Ukuqonda Isifo Sokuqaqamba Kwamalunga
“EBUSUKU, NGIYE NGIBHEKE IZINYAWO NEZANDLA ZAMI EZIGOGEKILE, NGIKHALE.”—UMIDORI, EJAPANE.
SEKUNGAMAKHULU eminyaka abantu behlushwa isifo sokuqaqamba kwamalunga. Izidumbu ezomisiwe zaseGibithe zinobufakazi bokuthi lesi sifo sasikhona emakhulwini amaningi eminyaka adlule. Kubonakala sengathi umhloli wamazwe uChristopher Columbus wayenaso. Futhi kunezigidi namuhla ezinaso. Siyini ngempela lesi sifo esikhubazayo?
Igama lesiNgisi elithi “arthritis (ukuqaqamba kwamalunga)” lithathwe emagameni esiGreki asho “amalunga avuvukele” futhi lihlotshaniswa nezifo nezinkinga zokuqaqamba kwamalunga ezingaphezu kwekhulu.a Lezi zifo zingase zingathinti nje amalunga kuphela kodwa nemisipha, amathambo, nemithambo ewasekelayo. Ezinye izinhlobo ze-arthritis zingonakalisa nesikhumba sakho, izitho zangaphakathi ngisho namehlo akho. Ake sigxile ezifweni ezimbili ezivame ukuhlobana nesifo sokuqaqamba kwamalunga—i-rheumatoid arthritis (i-RA) ne-osteoarthritis (i-OA).
Ukwakheka Kwelunga
Ilunga kulapho kuhlangana khona amathambo amabili. Ilunga le-synovia lizungezwe yigobolondo eliqinile elilivikelayo futhi liliqinise. (Bheka umdwebo ekhasini 4.) Leli gobolondo lelunga linolwelwesi lwe-synovia. Lolu lwelwesi lukhipha uketshezi olubushelelezi. Ngaphakathi egobolondweni lelunga, amaphethelo ala mathambo amabili avalwe yisicubu esibushelelezi esinwebekayo okuthiwa uqwanga (cartilage). Lokhu kuvimbela amathambo akho ukuba angakhuhlani aququdeke. Uqwanga luvikela nasekushayekeni kabuhlungu, luvikela iphethelo lamathambo akho futhi lwenze amathambo akwazi ukuthwalisana isisindo.
Ngokwesibonelo, uma uhamba, ugijima, noma ugxuma, umfutho othwalwa yizinqulu namadolo akho ungaphindeka izikhathi ezine kuya kwezingu-8 kunesisindo somzimba wakho! Nakuba ubukhulu besisindo buthwalwa yimisipha ezungezile, uqwanga lusiza amathambo akho akwazi ukuthwala lesi sisindo ngokuthi lufinyele njengesiponji.
I-rheumatoid Arthritis
Lapho umuntu ene-rheumatoid arthritis (RA), isimiso somzimba sokuzivikela ezifweni sihlasela amalunga omzimba. Ngesizathu esingaziwa, umthamo omkhulu wamangqamuzana egazi—kuhlanganise nama-T cell, anendima eyinhloko esimisweni somzimba sokuzivikela—ungena ezikhoxweni zamalunga. Lokhu kubangela ukuxubana kwamakhemikhali okugcina kwenze ukuba ilunga livuvukale. Amangqamuzana e-synovia angase aqale ukwanda angalawuleki, akhe isicubu esinjengesimila okuthiwa i-pannus. I-pannus yona ikhiqiza uketshezi olunamandla oludla uqwanga. Amaphethelo amathambo angase aqale ukunamathelana, okubangela ukuba angakwazi ukunyakaza kahle—nobuhlungu obunjunjuthayo. Le nqubo ebhubhisayo idla nemisipha, okwenza ilunga lintengantenge futhi likhumuke kancane, okushiya isitho sibukeka sengathi sikhubazekile. Ngokuvamile i-RA ihlasela amalunga ezitho ezihambelanayo, idla izihlakala, amadolo nezinyawo. Abantu abangaphezu kwamaphesenti angu-50 abaye batholakala bene-RA baba namaqhubu ngaphansi kwesikhumba. Abanye baba nesifo sokuntuleka kwegazi kanye namehlo nomphimbo okomile, okubuhlungu. I-RA ihambisana nokukhathala kanye nezimpawu ezifuze ezomkhuhlane, kuhlanganise imfiva nokuqaqamba kwemisipha.
