeg mob ntshav qab zib, muaj lwm qhov ntxiv ntawm kev siv Dibicor - nyob rau hauv cov koob tshuaj siab, rau 14 hnub, nws txo qhov kev mloog zoo ntawm cov piam thaj hauv cov ntshav.

Nws yog ib qho tsim nyog yuav tsum coj Dibicor qhov ncauj nrog qhov txaus ntawm cov dej sov tsis muaj roj. Qhov ntau npaum li cas nyob ntawm:

1. hom ntshav qab zib
2. nws qhov mob hnyav.

Yog tias tus neeg muaj keeb kwm mob plawv lossis lub plawv tsis ua haujlwm, nws raug nquahu kom noj 250-500 mg ntawm cov tshuaj nquag ib hnub 15 feeb ua ntej noj mov. Lub sijhawm tiv thaiv yog 1 hlis. Yog tias tsim nyog, muab tshuaj rau raug kho. Qee zaum cov ntshav qab zib tau kho nrog Dibicor 1.5 hli.

Hauv cov ntshav qab zib mellitus ntawm yam thib ob, Dibicor yog noj hauv qhov ntau npaum li 500 mg ob zaug ib hnub, nws tsuas tuaj yeem tshem tawm cov kua dej ntau hauv lub cev yog tias nws siv ua ke nrog cov tshuaj tiv thaiv hypoglycemic.

Thaum muaj mob hypercholesterolemia tshwm sim, nws txaus noj ib zaug xwb ntawm cov tshuaj txhawm rau txo cov ntshav piam thaj hauv siab. Ntau tus neeg mob tshuaj xyuas tau paub meej txog qhov zoo ntawm cov ntsiav tshuaj uas twb tau nyob hauv lub lim tiam thib ob lossis thib peb ntawm chav kawm.

Cov kev lag luam kws tshuaj muaj peev xwm muab ob peb analogues ntawm Dibikor, ntawm lawv yog cov khoom siv tshuaj ntsuab. Tus nqi ntawm analogues yuav txawv nyob ntawm cov neeg tsim khoom, cov concentration ntawm taurine, lwm yam tshuaj yeeb dej caw.

Cov tshuaj yeeb yaj kiab uas nrov tshaj plaws ntawm cov tshuaj:

• Mildrazine
• Kapikor,
• Taufon
• Txhawj Mildronate tsuas yog siv rau cov ntshav qab zib hom 2 xwb.

Ntuj analogues ntawm no tshuaj diuretic yuav tsum tau sau tseg tincture ntawm paj thiab nplooj ntawm hawthorn.

Piav xaiv ntsej muag

Nrog ntshav qab zib hom 2, koj tuaj yeem siv tsis tsuas yog cov tshuaj diuretics, tab sis kuj siv tshuaj suav tshuaj.Txawm li cas los xij, ua ntej siv lawv, koj yuav tsum tau sab laj nrog koj tus kws kho mob tas li, qhov no yuav cia koj:

1. teem caij pes tsawg
2. kuaj cov khoom lag luam kom sib raug zoo nrog cov tshuaj tseem ceeb.

Feem ntau feem ntau, cov kws kho mob pom zoo nyom kom hnoos, nws yog siv nyob rau hauv daim ntawv ntawm decoction peb zaug ib hnub rau 2 diav. Nws yog qhov zoo tshaj plaws los haus dej haus xws li kev nqus nrog nrog kev da dej kub. Cov txheej txheem ua tau zoo tshaj plaws ua ntej mus pw.

Tshem cov kua dej ntau dhau ntawm lub cev tuaj yeem ua tiav los ntawm kev noj cov laus elderberry, uas kuj yog ib qho sedative. Cov khoom sib xws sib txawv dub blackberry hauv paus. Blueberry cov ntawv txheeb muaj cov diuretic thiab tonic ua haujlwm, cov cuab yeej tuaj yeem siv los ua kom txhua txoj kev ua haujlwm hauv cov plab hnyuv siab raum.

Txhawm rau kho qhov ua haujlwm, pob tw thiab nplooj ntoo tuaj yeem muaj cov nyhuv diuretic. Ginseng hauv paus pab txhawm rau txhim kho qhov tseem ceeb ntawm kev mob ntshav qab zib thiab ua kom lub cev tsis xis nyob. Cov cuab yeej no suav tau tias yog qhov ua tau zoo tshaj plaws rau ntshav qab zib ntawm txhua yam.

Cov lus thov kho mob ntshav qab zib yog kuaj sijhawm, ntau qhov ntawm lawv muaj feem tau lees paub los ntawm cov tshuaj raug cai thiab raug siv los tshem tawm cov teebmeem kev mob ntshav qab zib. Nws yog qhov yooj yim heev uas tshuaj ntsuab thiab tshuaj qab zib pub rau coj los ua ke nrog tshuaj tiv thaiv kab mob thiab lwm yam tshuaj. Txog ntawm no thiab txog cov hau kev tshiab ntawm kev kho mob ntshav qab zib - hauv yeeb yaj kiab hauv tsab xov xwm no.

Qhia qhov koj muaj piam thaj lossis xaiv poj niam txiv neej rau cov lus pom zoo

Tsev »Kev Kho Mob» Tshuaj » Los ntawm ntshav qab zib thiab kub siab - dab tsi cov tshuaj diuretics tuaj yeem coj thiab qhov txiaj ntsig twg yuav tsum cia siab los ntawm lawv?

Diuretics tshwm sim nyob rau xyoo 19th, tab sis thawj zaug tau siv los txo cov ntshav siab hauv 60s ntawm lub xyoo pua xeem.

Qhov tshwj xeeb ntawm diuretics yog ua raws li cov nyhuv ntawm lub raum ua haujlwm xws li ua kom nrawm cov txheej txheem ntawm cov zis kom tso tawm ntawm lub cev.

Yog tias siv cov tshuaj diuretics rau kev kho mob ntawm cov kab mob hauv lub plawv thiab cov hlab ntsha (nrog rau mob ntshav siab) tsis muaj kev tsis ntseeg, ces kev siv tshuaj diuretics rau ntshav qab zib thiab ntshav siab yuav tsum mus kom ze, ua kom zoo nrog koj tus kws kho mob. Muaj plaub pawg ntawm diuretics, uas peb yuav txiav txim siab hauv ntau yam.

Hom tshuaj diuretics siv nyob rau hauv cov ntshav qab zib thiab kub siab

Ntxees diuretics (tshuaj uas ua rau kom qhov zis ntau ntxiv) yog qhov muaj zog tshaj plaws ntawm cov tshuaj diuretics uas siv hauv kev soj ntsuam.

Cov tshuaj no feem ntau siv rau edema ntawm ntau lub hauv paus pib thiab kub siab. Lub npe ntawm cov pab pawg tau los ntawm qhov tseeb tias thaj chaw tseem ceeb ntawm lawv lub cawv yog nyob rau hauv lub voj ntawm Henle, qhov chaw uas dej rov nkag mus rau hauv lub cev.

Furosemide voj diuretic

Qhov cuam tshuam tshwm sim vim yog "inhibition" ntawm reabsorption, txuam nrog cov kua dej thiab cov zis sai dua, uas lub cev yuav hle dej thiab cov ntsev. Thaum ua ntawv thov cov voj diuretics, so ntawm cov leeg cov leeg ntawm cov hlab ntshav thiab nce ntxiv hauv cov ntshav raum tshwm sim.

Ntxiv nrog rau kev kub siab, cov tshuaj ntawm cov pab pawg no tuaj yeem kho rau mob hlwb txha caj qaum, hypercalcemia, lub plawv tsis ua haujlwm, lom los ntawm qee pawg ntawm cov tshuaj lom thiab lub raum tsis ua haujlwm. Kev npaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj lossis hauv ampoules rau kev txhaj tshuaj. Cov tshuaj yeeb yaj kiab tshaj plaws hauv cov pab pawg no yog Furosemide.

Lub voj hom tshuaj tsis tsim nyog rau kev kho mob ntshav siab hauv ntshav qab zib. Tsuas yog siv ib zaug xwb txhawm rau txo cov mob huam sai.

Thiazide diuretics ua qhov sib txawv pharmacological chav kawm ntawm cov tshuaj diuretic, uas yog homogeneous hauv nws cov nyhuv.

Cov tshuaj ntawm cov tshuaj sib txawv tsuas yog nyob rau hauv lub zog thiab ntev ntawm cov nyhuv.

Hauv ntau lub teb chaws ntawm lub ntiaj teb, pawg tshuaj no tshwj xeeb tshaj plaws yog pheej yig tshaj plaws: nws raug faib hauv cov khw muag tshuaj yam tsis muaj daim ntawv xaj thiab muaj tus nqi pheej yig. Cov tshuaj thiazide tsis yog siv rau kev kho mob ntshav siab xwb, tabsis tseem ua rau puffiness ntau ntxiv, uas dhau los ua rau lub siab ua haujlwm rau daim siab, lub siab lossis lub raum tsis ua haujlwm.

