ʻO ka ʻeha neuropathic e pili ana i ka hana sensory abnormal, ka ʻeha ʻeha a me ka ʻeha kūlohelohe i hoʻokumu ʻia e ka ʻeha a i ʻole ka maʻi o ka ʻōnaehana nerve somatic.Hiki i ka hapa nui o lākou ke hele pū me ka ʻeha ma ka wahi innervated e pili ana ma hope o ka hoʻopau ʻia ʻana o nā mea hōʻeha, ka mea i hōʻike ʻia e like me ka ʻeha spontaneous, hyperalgesia, hyperalgesia a me nā ʻano kūlohelohe.I kēia manawa, ʻo nā lāʻau lapaʻau no ka hoʻomaha ʻana i ka ʻeha neuropathic e komo pū me nā tricyclic antidepressants, 5-hydroxytryptamine norepinephrine reuptake inhibitors, anticonvulsants gabapentin a me pregabalin, a me nā opioids.Eia nō naʻe, ua kaupalena ʻia ka hopena o ka lāʻau lapaʻau, kahi e koi ai i nā papa hana lapaʻau multimodal e like me ka hoʻōla kino, hoʻoponopono neural a me ka hana ʻoki.ʻO ka ʻeha maʻi a me ka palena hana e hōʻemi i ke komo ʻana o ka poʻe maʻi a hoʻokau i ke kaumaha noʻonoʻo a me ka hoʻokele waiwai i nā maʻi.
ʻO Platelet Rich Plasma (PRP) kahi huahana plasma me nā platelets maʻemaʻe kiʻekiʻe i loaʻa ma ka centrifuging autologous blood.I ka makahiki 1954, ua hoʻohana mua ʻo KINGSLEY i ka huaʻōlelo lapaʻau PRP.Ma o ka noiʻi ʻana a me ka hoʻomohala ʻana i nā makahiki i hala iho nei, ua hoʻohana nui ʻia ʻo PRP i ka ʻoki ʻana i ka iwi a me ka hui ʻana, ka ʻoki ʻana i ka spine, dermatology, rehabilitation a me nā keʻena ʻē aʻe, a he hana koʻikoʻi i ke kahua o ka hoʻoponopono ʻenehana kiko.
ʻO ke kumu kumu o ka mālama ʻana i ka PRP, ʻo ia ka hoʻokomo ʻana i nā platelets concentrated ma ka wahi i hōʻeha ʻia a hoʻomaka i ka hoʻoponopono ʻana o ka ʻiʻo ma o ka hoʻokuʻu ʻana i nā ʻano mea bioactive like ʻole (nā kumu ulu, cytokines, lysosomes) a me nā protein adhesion.ʻO kēia mau mea bioactive ke kuleana no ka hoʻomaka ʻana i ka hopena hemostatic cascade, ka synthesis o ka ʻiʻo pili hou a me ke kūkulu hou ʻana i nā vascular.
Hoʻohālikelike a me ka pathogenesis o ka ʻeha neuropathic Ua hoʻokuʻu ka World Health Organization i ka 11th revised version of the International Classification of Pain ma 2018, e hoʻokaʻawale ana i ka ʻeha neuropathic i ka ʻeha neuropathic waena a me ka ʻeha neuropathic peripheral.