I-RA iyahlukahluka ngamandla, indlela ehlasela ngayo nesikhathi esithathayo. Komunye umuntu ubuhlungu nobunzima bokunyakazisa amathambo kungase kuqale kancane kancane isikhathi esingamasonto noma iminyaka ethile. Komunye, ingase iqale kungazelelwe. Kwabanye abantu, i-RA ihlala izinyanga ezimbalwa bese inyamalala kungasali mkhondo wayo. Abanye bangase babe nezimpawu eziba zimbi ngezikhathi ezithile, kulandele izikhathi lapho ubuhlungu budamba khona bazizwe bengcono. Kwezinye iziguli lesi sifo siba namandla iminyaka eminingi, sizikhubaze ngokuqhubekayo.
Obani abasengozini yokuba ne-RA? “Ivame kakhulu kwabesifazane asebeqinile,” kusho uDkt. Michael Schiff. Kodwa-ke, uSchiff uqhubeka athi “ingahlasela noma ubani noma engakanani ubudala kuhlanganise nezingane, ngisho namadoda.” Kulabo abanezihlobo ezine-rheumatoid arthritis, ingozi iba nkulu nakakhulu. Ucwaningo oluningi luveza nokuthi ukubhema, ukukhuluphala nokumpontshelwa igazi kaningi nakho kunomthelela.
I-osteoarthritis
I-Western Journal of Medicine ithi: “I-osteoarthritis ngokuvamile ifana nesimo sezulu—ikuyo yonke indawo, futhi ivame ukuba nemiphumela engaqapheleki, ngezinye izikhathi emibi kakhulu.” Ngokungefani ne-RA, i-osteoarthritis (OA) ayivamile ukudlulela kwezinye izitho zomzimba kodwa iququda ilunga elilodwa noma ambalwa kuphela. Njengoba uqwanga ludleka kancane kancane, amathambo aqala ukukhuhlana. Lokhu kuhambisana namaqhubu emathanjeni okuthiwa i-osteophyte. Kungase kube namathumba, bese ithambo elingaphansi liba ugqinsi likhubazeke. Ezinye izimpawu zihlanganisa amaqupha avuvukele, ukuqhuma kwamalunga aqaqambayo nokuqhakanyeka kwemisipha, kanye nobuhlungu, ukuqina kwemisipha nobunzima bokunyakaza kwamathambo.
Ezikhathini ezidlule, kwakucatshangwa ukuthi i-OA ingomunye wemiphumela yokuguga. Kodwa ochwepheshe sebeyilahlile leyo nkolelo yakudala. I-American Journal of Medicine ithi: “Abukho ubufakazi bokuthi ilunga elivamile, elithwala isisindo esivamile, lizowohloka ngokuhamba kwesikhathi ekuphileni komuntu.” Pho ibangelwa yini i-osteoarthritis? Ngokukamagazini waseBrithani i-Lancet, imizamo yokuqonda imbangela yayo ngokuthé ngqo “igcwele izimpikiswano.” Abanye abacwaningi bathi kungenzeka ukuthi iqala ngokulimala kwethambo, njengokuchachamba okuncane. Lokhu kungase kubangele amaqhubu emathanjeni nokudleka koqwanga. Abanye bacabanga ukuthi i-OA iqala oqwangeni ngokwalo. Bathi njengoba lukhumuzeka futhi ludleka, ithambo elingaphansi lithwala kanzima. Umzimba uyakhubazeka njengoba uzama ukulungisa uqwanga olulimele.
Obani abasengozini ye-OA? Nakuba ubudala bubodwa bungayibangeli i-OA, ukudleka koqwanga lwamalunga kuvame ukwenzeka njengoba abantu bekhula. Abanye abasengozini bangase bahlanganise labo abanamalunga angahlangani kahle noma abanemisipha ebuthaka ezinyaweni nasemathangeni, imilenze engalingani, noma umgogodla onamathambo angaqondile. Ukulimala ilunga engozini noma ukukhandleka kwamalunga emsebenzini nako kungayibangela i-osteoarthritis. Lapho inkinga isiqalile, ukukhuluphala kungayibhebhethekisa i-OA.