Chav kawm diuretic no tau pom rov qab rau hauv nruab nrab ntawm lub xyoo pua xeem. Thiazide diuretics muaj "ob" qhov txhais: lawv yog ob qho tshuaj thiab cov qauv tshwj xeeb nrog cov qauv tshwj xeeb.

Txawm li cas los xij, muaj ib tug xov tooj ntawm cov tshuaj nrog cov nyhuv zoo sib xws, raws li qhov uas tsis muaj thiazide lwg me me los ntawm cov pa tshuaj xav.

Vim li no, thiazide thiab thiazide-zoo li cov diuretics yuav tsum tau pom zoo. Cov tom kawg suav nrog Metolazone thiab Chlortalidone.

Tej zaum qhov xav tsis thoob zoo tshaj plaws ntawm chav kawm ntawm cov tshuaj no yog kev kho kom zoo uas lawv muaj nyob rau hauv lub cev. Txog rau thaum kawg, qhov kev ua ntawm kev thiazides tsis tau kawm. Nws paub txog qee yam uas thaum cov tshuaj lom neeg nkag mus rau hauv tib neeg lub cev, cov txheej txheem tsim zis yog ua kom nrawm nrawm, cov zis hauv plawv thiab ntshav ntau hauv cov ntshav txo qis.

Thiazide hom diuretics zoo tshaj rau cov ntshav siab, uas tawm tsam tiv thaiv keeb kwm ntawm ntshav qab zib mellitus.

Nrog kev siv thiazide diuretics ntev, "so" ntawm cov leeg du ntawm cov hlab ntsha tau pom, uas ua rau txo qis tsis kam rau qhov tsis kam. Qhov tom kawg yog lub luag haujlwm tseem ceeb hauv kev tiv thaiv kev kub siab.

Tag nrho cov kab mob ntawm thiazide tuaj yeem faib ua ob pawg:

• derivatives ntawm chlorobenzamide thiab quinazolinone,
• derivatives ntawm benzothiadiazine thiab phthalimidine.

Cov neeg sawv cev ntawm thawj pab pawg muaj tus yam ntxwv tsis zoo: lawv ntawm txhua lub raum tsis ua haujlwm tau muaj txiaj ntsig diuretic.

Los ntawm lawv cov yam ntxwv pharmacological, kev npaj cov pab pawg no muaj ntau qhov nco txog cov voj kev kho mob.

Ntawm cov kev mob tshwm sim loj yog kev ua xua, impotence, dermatitis, hyperglycemia, paresthesia, pancreatitis, cholecystitis, mob thiab mob hauv plab.

Feem ntau cov thiazide-zoo li cov diuretics muaj xws li:

• Clopamide
• Indapamide,
• Chlortalidone
• Hydrochlorothiazide,
• Metolazone
• Quinetasone.

Osmotic

Osmotic diuretics ua rau kev tshem tawm cov kua dej los ntawm cov nqaij mos los ntawm qhov ua kom ntshav qis. Vim tias cov txiaj ntsig no, ntshav nce ntxiv tsis yog hauv cov teeb meem nqaij, tab sis kuj nyob rau hauv lub raum nephrons.

Cov tom kawg provokes kev txhim kho nyob rau ntawm qhov pom ntawm cov yeeb yam hauv cov haujlwm ntawm lub cev. Nyob rau hauv parallel nrog no, qhov passive reabsorption ntawm sodium thiab chlorine nyob rau hauv lub qaum caug ntawm Henle voj poob.

Osmotic diuretics yog ib txwm muab tshuaj tso ntshav. Ntawm lawv, cov feem ntau:

Cov tom kawg tau sau tseg feem ntau vim hais tias ntawm lub caij nyoog siv. Qhov thib ob yog tus cwj pwm los ntawm qhov tsis muaj zog, lub sij hawm luv luv.

Cov pab pawg ntawm diuretics yog tsis zoo reabsorbed nyob rau hauv lub cev thiab nyhav tsub zuj zuj. Raws li, qhov rov ua kom dej thiab sodium ions yog cuam tshuam, uas ua rau lawv tshem tawm hauv lub cev. Ua ke nrog lawv, cov tshuaj kuj tau dhau los.

Ntawm cov kev mob tshwm sim tuaj yeem sau tseg mob taub hau, xeev siab, ntshav tawm, ntaub so ntswg necrosis thaum cov tshuaj tsis nkag mus rau txoj hlab ntshav, tab sis nyob hauv qab daim tawv nqaij. Tshuaj ntawm cov pab pawg no tau raug qhia tsis tsuas yog rau kev kub siab, tab sis kuj rau lom, hypovolemic poob siab thiab raws li prophylactic rau anuria.

Nws yog txwv tsis pub noj tshuaj osmotic diuretics hauv lub plawv tsis ua haujlwm.

Hauv txoj ntsiab cai, hom tshuaj no tuaj yeem siv rau ntshav qab zib, tab sis nws muaj cov nyhuv luv luv. Ib lub sijhawm ntev ntawm kev kho mob feem ntau tsis yog kws kho, yog li lawv tsim nyog tsuas yog siv ib zaug xwb.

Poov tshuaj-sparing

Lub tshuab ntawm kev ua ntawm cov tshuaj potassium-sparing muaj ib qho tshwj xeeb: lawv khaws cov poov tshuaj hauv lub cev, uas ua raws los ntawm cov npe ntawm cov pab pawg ntawm cov tshuaj.

Cov tshuaj noj muaj qhov cuam tshuam txog qhov tseem ceeb ntawm cov qe ntshav ntawm lub ntsej muag distal ntawm nephron.

Qhov kis raug tso cai ua rau txo qis hloov chaw ntawm cov poov tshuaj rau hlwb thiab yog li thaiv nws txoj kev nthuav tawm ua ke nrog zis. Poov tshuaj yog lub hauv paus tseem ceeb rau lub cev. Tsis tas li ntawd, nws txoj kev khaws cia yog qhov tseem ceeb rau cov neeg mob ntshav hypokalemia, uas nrog los ntawm kev txo qis hauv cov concentration potassium ions hauv cov ntshav ntshav.

Potassium-sparing diuretics kho tsis yog rau cov neeg mob ntshav siab xwb, tab sis kuj tseem siv rau kev kho mob ntawm cov kab mob tsis tshua muaj mob ntawm adrenal cortex, gout, mob plawv tsis ua hauj lwm thiab txo cov edema los ntawm kev puas tsuaj rau tsim adrenal lawm.

Poov tshuaj-sparing diuretics yog tus cwj pwm los ntawm lub zog tsis zoo rau lub cev, uas yog vim li cas cov tshuaj suav hais tias ua tsis zoo.

Vim li no, lawv tsis tshua tau raug coj los ua lub hauv paus rau kev kho, thiab ntau zaus dhau ntawm cov tshuaj uas yuav pab tau. Yog tias thaum noj cov tshuaj tsis muaj kev hloov pauv hauv lub cev txhua lub sijhawm, tom qab ntawd cov koob tshuaj tsis pom zoo kom ua dhau.

Cov tshuaj tsuas yog tso tseg lossis "los ntawm inertia" tseem txuas ntxiv rau qee lub sijhawm kom paub meej tias qhov tsis ua dab tsi ntawm txoj kev kho mob. Los ntawm txoj kev, tshuaj yog suav hais tias yog qhov tsis muaj nuj nqis kiag li. Nws yog qhov feem ntau sparing ntawm diuretics, yog li ntawd, cov txiaj ntsig ntawm nws qhov nqus "ua rau koj tos."

Potassium-sparing diuretics hauv ntshav qab zib yog suav tias yog qhov tsis muaj txiaj ntsig vim tias qhov kev pheej hmoo siab ntawm kev phiv.

Qhov ua tau tsis muaj zog yog vim qhov tseeb tias cov tshuaj no yog antagonists ntawm aldosterone. Aldosterone yog qhov tseem ceeb ntawm cov qog adrenal cortex, uas muaj kev cuam tshuam ncaj qha rau cov dej-ntsev kom sib npaug hauv lub cev. Diuretics muaj qhov cuam tshuam ntawm cov tshuaj no.

Aldosterone thaiv cov khoom yog nqa tawm raws li ob lub txheej txheem:

• txav kev thauj mus los ntawm sodium ions,
• "Kev txwv" kev tsim cov tshuaj hormone, ua rau cov receptors nyob rau hauv ib txoj kev tshwj xeeb, vim tias sodium ua tawm hauv cov zis, thiab cov ntsiab lus potassium nce siab.

Potassium-sparing diuretics kho yog tsis tsuas yog rau cov teeb meem nrog lub siab, tab sis kuj tseem daws teeb meem o thiab tshem tawm cov kua dej ntau dhau.

Rau cov laj thawj no, cov tshuaj ntawm hom no yog tau hais qhia txawm tias cov poj niam cev xeeb tub hauv cov theem kawg.

Cov kev daws kuj muaj cov npe ntawm cov kev mob tshwm sim, suav nrog xeev siab, ntuav, kiv taub hau, raws plab, tsis muaj zog, coj khaub ncaws tsis txaus, coj khaub ncaws, tsaug zog, nkees thiab kev nyuaj siab.

Poov tshuaj-sparing diuretic Veroshpiron

Daim ntawv uas muaj cov tshuaj muaj poov tshuaj zoo tshaj suav nrog:

Cov tshuaj twg zoo siv?

Diuretics los ntawm chav kawm ntawm thiazide thiab thiazide-zoo li yog suav hais tias yog pawg "hnyav zuj zus" ntawm diuretics, uas tsis tshua muaj kev phiv thiab zoo heev hauv kev tshem tawm o thiab txo ntshav siab.

Cov pab pawg osmotic tuaj yeem tsim txom qhov kev tshem tawm ntawm qhov ntau ntawm cov zis nyob hauv ob peb teev, tab sis lawv cov nyhuv tsis ntev. Rau kev kho mob ntev ntev, lawv tsis tsim nyog thiab tsuas yog siv rau hauv qhov xwm txheej uas yuav tsum tau txhawm rau kom tshem tawm qhov mob sai sai lossis txo qhov siab.

Cov tshuaj poov tshuaj-sparing yog txiav txim siab dhau lawm, tuaj yeem ua rau ntau cov kev phiv, yog li lawv tsuas yog siv los ua cov tshuaj txuas ntxiv rau kev kho mob ntshav siab. Ntxees diuretics zoo heev tiv nrog kev txo qis siab.

Lawv qhov kev ua yog hauv zos thiab txwv rau lub voj ntawm Henle. Ib pawg ntawm cov tshuaj yog suav tias yog cov tshuaj diuretic uas muaj zog, yog li lawv siv ntev heev tsis pom zoo.

Cov chav kawm ntawm kev kho, thiab, raws li, cov hom kev kho mob yuav tsum yog kws kho mob tshwj xeeb.Tsuas yog tus kws kho mob tuaj yeem xaiv cov tshuaj kom raug rau txoj kev kho mob ntawm tus neeg mob tshwj xeeb, xav txog tus yam ntxwv ntawm nws lub cev.

Related videos

Yuav kho ntshav siab mob ntshav qab zib li cas thiab kho mob li cas? Cov lus teb hauv video:

Los ntawm txoj kev, tib cov tshuaj muaj peev xwm raug coj los ua ib qho kev tiv thaiv kev tawm tsam tiv thaiv ntshav qab zib mellitus. Thaum noj cov tshuaj osmotic diuretics, koj yuav tsum ua tib zoo saib nrog kev siv lwm yam tshuaj. Tsuas yog pab pawg ntawm cov tshuaj diuretics ua rau cov ntshav-hlwb teeb meem permeable rau lwm cov tshuaj, uas tuaj yeem ua rau cov ntshav tsis tuaj yeem.

Diuretics rau ntshav qab zib mellitus (DM) feem ntau yog siv rau kev kho mob ntawm concomitant arterial hypertension (AH), lub plawv tsis ua haujlwm lossis tshem tawm ntawm pob txha caj dab. Nyob rau lub sijhawm tam sim no, muaj ntau yam tshuaj kho tau tuaj yeem ua rau kom diuresis (cov zis tso zis).

Txawm li cas los xij, nws yog qhov nyuaj hais qhov tsis txaus ntseeg twg ntawm lawv yog qhov zoo tshaj plaws. Txhua yam tshuaj kho tau nws tus kheej qhov ua tau zoo thiab tsis muaj zog thiab rau qee tus neeg mob nws yuav tau qhia lossis txwv.

Diuretic thiab ntshav qab zib

Cov tshuaj kho ntshav qab zib uas siv rau ntshav qab zib yog cov cim rau cov tshuaj tiv thaiv ntshav siab tshaj plaws. Tab sis nws yuav tsum nco ntsoov tias nrog kub siab, uas nrog mob ntshav qab zib mellitus, nws yog ib qho tsim nyog yuav tsum tau noj cov tshuaj no nrog kev ceev faj heev.

Koj tuaj yeem siv lawv tsuas yog nyob ntawm kev saib xyuas ntawm kws kho mob. Diuretics kho raum muaj nuj nqi thiab cuam tshuam rau cov zis tso zis tawm.

Diuretics (diuretics) rau kev kho mob ntshav siab hauv ntshav qab zib

Diuretics (diuretics) yog ib qho ntawm cov muaj txiaj ntsig zoo tshaj plaws ntawm antihypertensives vim lawv lub siab, ua siab ntev ntawm tus nqi qis lossis nruab nrab. Txog tam sim no, nrog kev mob ntshav siab, feem ntau thiazide (hypothiazide, hydrochlorothiside, thiab lwm yam) thiab thiazide-zoo li (indapamide, chlortalidone, xipamide) diuretics raug siv, cov nyhuv ntawm uas cuam tshuam nrog nce ntxiv hauv cov zis ntawm sodium.

Voj diuretics (furosemide, thiab lwm yam) tau siv tsis siv rau kev kho mob ntev ntev ntawm txoj kev mob ntshav siab, tab sis lawv tau qhia rau cov neeg mob txo qis raum tsis siv thiazide diuretics. Potassium-sparing diuretics (triamteren, thiab lwm yam) feem ntau poob lawv qhov tseem ceeb rau kev kho mob tawg.

Txog thaum nyuam qhuav dhau los, thiazide diuretics rau kev kho mob ntawm txoj hlab ntshav hauv ntshav qab zib hom 2 tau siv qee yam vim lawv lub peev xwm los txo qhov rhiab ntawm cov hlwb rau insulin, nce piam thaj, ntxiv rau cov roj (cholesterol) thiab triglycerides hauv cov ntshav.

Txawm li cas los xij, nws tau pom tias cov kev mob tshwm sim tsuas yog siv sij hawm ntev ntawm kev siv ntau ntawm cov tshuaj, thiab hauv cov koob tshuaj me me lawv tsis cuam tshuam loj heev rau cov carbohydrate thiab lipid metabolism. Thiazide thiab thiazide-zoo li diuretics tshem tawm tsis tsuas yog sodium, tab sis kuj muaj cov potassium, ntxiv rau magnesium ntawm lub cev.

Kev noj ntau ntxiv ntawm cov zaub mov ntau nyob hauv cov poov tshuaj thiab magnesium (cov txiv hmab txiv ntoo tshiab thiab ziab thiab cov txiv, cov zaub, qos yaj ywm, oatmeal thiab buckwheat, thiab lwm yam) tiv thaiv lub cev tsis ua kom cov zaub mov no ploj mus. Thaum noj ua ke thiazide thiab potassium-sparing diuretics (triampur, triamco), cov piam thaj poob yog tsawg heev.

Thiazide-zoo li cov diuretics, uas cuam tshuam me ntsis ntawm cov carbohydrate thiab lipid metabolism, pom zoo rau kev sib xyaw ntawm kev kub siab thiab hom 2 mob ntshav qab zib mellitus, txawm hais tias insulin tswj hwm yuav ua rau me ntsis xav tau cov tshuaj insulin. Cov tshuaj ntawm cov kev xaiv thawj zaug yog indapamide retard (arifon), noj ib zaug ib hnub.

Diuretics lav kom txo qis ntshav siab hauv ntshav qab zib

Cov kev mob tshwm sim tsis zoo ntawm cov tshuaj diuretic yog qhov teeb meem tseem ceeb.Tshwj xeeb, vim tias muaj kev pheej hmoo mob ntshav qab zib mellitus, uas nyob rau hauv ntau txoj kev tshawb fawb tau tsim nyob rau hauv 25-30% ntawm cov neeg mob, qhov kev siv tshuaj tam sim no tau qis dua li cov uas siv hauv kev tshawb fawb txog lawv cov hauj lwm yav dhau los.

Ntxiv rau, kev sib xyaw ua ke muaj qhov zoo uas nyob rau hauv kev sib xyaw ua ke no muaj qhov sib cuam tshuam ntawm qhov tsis txaus siab ntawm ob yam tshuaj cuam tshuam nrog cov piam thaj thiab poov tshuaj qib, uas yog, kev tshawb PATHWAY3, qhov tseeb, yog qhov txiaj ntsig rau cov neeg mob koom nrog nws.