UDkt. Tim Spector uthi: “I-osteoarthritis iyisifo esixakayo esibangelwa yizici ezingaphandle kodwa nezakhi zofuzo zinendima enkulu.” Abasengozini ye-OA kakhulu abesifazane asebeqinile noma asebekhulile abanomlando walesi sifo emkhayeni wabo. Ngokungefani nesifo sokuchachamba kwamathambo, i-OA ibangelwa amathambo asindayo esikhundleni samathambo abuthaka. Abanye abacwaningi bathi umonakalo ubangelwa inkinga yomoya-mpilo nokuntuleka kukavithamini C no-D.
Ukwelashwa
Ukwelapha isifo sokuqaqamba kwamalunga ngokuvamile kuhilela ukusebenzisa imithi, ukuvivinya umzimba nokushintsha indlela yokuphila. Umelaphi angase aqale uhlelo lokwelapha ngokuvivinya umzimba. Kungase kuhlanganise ukuzivivinya ngokuhamba, ngokuzelula, ngokuzivocavoca, noma ngokuphakamisa izinsimbi. Lokhu kuye kwabonakala kudambisa izinkinga eziningi kuhlanganise nobuhlungu nokuvuvukala kwamalunga, ukukhathala, ukucobeka nokucindezeleka. Izinzuzo zokuvivinya umzimba zibonakala ngisho nakubantu asebekhule ngempela. Ukuvivinya umzimba kunganqanda nokuwohloka kwamathambo. Abanye bathi baye badambisa ubuhlungu ngezinga elithile ngezinqubo ezihlukahlukene zokwelapha ngokushisa namakhaza kanye nokutshopa.b
Ngenxa yokuthi ukwehlisa umzimba kungabunciphisa kakhulu ubuhlungu bamalunga, ukukhetha ukudla kungase kube isici esiyinhloko sokulawula ukuqaqamba kwamalunga. Abanye bathi ukudla okuhlanganisa ukudla okune-calcium eningi njengemifino eluhlaza, izithelo nenhlanzi enamafutha e-omega-3—okungekho emathinini futhi okungenamafutha anqumayo—akunakwehlisa umzimba kuphela kodwa kungadambisa nezinhlungu. Kanjani? Abanye bathi ukudla okunjalo kuvimbela ukuvuvukala. Bakhona nabanye abathi ukudla okungenayo inyama, imikhiqizo yobisi, ukolweni nemifino yohlobo lwe-nightshade, enjengotamatisi, amazambane, upelepele ne-eggplant, kuye kwabasiza abanye.
Kwezinye izimo kutuswa inqubo yokuhlinza okuthiwa i-arthroscopy. Lokhu kuhilela ukufaka ithuluzi elithile elungeni, ukuze udokotela ohlinzayo asuse isicubu se-synovia esikhiqiza uketshezi olubhubhisayo. Kodwa le nqubo ayiphumeleli ngokuphelele, ngoba ukuvuvukala kuphinde kubuye. Inqubo enamandla nakakhulu i-joint arthroplasty, lapho kukhishwa khona lonke ilunga (ngokuvamile inqulu noma idolo) bese kufakwa elokwenziwa. Lokhu kuhlinza kunemiphumela ehlala iminyaka eyishumi kuya kwengu-15 futhi ngokuvamile kuyaphumelela ekuqedeni ubuhlungu.
Muva nje, odokotela baye bazama ukwelapha okungaphazamisi kakhulu, njenge-viscosupplementation, lapho ilunga lijovwa khona ngokuqondile ngoketshezi i-hyaluronic. Ngokuvamile lokhu kwenziwa emadolweni. Ucwaningo oluthile eYurophu lubonisa ukuthi ukujova ngezithako ezilungisa uqwanga nakho kuye kwaphumelela ngezinga elithile.
Nakuba ungekho umuthi osutholakele owelapha isifo sokuqaqamba kwamalunga, imithi eminingi inciphisa ubuhlungu nokuvuvukala, futhi eminye iye yabonakala inekhono lokunqanda ukuqhubeka kwesifo. Izibulala-zinhlungu, kanye nokwelapha ngama-corticosteroid, imithi enqanda ukuvuvukala (ama-nonsteroid anti-inflammatory drug [NSAID]), imithi enqanda ukuhlasela kwesifo samalunga (ama-disease-modifying antirheumatic drug [DMARD]), imithi evala isimiso somzimba zokuzivikela ezifweni, ama-biologic response modifier nemithi eshintshwe izakhi ukuze idambise ubuhlungu emzimbeni, kuyingxenye yezindlela zokwelapha ezisetshenziswayo ukuze kudanjiswe izimpawu eziwohlozayo zesifo sokuqaqamba kwamalunga. Nokho, impumuzo ingase ilethe inkinga enkulu, ngoba zonke lezi zinhlobo zemithi zingase zibe nemiphumela engemihle. Ukuhlaziya izinzuzo nezingozi ezingase zivele kuyinselele kogulayo nakudokotela.