Kev kawm PATHWAY3 tau txais kev txhawb nqa los ntawm British Heart Foundation thiab National Institute rau Kev Tshawb Nrhiav Kev Noj Qab Haus Huv. Nws suav nrog cov neeg mob uas tsis tuaj yeem tswj hwm cov leeg ntshav (systolic ntshav siab> 140 mmHg), uas tuaj yeem raug tshuaj kho kho diuretic.

Cov neeg tuaj koom kev tshawb nrhiav kuj tseem muaj tsawg kawg ib qho tiv thaiv ntxiv ntawm cov metabolic syndrome. Tag nrho ntawm 440 tus neeg mob tau xaiv kho rau 10-20 mg amiloride, lossis 5-10 mg amiloride thiab 12-25-25 mg GHTZ, lossis 25-50 mg GHTZ. Qhov kawg ntawm qhov kawg yog qhov kev hloov pauv ntawm cov txiaj ntsig ntawm 2-teev ntawm qhov ncauj kuaj ntshav qab zib (OGTT) piv nrog thawj zaug.

Ntawm qhov tsis sib xws, kev sib xyaw ntawm amiloride thiab HCTZ muaj qhov cuam tshuam nruab nrab rau cov piam thaj tom qab 2 teev (qhov sib txawv piv nrog HCTZ tom qab 24 lub lis piam yog 0.58 mmol / L). Raws li rau systolic ntshav siab, ob qho tshuaj nyob rau hauv ib koob tshuaj tag nrho txo ​​nws los ntawm kwv yees li 14 mmHg. Txuj ci., Tab sis tawm tsam keeb kwm ntawm kev sib xyaw ntawm amiloride / GHTZ, ib qho ntxiv txo ntawm 3.4 hli RT tau txais. Kos duab.

Nws yog ib qho tseem ceeb tias cov txiaj ntsig no tsis tau tiav vim muaj kev txo qis hauv kev nyab xeeb, nrog rau qhov nruab nrab zoo rau cov tshuaj potassium ntau ntau. Tsis muaj ib qho ntawm cov neeg mob tau nce siab ntxiv hauv qib siab dua li 5,8 mmol / L, txawm hais tias siv los ntawm ACE inhibitors lossis angiotensin receptor blockers ib txhij.

Kev tawm tswv yim txog cov ntaub ntawv tau txais, cov kws sau ntawv ntawm kev ua haujlwm tau hais tias, los ntawm lawv qhov kev xav, nws yog qhov tsim nyog yuav tsum tso tseg txoj kev tsim txoj kev xav tias thiazide diuretics tuaj yeem siv tsuas yog hauv koob tshuaj tsawg. Qhov pom ntawm no coj tsis tau tsuas yog qhov tseeb tias cov koob tshuaj thiazides siv rau hauv kev coj ua txhua hnub yog qis dua cov uas nws cov txiaj ntsig tau ua pov thawj hauv kev soj ntsuam, tab sis kuj pom qhov tseeb tias ntau qhov kev pom zoo hauv cov chaw kho mob, tshwj xeeb hauv Askiv, xav txog thiazide diuretics li tsawg dua nyiam kom zoo, nrog rau kev txo qis lawv cov chaw muag tshuaj kom zoo.

Kev kawm PATHWAY3 tau qhia tias muaj ib txoj hauv kev los ua ke zam kev muaj mob ntshav qab zib thiab ua tiav ntshav siab tswj hwm. Nws yog qhov ua tau hais tias kev sib xyaw ntawm amiloride thiab HCTZ yuav raug txiav txim siab tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas muaj tshuaj tiv thaiv insulin lossis mob metabolic.

Kev faib tawm - hom kev kuaj mob

Niaj hnub nimno cov tshuaj tso ntshav - ib qho tseem ceeb tshaj plaws ntawm cov tshuaj hauv 25 xyoo dhau los. Hauv nephrological xyaum, hauv qab no 4 pawg ntawm diuretics:

thiazide diuretics (benzothiazidine derivatives - thiazides), lub voj diuretics - furosemide thiab ethacrylic acid, potassium-sparing diuretics, osmotic diuretics.

Qee qhov tso tshuaj diuretics zoo ib txwm tsis siv rau mob raum vim yog nephrotoxicity (mercury diuretics) los yog vim tsis muaj txiaj ntsig (theophylline, ammonium chloride).

Thiazide diuretics

Thiazide pab pawg ntawm diuretics - hypothiazide (dichlothiazide, hydrochlorothiazide), cyclomethiazide thiab lwm tus inhibit sodium reabsorption hauv thaj av cortical ntawm lub voj nephron, nrog rau qee qhov txawv ntawm cov tub kaw lus. Cov nyhuv diuretic tshwm sim tsis dhau 1 - 2 teev, kav ntev li 10 - 12 teev lossis ntau dua, yog li nws yog qhov zoo dua los noj tshuaj thaum sawv ntxov.

Cov nyhuv tshuaj ci ua kom tiav ntawm pab pawg ntawm diuretics yog muaj ntsis, kwv yees li 10% ntawm cov ntxaij lim dej sodium tawm. Txawm li cas los xij, txawm tias muaj kev cuam tshuam ntawm diuretic nyhuv, cov tshuaj tau dav dav, vim tias lawv yooj yim siv, muaj cov nyhuv hypotensive, thiab tseem txhim kho cov chav kawm ntawm nephrogenic diabetes insipidus thiab idiopathic hypercalciuria.

Localization ntawm kev ua ntawm diuretic tshuaj nyob rau hauv lub nephron

Phiv los ntawm thiazide diuretics:

Ua kom muaj qhov tsis pom kev ntawm cov poov tshuaj nrog kev tsim kho hypokalemia, qee zaum metabolic alkalosis, nce ntxiv excretion ntawm magnesium Txo kev tsis txaus ntawm calcium nyob rau hauv cov zis - nce nws cov ntsiab lus hauv cov ntshav dej (qhov no yog lub hauv paus rau lawv siv rau kev kho mob idiopathic hypercalciuria) Kev txo qis (thim rov qab) kev tsis txaus siab ntawm uric acid nrog kev loj hlob ntawm hyperuricemia Disrupt ua rau hyperglycemia, nrog rau kev ua kom mob ntshav qab zib mellitus ntau heev (vim li cas lawv siv rau ntshav qab zib nephropathy raug txwv). Cov raum tsis ua hauj lwm tuaj yeem ua rau mob ntxiv, yog li ntawd, nrog rau kev mob raum tsis zoo, kev siv cov tshuaj no yog contraindicated. Kev phiv los ntawm diuretic suav nrog cov mob ntawm pancreatitis, kev fab tshuaj nrog photosensitivity lossis necrotic angiitis.

Voj-hom diuretics

Furosemide muaj qhov cuam tshuam txog kev rov ua haujlwm ntawm rov siv cov tshuaj chlorine, ua rau thaj tsam tseem ceeb ntawm thaj tsam ntawm qhov ntu ntawm nephron lub voj, thiab tseem (nyob rau hauv cov koob tshuaj loj) hauv qhov kwv yees sib luag. Nws muaj lub cev sai, lub sij hawm luv luv thiab cov lus tshaj tawm, 20-30% ntawm cov kua ntsev tau tawm hauv cov zis.

Txawm tias thaum noj cov tshuaj hauv, nws yog nqus tau sai thiab tag nrho. Cov nyhuv diuretic pib tsawg dua 1 teev tom qab kev tswj hwm, sai sai (hauv 15 - 20 feeb) nce mus txog qhov siab thiab kav ntev li 4 teev. Tom qab kev tso tshuaj, cov diuretic nyhuv tau sau tseg rau ob peb feeb thiab ploj tom qab 2 teev.

Ntxiv nrog rau kev kho mob edematous syndrome, no lub voj-hom diuretic kuj tseem siv rau cov mob ntsws tubular txhaws los tiv thaiv (lossis txo qis) anuria. Thaum noj cov tshuaj hauv, pib koob yog 20 - 40, qhov siab tshaj plaws yog 400 - 600 milligrams, nrog cov tshuaj cia siab, cov peev nyiaj nyob ntawm 20 txog 1200 milligrams.

Hauv kev sib piv rau thiazides, furosemide me ntsis nce glomerular pom, thiab yog li ntawd yog txhais tau tias kev xaiv hauv lub raum tsis ua haujlwm. Lub diuretic yog feem ntau zoo tiv thaiv. Nrog rau kev siv ntev, hyperuricemia tuaj yeem txhim kho tus mob gout, mob pob ntseg (tshwj xeeb tshaj yog thaum siv tshuaj tua kab mob tib lub sijhawm), thrombocytopenia.

Cov nyhuv hyperglycemic yog negligible. Tsis tshua muaj heev (thaum siv tshuaj tua kab mob los ntawm pab pawg cephalosporin), lub raum kev ua haujlwm tuaj yeem ua haujlwm tsis zoo. Tsis zoo li thiazides, nws tuaj yeem ua rau kom muaj cov sodium chloride ntau dhau nrog kev txhim kho hyponatremia. Ethacrylic acid (uregitis) yog lwm txoj kev voj-hom diuretic uas ua tib yam li furosemide, txawm hais tias nws muaj cov qauv tshuaj lom neeg sib txawv.

Lub ncov ntawm diuresis tshwm sim 2 teev tom qab noj tshuaj sab hauv, cov nyhuv diuretic nres tom qab 6 - 9 teev. Muab tso rau sab hauv, pib nrog 50 milligrams (1 ntsiav tshuaj), nce qhov koob tshuaj txhua hnub rau 200 mg yog tias tsim nyog. Siv cov tshuaj tom qab noj mov. Hyperuricemia yog qhov phiv los ntawm diuretic. Hauv qee qhov tsis tshua muaj, kev lag luam lag ntseg, tsis tshua muaj kev cuam tshuam (tshwj xeeb yog thaum noj tshuaj nrog tshuaj tua kab mob).

Diuretics ua kev pom zoo ua ke

Txij li thaum lub tshuab ntawm kev ua ntawm cov pab pawg sib txawv ntawm diuretics tsis zoo li qub, yog tias ib tus neeg sawv cev yog qhov ua tsis tau zoo, hloov nws nrog lwm lossis sib txuas ua ke. Cov tshuaj sib xyaw ua ke thiab kev kho kom zoo li nram no tuaj yeem pom zoo.

Koj tuaj yeem ua ke tshuaj thiab kaw kev ua haujlwm.Yog li, furosemide, qhia paub thaum lub sijhawm siab tshaj plaws diuresis tshwm sim los ntawm thiazides, nce diuresis (tib lub sijhawm, thiazides tsis nce diuresis tshwm sim los ntawm furosemide). Thiazides tuaj yeem txhim kho kev ua haujlwm ntawm ethacrine acid - furosemide tsis muaj cov cuab yeej no).

Eufillin nrog kev tswj hwm qeeb qeeb tuaj yeem txhim kho cov nyhuv ntawm natriuretics thaum muab rau ntawm qhov siab ntawm lub ncov ntawm diuresis (piv txwv, 30 feeb tom qab noj furosemide lossis ethacrine acid).

Kev sib txuam ua ke ntawm diuretics

Nws yog ib qho tsim nyog yuav tsum nco ntsoov qee qhov kev sib xyaw ua ke ntawm diuretics nrog lwm yam tshuaj. Kev sib xyaw ntawm ethacrylic acid los yog furosemide nrog kanamycin, gentamicin, streptomycin tuaj yeem ua rau lag ntseg lag ntseg. Kev sib xyaw ntawm ethacrylic acid los yog furosemide nrog cephaloridine yog nephrotoxic.

Nrog kev sib xyaw ntawm diuretics nrog acetylsalicylic acid, nws txoj kev zais cia yog mob los ntawm ob lub raum. Yog tias cov diuretics thiab calcium npaj tau ua ke tib lub sijhawm, hypercalcemia yuav loj hlob tuaj. N.E. de Wardener (1973) pom zoo rau cov txheej txheem tom qab ntawm kev them nyiaj kho:

txhawm rau kom txo cov poov tshuaj hauv cov zis, kev kho yuav tsum tau pib nrog veroshpiron lossis triamteren, thiazide diuretics yuav tsum tau ntxiv tom qab 2 txog 3 hnub, yog tias thiazides tsis muaj txiaj ntsig, hloov nrog furosemide lossis ethacrylic acid. Muab ob npaug rau koob tshuaj furosemide txhua hnub kom txog rau thaum pib ntawm diuresis lossis kom txog thaum txhaj 4000 milligrams ib hnub twg yog tau, yog tias diuresis tsis tshwm sim, txuas ntxiv noj furosemide (ib feem ntawm cov koob tshuaj yog tso tshuaj), thaum nce ntshav ntau los ntawm kev tso ntshav tshuaj los ntawm cov leeg albumin lossis ntsev tsis pub dextran. Cov nyhuv no tseem muaj peev xwm ntau dua yog tias mannitol raug muab tshuaj pleev ib leeg. Tus neeg mob yuav tsum tau hnyav txhua hnub. Qhov no muab lub tswv yim zoo dua ntawm kev ntsuas dej dua li ntsuas qhov ntsuas ntawm diuresis thiab cov dej uas koj haus. Nrog kev ploj ntawm edema, diuretics raug muab tso tseg.

Kev kho mob diuretic

Thaum kho nrog diuretics, cov ntsiab lus hauv qab no yuav tsum khaws cia hauv nruab siab (hauv feem peb tau hais txog lawv).
Cov kab mob no tuaj yeem ua rau hypokalemia thiab metabolic alkalosis. Yog tias lub voj-hom diuretic raug kho, cov tshuaj poov tshuaj npaj yuav tsum tau ntxiv.

Hypothiazide thiab furosemide nyob rau hauv cov chaw kho mob tawm tau hais hauv cov chav kawm sib quas ntus (piv txwv, 2 hnub hauv ib lub lis piam lossis txhua lwm hnub). Cov tshuaj Diuretic tuaj yeem ua rau kom cov kua tshuaj sodium chloride ntse thiab qhov txo qis hauv bcc nrog cov txiaj ntsig txo qis dua rau qhov rov kho dua. Diuretics, txo qis bcc, ua rau muaj kev nce siab hauv qib ntawm renin thiab aldosterone.

Hauv cov hyperaldosteronism loj, kev noj cov poov tshuaj tsis muaj qhov ntxiv ntawm veroshpiron tsis cuam tshuam rau hypokalemia.
Hauv cov neeg mob uas muaj lub ntsej muag ntaug ntev ntev uas tau noj tshuaj pab ntev ntev, hyponatremia feem ntau muaj (cov sodium ntau hauv lub cev yuav nce).

Qhov kev txo qis ntawm sodium muaj kev sib txuas nrog qhov tsis tseem ceeb ntawm cov leeg ntshav tsis txaus (hypovolemic poob siab), hyperaldosteronism txo qis, txo poov tshuaj, alkalosis, txo qis hauv CF, thiab kev nce ntawm urea concentration.
Thaum CF tsawg dua 20 ml / min, furosemide yog kev kho mob ntawm kev xaiv, uas tso cai rau kev ua kom muaj cov tshuaj sodium ntau ntau (sodium chloride), tej zaum muaj qhov nce CF.

Veroshpiron thiab triamteren yuav tsum tsis txhob muab tshuaj vim qhov kev phom sij ntawm hyperkalemia. Hauv kev kho mob ntawm cov neeg mob uas mob raum tsis ua haujlwm, nws yuav tsum nco ntsoov tias cov kua dej tsis ua haujlwm, tom qab ntawd txo qis hauv bcc, tuaj yeem ua rau muaj kev cuam tshuam ntxiv ntawm lub raum. Kev cuam tshuam sov hauv Electrolyte tshwm sim tau yooj yim dua - hyperkalemia, hypochloremia, alkalosis, hypercalcemia, nrog rau hyperuricemia thiab hyperglycemia. Thaum noj ntau dua ntawm furosemide thiab ethacrylic acid, hnov ​​lus tsis zoo (feem ntau hloov zuj zus) yuav tshwm sim.

Kev kho mob ntawm txoj hlab ntshav txhaws hauv ntshav qab zib. Kev tshuaj ntsuab

Txij li thaum kev tuav ntawm Na thiab kua dej thiab lub txiaj ntsig hypervolemia ua lub luag haujlwm tseem ceeb hauv kev sim keeb ntawm kev mob ntshav siab hauv hom 1 thiab ntshav qab zib hom 2, kev siv tshuaj diuretics los ua kom ntshav siab yog qhov tsim nyog. Txawm li cas los xij, tsis yog txhua pawg diuretic zoo sib xws thiab muaj txiaj ntsig zoo rau cov neeg mob ntshav qab zib.

Kev faib tawm ntawm diuretics

Kev hloov kho thaj chaw ntawm kev nqis tes ua thiab cov kev ua ntawm kev txiav txim siab ntawm diuretics raug nthuav tawm:

Qhov chaw ntawm kev txiav txim ntawm diuretics thiab nws cov tshuab

Thiazide diuretics Cov tshuaj no feem ntau ua rau lub hlwb ntawm qhov distal convoluted tubule los ntawm sab hauv, qhov chaw uas lawv thaiv diuretics tshwm sim 1-2 teev tom qab kev tswj hwm qhov ncauj thiab kav ntev, raws li txoj cai, 12-18 teev (hypothiazide) thiab mus txog 24 teev (chlortalidone). Thiazide diuretics yog cov muaj zog potassium-diuretics.