Abanye abaye babhekana nemiphumela elimazayo yokuqaqamba kwamalunga baye bakwazi kanjani ukubhekana nalesi sifo esibuhlungu?
[Imibhalo yaphansi]
a Phakathi kwalezi zifo kubalwa i-osteoarthritis, i-rheumatoid arthritis, i-systemic lupus erythematosus, i-juvenile rheumatoid arthritis, i-gout, i-bursitis, i-rheumatic fever, isifo i-Lyme, i-carpal tunnel syndrome, i-fibromyalgia, i-Reiter’s syndrome ne-ankylosing spondylitis.
b I-Phaphama! ayigunyazi ukwelapha okuthile, imithi noma ukuhlinzwa. Umuntu ngamunye ogulayo unomthwalo wokucwaninga nokuhlaziya ngokucophelela noma iyiphi inqubo yokwelapha ngokwamaqiniso aziwayo.
[Amazwi acashunwe esihlokweni ekhasini 6]
UKUKHULUPHALA, UKUBHEMA NOKUMPONTSHELWA IGAZI KANINGI KUNGASE KWANDISE AMATHUBA OMUNTU OKUPHATHWA I-“RHEUMATOID ARTHRITIS”
[Ibhokisi/Isithombe ekhasini 8]
EZINYE IZINDLELA ZOKWELAPHA
Eminye imithi kucatshangwa ukuthi iphephile, ayinayo imiphumela eminingi engemihle njengezindlela zokwelapha ezivamile. Phakathi kwayo kune-type II collagen ephuzwayo, abanye abacwaningi abathi iyaphumelela ekunciphiseni ukuvuvukala kwamalunga nobuhlungu obubangelwa i-rheumatoid arthritis (RA). Kanjani? Ngokunqanda ama-cytokine abhubhisayo abangela ukuvuvukala, okuwukuthi i-interleukin-1 ne-tumor necrosis factor α. Kubikwa ukuthi ezinye izithako zemvelo nazo ziye zabonakala zikwazi ukunqanda lezi zakhi ezibhubhisayo. Zihlanganisa uvithamini E, uvithamini C, i-niacinamide, amafutha ane-asidi eningi i-eicosapentaenoic ne-gammalinolenic, nowoyela wezinhlamvu ze-borage, kanye nowoyela we-evening primrose. EChina, sekuyiminyaka eminingi kusetshenziswa ikhambi i-Tripterygium wilfordii Hook F. Kubikwa ukuthi liye laphumelela ngezinga elithile ekunciphiseni imiphumela ye-RA.
[Umdwebo ekhasini 4, 5]
(Ukuze ubone ukuthi indaba ihlelwe kanjani, bheka encwadini)
ILUNGA ELINEMPILO
I-BURSA
UMSIPHA
UQWANGA LWELUNGA
UMTHAMBO
IGOBOLONDO LELUNGA
ULWELWESI LWE-SYNOVIA
UKETSHEZI LWE-SYNOVIA
ITHAMBO
ILUNGA ELINE-RHEUMATOID ARTHRITIS
UKUMINYANA KWENDAWO
UKUKHUMUZEKA KOQWANGA NETHAMBO
ULWELWESI LWE-SYNOVIA OLUVUVUKELE
ILUNGA ELINE-OSTEOARTHRITIS
IZIMVUTHU ZOQWANGA OLUDLEKILE
UKUDLEKA KOQWANGA
IPHETHELO LETHAMBO
[Umthombo]
Source: Arthritis Foundation
[Izithombe ekhasini 7]
Isifo sokuqaqamba kwamalunga singaphatha abantu noma bengakanani ubudala
[Izithombe ekhasini 8]
Uhlelo lokuvivinya umzimba nokudla okufanele lungadambisa izinhlungu ngandlela-thile