Lub tshuab ntawm cov ntshav qab zib ua tau ntawm thiazides yog vim lub suab nrov poov tshuaj excretory nyhuv ntawm cov tshuaj no. Kev ploj ntawm cov tshuaj tua kab mob ntxiv thiab cov kab mob txhab ntxiv hauv β-hlwb ntawm cov txiav ua qab ntawm thiazides ua rau cov tsis muaj peev xwm tiv thaiv cov tshuaj insulin secretion thiab hyperglycemia. Qhov ntau cov diuretic tshem cov poov tshuaj, qhov ntau dua nws cov nyhuv ntshav qab zib.

Hauv kev tshawb nrhiav ncauj lus kom ntxaws ntawm thiazide diuretics, nws muab tawm tias cov teebmeem ntawm potassium-excreting ntawm thiazides tsuas yog tshwj xeeb tshaj tawm cov tshuaj hauv qhov. Koob tshuaj dependence ntawm cov potassium-tshem tawm cov nyhuv ntawm hypothiazide (feem ntau siv dav thiazide diuretic hauv Russia) tau nthuav tawm.

Qhov tos ntawm cov poov tshuaj-tshem tawm cov nyhuv ntawm hypothiazide ntawm nws cov koob tshuaj

Yog li ntawd, nrog ib koob tshuaj hypothiazide ntawm 12.5 mg / hnub los yog tsawg dua, nws cov nyhuv potassium-excreting yog qhov tsis lees paub. Yog hais tias lub zog ntawm cov potassium-tshem tawm cov nyhuv ntawm thiazides nyob ntawm qhov ntau ntawm cov tshuaj, tom qab ntawd cov nyhuv diabetogenic ntawm cov diuretics (ncaj qha ntsig txog cov ntsiab lus ntawm cov poov tshuaj) tseem yuav tsum yog koob tshuaj, i.e., yog qhov siab tshaj plaws ntawm qhov siab ntawm cov tshuaj thiab tsawg kawg ntawm qis.

Tseeb, ntau cov kev tshawb fawb pom tau tias qhov ntau dua me dua cov koob tshuaj thiazide noj, qhov tsawg dua nws cov nyhuv ntawm cov metabolism hauv kev ua kom yuag. Nrog rau ib qho koob tshuaj hypothiazide siab tshaj 50 mg / hnub, qhov kev pheej hmoo ntawm tus mob ntshav qab zib hom 2 nce mus txog 7% (kev kawm MRFIT), nrog qhov kev txhaj tshuaj 25 mg lossis tsawg dua, tsis muaj ib qho tseem ceeb ntxiv rau qhov kev pheej hmoo ntawm tus mob ntshav qab zib hom 2 (SHEP, TOMHS kev tshawb fawb).

Qhov tos ntawm cov piam thaj hauv cov piam thaj ntawm kev txhaj tshuaj ntawm thiazide diuretics

Hauv kev tshawb fawb ntau ntawm cov pej xeem ARIC, uas suav nrog ntau dua 12,000 tus neeg tsis muaj ntshav qab zib, nws tau qhia tias kev noj thiazide diuretics ntawm 12,5-25 mg / hnub rau 6 xyoo tsis yog nrog los ntawm kev pheej hmoo ntawm tus mob ntshav qab zib hom 2 (OP = 0.91) Cov. Yog li, cov kev tshawb fawb ntau tus neeg ua haujlwm tau lees tias qhov kev pheej hmoo ntawm kev tsim hom 2 de novo ntshav qab zib nrog kev siv thiazide diuretics tau ntev yog tsawg heev thaum lawv cov koob tsis siab tshaj 25 mg / hnub.

Cov nyhuv ntawm thiazide diuretics rau lipid metabolism ntau dua nyob ntawm lub sijhawm ntawm cov tshuaj thiab kom tsawg dua raws li nws cov koob tshuaj. Yog li, thaum noj thiazides rau 3-12 lub hlis. ntshiab ntshav theem nce ntxiv 5-7%. Nyob rau tib lub sijhawm, kev soj ntsuam cov tshuaj placebo ua rau pom tias kev siv tshuaj ntev ntev (rau 3-5 xyoos) tsis cuam tshuam rau lipid metabolism. Hauv HAPPHY thiab EWPHE cov kev tshawb fawb, lub hauv paus hypercholesterolemia tau sau tseg (ntshiab qib OX tshaj 6.5 mmol / L).

Cov nyhuv ntawm kev siv mus sij hawm ntev ntawm thiazide diuretics rau cov metabolism hauv lipid

Yog li, tsis muaj pov thawj txaus ntseeg tias cov thiazide diuretics tsis tuaj yeem raug kho rau cov neeg muaj dyslipidemia, yog tias lawv yuav tsum tau txo cov ntshav siab.

Los ntawm ntshav qab zib thiab kub siab - dab tsi cov tshuaj diuretics tuaj yeem coj thiab qhov txiaj ntsig twg yuav tsum cia siab los ntawm lawv?

Diuretics tshwm sim nyob rau xyoo 19th, tab sis thawj zaug tau siv los txo cov ntshav siab hauv 60s ntawm lub xyoo pua xeem.

Qhov tshwj xeeb ntawm diuretics yog ua raws li cov nyhuv ntawm lub raum ua haujlwm xws li ua kom nrawm cov txheej txheem ntawm cov zis kom tso tawm ntawm lub cev.

Yog tias siv cov tshuaj diuretics rau kev kho mob ntawm cov kab mob hauv lub plawv thiab cov hlab ntsha (nrog rau mob ntshav siab) tsis muaj kev tsis ntseeg, ces kev siv tshuaj diuretics rau ntshav qab zib thiab ntshav siab yuav tsum mus kom ze, ua kom zoo nrog koj tus kws kho mob. Muaj plaub pawg ntawm diuretics, uas peb yuav txiav txim siab hauv ntau yam.

Tshuaj kho ntshav qab zib

Txhawm rau tswj cov ntshav khov mus ntev (BP), tshuaj kho ntshav qab zib kom ntshav tau. Lawv raug kho thaum muaj qhov hnyav rau ntawm txoj hlab plawv (CCC) lossis thaum muaj kev ua txhaum ntawm kev ua haujlwm ntawm cov zis ua haujlwm los ntawm lub raum. Lub hom phiaj kev kho mob tseem ceeb yog ua raws cov txheej txheem ntawm kev txiav txim siab, ntawm qhov kev xaiv ntawm cov tshuaj hauv ib qho kev soj ntsuam cov duab ntawm tus kabmob.

Thaum muaj ntshav qab zib mellitus (DM), lwm yam tshuaj tseem raug kho rau kev kho mob, yog li cov tshuaj kho mob tsuas yog kho los ntawm tus kws kho mob kom ua raws li cov tshuaj hauv daim ntawv. Lawv muaj ntau cov kev mob tshwm sim.

Kev ntsuas rau ntshav qab zib

Mob ntshav qab zib, hom 2 thiab ntshav tshuaj 1 yog tshuaj kho mob:

• los nplij puffiness,
• nyem ntawm cov hlab plawv tsis ua haujlwm,
• tso zis tawm vim lub raum mob thiab cov diuretic muaj nuj nqi cuam tshuam,
• kho mob ntshav siab
• tshem tawm ntawm co toxins thiab tshuaj lom.

Vim yog hloov hauv lub cev, sodium hauv cov neeg mob ntshav qab zib accumulates. Nws raug tshem tawm los ntawm diuretics rau hom ntshav qab zib 2. Nrog lawv siv, lub siab ntawm cov hlab plawv txo qis thiab qhov siv ntawm kev mob plab los rov qab zoo li qub. Siv cov tshuaj tiv thaiv ntshav qab zib, cov kws kho mob muab cov diuresis yuam (tshem tawm cov co toxins los ntawm lub raum nrog tshuaj noj), yog tias tsim nyog, hauv kev kho mob ntshav qab zib.

Hom tshuaj

Lub ntsiab pawg thiab hom ntawm raug mechanism:

Pawg ntawm diuretics ua raws li lub ntsiab cai ntawm kev ua.

• rov qab - ua haujlwm los ntawm lub voj ntawm Henle nefron ("Torasemide", "Furosemide", "Ethacrine acid"),
• thiazide - txo ntshav siab, feem ntau yog kho mob ntshav qab zib ("Hypothiazide", "Dichlothiazide", "Indapamide", "Arifon", "Noliprel"),
• osmotic - rau kev siv ib zaug thiab rau qhov tshem ntawm lub ntim loj ntawm cov kua ("Mannitol", "Urea", "Potassium acetate"),
• poov tshuaj-sparing - tswj cov nyiaj electrolyte ("Spironolactone", "Triamteren", "Veroshpiron").

Diuretic tshuaj rau ntshav qab zib tau muab faib ua tej pawg:

• qes qes (5%),
• nruab nrab (10%),
• siab (dhau 15%).

Tshuaj kho ntshav qab zib mellitus hom 2 thiab hom 1 muaj cov tuam txhab sib txawv, koom nrog cov nqi sib txawv. Qee qhov ntawm lawv muag los ntawm cov tshuaj, qee qhov raug muag yam tsis muaj. Ntau hom tshuaj diuretic tuaj yeem nqa tus neeg mob thiab tsis qhia qhov twg. Koj yuav tsum ua tib zoo kawm cov lus qhia, pharmacodynamics, hom kev nqis tes ua, contraindications thiab ua tau ntawm kev sib txuas nrog lwm cov tshuaj muaj zog. Qhov ua tau zoo ntawm kev tso dag tso ntshav yog raws li sodium excretion.

Dab tsi siv tshuaj rau tso ntshav qab zib?

Kev xaiv tshuaj los txo cov ntshav siab hauv cov ntshav qab zib yuav tsum yog raws li cov duab hauv chaw kuaj mob, tus neeg mob lub neej zoo, hnub nyoog thiab hom phiaj ntawm kev siv. Tus kws kho mob txiav txim siab qhov ua rau muaj kev txuam nrog cov kua thiab, ntawm lub hauv paus ntawm no, ib qho tshuaj tua kab mob tso tawm. Tus lej, qhov tseeb ntawm cov kev mob tshwm sim, qhov xav tau rau lawv cov kev siv ua ke nrog lwm cov tshuaj txo cov kev tshawb rau qhov uas siv tau diuretic.

Nrog tus mob ntshav qab zib hom 1, ib qho kev tsis ncaj ncees yog muab rau ntawm thiazide pawg tshuaj ntawm cov tshuaj me me. Qee cov tshuaj cuam tshuam rau cov metabolism hauv qab zib, uas yuav tsum tau txiav txim siab thaum haus dej. Kev txo ntshav siab sai yog ua siv cov diuretics. Lawv qhov kev siv mus ntev yog qhov tsis lees txais. Nrog poob loj ntawm cov poov tshuaj, uas muaj kev phom sij rau kev noj qab haus huv, qhov kev xaiv yog ua raws cov potassium-sparing pawg kom khaws cia cov khoom no hauv lub cev.

Sau cov tshuaj

Cov ntsiav tshuaj tau muab tshuaj raws li lub hom phiaj ntawm kev kho mob thiab mob ntawm cov ntshav qab zib kom tag nrho, raws li tshuaj xyuas tus kws kho mob. Nrog rau kev kub siab, cov neeg mob ntshav qab zib yuav tsum tau ceev faj hauv kev xaiv cov tshuaj thiab tsis txhob noj tshuaj ntawm qhov muaj zog tshaj li qhov tsim nyog. Qhov no yog fraught nrog lub raum tsis zoo muaj nuj nqi thiab exacerbation ntawm hom 2 mob ntshav qab zib. Cov lus qhia nrog cov npe tshuaj siv tau muab rau.

Kev sib xyaw ntawm cov tshuaj, cov lus piav qhia dav dav thiab cov chaw muag tshuaj

Cov tshuaj yog tsim los ntawm kev lag luam kws tshuaj hauv daim ntawv ntawm cov ntsiav tshuaj rau kev tswj hwm qhov ncauj.

Cov tshuaj rau saum npoo muaj ib txheej zaj duab xis.

Lub ntsiab tseem ceeb nquag noj ntawm cov tshuaj yog indapamide, ib ntsiav tshuaj muaj 2.5 mg ntawm qhov sib txuas.

Ntxiv nrog rau cov tshuaj nquag, ntxiv cov tshuaj sib txuas uas muaj lub luag haujlwm pabcuam yog qhia rau hauv kev sib xyaw nrog cov tshuaj.

Tej ntu kev sib txuas yog cov haujlwm hauv qab no:

• lactose monohydrate,
• povidone-K30,
• crospovidone
• magnesium stearate,
• sodium lauryl sulfate,
• talcum hmoov.

Muaj pes tsawg leeg ntawm lub plhaub saum npoo ntawm cov ntsiav tshuaj suav nrog cov tshuaj hauv qab no:

1. Hypromellose.
2. Macrogol 6000.
3. Talc.
4. Titanium dioxide

Cov ntsiav tshuaj muaj puag ncig, convex puab thiab pleev xim dawb.

Ib qho tshuaj yog nyob nrog pab pawg tshuaj diuretic. Nws cov khoom tau ze rau thiazide diuretics.

Tom qab siv cov tshuaj, tso zis tawm ntawm sodium thiab chlorine los ntawm tib neeg lub cev nce. Txhawm rau qis me me cuam tshuam cov txheej txheem ntawm kev nthuav dav ntawm cov poov tshuaj thiab magnesium ions los ntawm lub cev.

Cov tshuaj muaj peev xwm txhawm rau thaiv cov calcium raws ntawm daim nyias nyias thiab nce lub cev kev ywj pheej ntawm cov hlab ntsha ntawm cov hlab ntsha, txo tag nrho cov kev tawm tsam ntawm cov leeg ntshav ntawm lub cev.

Noj tshuaj pab txo cov ntshav siab ntsws ntawm nplooj siab tsis ntsws.

Kev siv cov tshuaj tsis cuam tshuam rau theem ntawm lipid concentration hauv cov ntshav thiab tsis cuam tshuam rau cov txheej txheem ntawm cov metabolism hauv qab zib.

Kev noj tshuaj tso cai rau koj txo qis rhiab heev ntawm cov phab ntsa vascular kom muaj kev cuam tshuam ntawm norepinephrine thiab angiotensin II rau nws, thiab tso cai rau koj los ntxiv dag zog cov synthesis ntawm prostaglandin E2 hauv lub cev.

Kev siv cov tshuaj txo cov kev siv ntawm kev tsim dawb thiab ruaj khov nyob rau hauv lub cev.

Cov nyhuv hypotensive tsis tu ncua ntawm cov tshuaj tshwm sim ib lub lim tiam tom qab pib noj tshuaj thiab muaj mob ntxiv rau ib hnub tom qab ib koob noj ib hnub.

Cov tshuaj tiv thaiv diuretics

Dab tsi yog cov tshuaj diuretics feem ntau nug koj tus kws kho mob. Diuretics yog diuretics ntawm qhov kev sib txawv ntawm kev ua nrog lub suab diuretic zoo. Hmoov tsis zoo, txhua tus muaj cov kev mob tshwm sim thiab kev siv lawv tus kws kho mob tsis muaj lus qhia yog qhov txaus ntshai rau kev noj qab haus huv. Cov tshuaj kho tau kab mob yog dab tsi?

Cov zaub mov txawv

Cov nqi them los ntawm cov tshuaj ntsuab rau cov kab mob ntshav siab thiab hom ntshav qab zib hom 2 muaj txiaj ntsig thiab txhim kho kev mob ntawm ib tug neeg.

Qhov feem ntau hypotensive, zoo heev tshuaj rau ntshav qab zib yog diuretics. Ua tsaug rau lawv, cov txheej txheem tsim dag zog ntawm cov zis ntau ntxiv hauv lub cev tau tsim, uas ua rau kev nce qib ntawm cov txheej txheem tom qab tau tso tseg, nrog rau kev tso tawm sai sai ntawm tib neeg lub cev los ntawm dej thiab dej qab ntsev.

Yog li ntawd, tag nrho cov ntshav tso ntshav tawm mus tsis txaus, cov ntshav siab poob qis thiab tib cov hlab ntsha nqaim.

Vim li cas siv cov tshuaj diuretics rau cov ntshav qab zib

Feem ntau, ntau yam tshuaj diuretic raug kho nyob rau hauv kev rau siab kho kub siab. Tab sis kws kho mob kuj tseem pom zoo cov tshuaj no rau mob qog nqaij thiab o o. Thiab qhov no tsis yog kev sib tsoo, vim hais tias cov kab mob no tuaj yeem qhia qhov pom ntawm lub plawv tsis ua haujlwm.

Hauv cov ntshav qab zib mellitus, cov lus qhia tshuaj tso rau hauv nqe lus nug yuav tsum tau siv nrog kev ceev faj, vim tias tsis yog txhua tus diuretics zoo rau qhov no lossis qhov muaj sia. Yog li, nws yog qhov yuav tsum tau mus ntsib kev sab laj ua ntej nrog kws kho mob tshwj xeeb uas tuaj yeem qhia tau yam tshuaj twg koj tuaj yeem haus rau tus neeg mob ntshav qab zib.

Raws li koj paub, cov tshuaj diuretic rau cov ntshav qab zib tuaj yeem muaj ntau hom. Piv txwv li, potassium-sparing thiab loopback pawg ntawm cov tshuaj tsis haum nyob rau hauv thiaj li yuav kho tau kub siab mob ntshav qab zib mellitus.

Nws yog ib qho tseem ceeb kom nco ntsoov tias cov kev faib tawm no yog qhov tsim nyog rau kev siv ib zaug, uas yog, txhawm rau tshem tawm qhov mob sai sai uas hnov ​​mob. Qhov tsawg tshaj plaws nyiam nyob rau lub sijhawm ntawm lo lus nug yog potassium-sparing diuretics, txij li nyob rau lub sijhawm tam sim no lawv raug txiav txim siab tshaj plaws thiab tau txais txiaj ntsig nrog ntau qhov tsis zoo lub siab.

Thiazide-xws li thiab thiazide tus neeg sawv cev

Thiazide-zoo li thiab thiazide tus neeg sawv cev raug lees paub tias yog cov neeg nyiam tshaj plaws hauv kev kho mob ntshav qab zib mellitus, nrog rau kev mob ntshav siab. Xav tias yuav tso cov tshuaj diuretic rau cov kab mob ntawm hom ob tuaj yeem ua rau hauv qhov ntau tsawg.

Cov no suav nrog Poithiazide thiab Dichlothiazide. Lawv qhov tsis zoo yog vim muaj lub peev xwm los txo qis ntawm qhov rhiab ntawm hlwb mus rau lub dag zog insulin xa.

Feem ntau feem ntau, qhov xwm txheej no tshwm sim vim yog cov li niaj zaus thiab kev siv tshuaj ntau. Yog lawm, cov xwm txheej zoo li no yuav tshwm sim ua ntej dhau los hauv ntau hom phiv.

Thiazide-zoo li tshuaj diuretic tuaj yeem noj los ntawm cov neeg mob ntshav qab zib uas tsis muaj kev ntshai tshwj xeeb. Cov sawv cev xws li indapamide yog cov tshuaj tsis haum tshaj plaws.

Siv cov ntsiab lus no, koj tuaj yeem tshem cov poov tshuaj, sodium, magnesium ntawm lub cev. Yog li, nrog kev kho mob nquag, ib tus neeg mob ntshav qab zib yuav tsum noj cov zaub mov uas muaj cov ntsiab lus saum toj no.

Qhov no thiab buckwheat porridge, oatmeal, Berries, txiv ntoo thiab, ntawm chav kawm, cov txiv hmab txiv ntoo tshiab.

Mob ntshav qab zib, tshuaj ntsuab los kuj tseem siv tau. Txawm li cas los xij, ua ntej siv ncaj qha, nws tsim nyog sab laj nrog koj tus kws kho mob txhawm rau tsim cov tshuaj ntau npaum li cas thiab tshawb xyuas cov khoom ua haujlwm kom sib haum nrog cov tshuaj muaj txiaj ntsig.

Cov lus qhia rau kev siv ntsiav tshuaj

Kev lees txais ntawm cov tshuaj yog nqa tawm tsis hais lub sijhawm rau kev noj zaub mov. Kev nqus cov ntsiav tshuaj yuav tsum nrog nrog haus cov dej kom ntau. Lub sijhawm ntxim nyiam tshaj plaws rau kev noj tshuaj thaum sawv ntxov.

Cov tshuaj uas ib txwm siv rau kev kho mob yog 2.5 mg lossis ib ntsiav tshuaj ib hnub. Yog tias tom qab 4-8 lub lis piam ntawm kev kho mob qhov xav tau tsis tiav, cov tshuaj yuav tsum tsis txhob nce ntxiv. Kev nce ntxiv ntawm cov tshuaj yuav ua rau txoj kev loj hlob hauv lub cev muaj kev phiv los ntawm kev siv tshuaj.

Thaum tsis muaj kev tshwm sim hauv kev kho, nws raug pom zoo kom hloov cov tshuaj mus rau ib qho zoo dua. Thaum muaj kev kho mob nrog kev siv ob yam tshuaj, kev noj ntau npaum ntawm Indapamide tseem tsis hloov ntawm 2.5 mg rau ib hnub.

Kev taw qhia thiab contraindications rau kev noj tshuaj

Qhov tseem ceeb tshaj plaws qhia txog kev noj tshuaj rau ntshav qab zib yog txoj kev loj hlob ntawm tus neeg mob ntshav siab.

Zoo li lwm yam khoom siv kho mob, Indapamide muaj ib tug xov tooj ntawm contraindications rau siv.

Kev siv cov tshuaj yog tso cai nyob rau hauv qhov tsis muaj qee yam contraindications hauv tus neeg mob.

Lub ntsiab contraindications rau kev siv tshuaj yog cov nram qab no:

• tus neeg mob muaj lub siab rhiab heev rau cov tshuaj uas tsim ntawm lub hauv paus ntawm sulfonamide,
• intolerance rau cov neeg mob uas lactose,
• tus neeg mob tau mob galactosemia,
• thaum ib tug neeg qhia tias muaj mob malabsorption syndrome ntawm qabzib lossis galactose,
• qhia txog tus neeg mob lub raum tsis ua haujlwm loj,
• muaj cov cim ntawm hypokalemia,
• muaj qhov ua rau daim siab ua haujlwm loj,
• mob raum ntshav qab zib
• lub sijhawm uas xeeb tub thiab pub niam mis,
• tus neeg mob lub hnub nyoog txog 18 xyoo,
• ua txoj kev kho nyob rau hauv uas ib txhij tswj hwm ntawm cov neeg sawv cev muaj peev xwm lengthening QT luv yog nqa tawm.

Nrog kev ceev faj, koj yuav tsum siv cov tshuaj thaum kuaj pom kev ua tsis zoo hauv kev ua haujlwm ntawm lub raum thiab mob siab, thaum tus neeg mob lub cev tsis sib haum hauv cov dej-electrolyte tshuav, nyob rau hauv muaj hyperparathyroidism hauv lub cev.

Ntxiv rau, Indapamide yuav tsum tau ua tib zoo siv thaum ua txoj kev kho nyob rau hauv uas cov tshuaj tiv thaiv kab mob uas twb siv lawm.

Kev ceev faj yog siv thaum siv tshuaj yeeb tshuaj rau kev txhim kho ntshav qab zib mellitus nyob rau theem ntawm decompensation.

Cov qauv tshuaj ntawm cov tshuaj, daim ntawv tso tawm, nqi thiab chaw cia

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj coated, txhua ntsiav tshuaj muaj 2.5 mg ntawm cov tshuaj.

Cov ntsiav tshuaj ntawm 10 daim yog ntim rau hauv ib lub cell contour tshwj xeeb ntim ua ntawm polyvinyl chloride zaj duab xis thiab coated nrog txhuas ntawv ci. Peb pob khoom tshwj xeeb pob, thiab cov lus qhia rau kev siv tshuaj, raug nqis peev hauv pob ntawv los qhia.

Cov tshuaj yog txwv kom muab cia rau hauv qhov chaw tsaus tsaus ntawm qhov kub ntawm qhov nruab nrab ntawm 15 txog 25 degrees Celsius. Qhov chaw khaws cia ntawm cov tshuaj yuav tsum tsis pub nkag mus rau me nyuam.

Lub txee lub neej ntawm cov tshuaj yog 3 xyoos. Tom qab tas sijhawm ntawm lub sijhawm khaws cia, cov tshuaj yog nruj me ntsis txwv tsis pub. Cov tshuaj tas sij hawm yog muab pov tseg.

Ntxiv rau Indapamide, tshuaj tau tsim tau uas yog nws txoj kev tsis sib thooj.

Qhov feem ntau nrov thiab nrov yog cov tshuaj yeeb yaj kiab hauv qab no:

1. Arifon Repard - qhov zoo tshaj plaws analog ntawm Indapamide, tsis cuam tshuam rau cov khoom noj metabolism.
2. Acripamide yog ib qho piv txwv ntawm Indapamide, uas yog keeb kwm Lavxias.
3. Indap yog ib qho yeeb tshuaj tsim hauv Czech koom pheej.
4. Noliprel yog kev sib txuam tshuaj uas muaj peev xwm ua tau zoo.
5. Perinide yog cov tshuaj nrov uas tsim nyog rau coob tus neeg mob.

Tus nqi ntawm Indapamide nyob rau hauv Lavxias Federation nruab nrab yog los ntawm 12 txog 120 rubles, nyob ntawm seb cov chaw tsim khoom thiab thaj chaw uas cov tshuaj muag.

Tus kws tshaj lij los ntawm daim yeeb yaj kiab hauv tsab xov xwm no yuav tham txog cov yam ntxwv ntawm pharmacological ntawm Indapamide.