Hoʻokaʻawale ʻia ka ʻeha neuropathic peripheral e like me ka etiology:
1) ʻO ka maʻi / ʻeha: postherpetic neuralgia, lepera ʻeha, syphilis/HIV maʻi neuropathy peripheral
2) Nerve compression: carpal tunnel syndrome, spinal degenerative radicular eha
3) Trauma: trauma / kuni / post-operative / post radiotherapy ʻeha neuropathic
4) Ischemia/metabolism: ʻeha neuropathic peripheral diabetes
5) Nā lāʻau lapaʻau: peripheral neuropathy i hana ʻia e nā lāʻau lapaʻau (e like me ka chemotherapy)
6) ʻO nā mea ʻē aʻe: ʻeha maʻi maʻi, neuralgia trigeminal, neuralgia glossopharyngeal, neuroma o Morton
ʻO ka hoʻokaʻawale ʻana a me ka hoʻomākaukau ʻana o ka PRP manaʻoʻiʻo he ʻehā a ʻelima paha ka nui o ka platelet concentration ma PRP ma mua o ke koko holoʻokoʻa, akā aia ka nele o nā hōʻailona quantitative.I ka makahiki 2001, ua wehewehe ʻo Marx i ka PRP aia ma kahi o 1 miliona platelets i kēlā me kēia microliter o ka plasma, ʻo ia kahi hōʻailona quantitative o ka maʻamau o PRP.ʻO Dohan et al.Hoʻokaʻawale ʻia ʻo PRP i ʻehā mau ʻāpana: PRP maʻemaʻe, PRP waiwai leukocyte, fibrin waiwai platelet maʻemaʻe, a me nā leukocyte waiwai platelet fibrin ma muli o nā ʻano like ʻole o ka platelet, leukocyte, a me ka fibrin i PRP.Inā ʻaʻole i kuhikuhi ʻia, pili pinepine ʻo PRP i ka PRP waiwai keʻokeʻo.
Mechanism of PRP in the Treatment of Neuropathic Pain Ma hope o ka hōʻeha, nā ʻano endogenous a me nā exogenous activators e hoʻoikaika i ka platelet activation α- Ke hana nei nā granules i ka hopena degranulation, e hoʻokuʻu ana i ka nui o nā kumu ulu, fibrinogen, cathepsin a me hydrolase.Hoʻopaʻa nā mea ulu i hoʻokuʻu ʻia i ka ʻili o waho o ka membrane cell o ka cell target ma o ka transmembrane receptors ma ka membrane cell.ʻO kēia mau mea hoʻokipa transmembrane e hoʻohuli a hoʻoulu i nā protein hōʻailona endogenous, e hoʻoulu hou i ka lua o ka ʻelele i loko o ke kelepona, kahi e hoʻoulu ai i ka hoʻonui ʻana o ka cell, ka hoʻokumu ʻana o ka matrix, synthesis o ka protein collagen a me nā ʻano ʻano ʻano intracellular ʻē aʻe.Aia nā hōʻike e pili ana nā cytokines i hoʻokuʻu ʻia e nā platelets a me nā mea hoʻouna ʻē aʻe i mea nui i ka hōʻemi / hoʻopau ʻana i ka ʻeha neuropathic mau loa.Hiki ke hoʻokaʻawale ʻia nā mīkini kikoʻī i nā mīkini peripheral a me nā mīkini kikowaena.
Mechanism o platelet rich plasma (PRP) i ka mālama ʻana i ka ʻeha neuropathic
ʻO nā hana āpau: ka hopena anti-inflammatory, neuroprotection a me ka hoʻolaha ʻana o ka axon regeneration, ka hoʻoponopono kūlohelohe, ka hopena analgesic
ʻO ka mīkini kikowaena: hoʻonāwaliwali a hoʻohuli i ka sensitization kikowaena a me ka pale ʻana i ka hoʻoulu ʻana o glial cell
Ka hopena anti-inflammatory
He kuleana koʻikoʻi ka ʻike ʻana o peripheral i ka loaʻa ʻana o nā hōʻailona ʻeha neuropathic ma hope o ka hōʻeha nerve.Ua hoʻokomo ʻia nā ʻano mea ʻeha like ʻole, e like me nā neutrophils, macrophages a me mast cell, i loko o ka pūnaewele hōʻeha nerve.ʻO ka hōʻiliʻili nui ʻana o nā cell inflammatory ke kumu o ka excitation excessive a me ka hoʻokuʻu mau ʻana o nā aʻalolo.Hoʻokuʻu ka hū i ka nui o nā mea hoʻolaha kemika, e like me nā cytokines, chemokines a me lipid mediators, e hoʻonanea a hauʻoli hoʻi i nā nociceptors, a e hoʻololi i ka nohona kemika kūloko.Loaʻa i nā platelets nā hopena immunosuppressive a me nā hopena anti-inflammatory.Ma ka hoʻoponopono ʻana a me ka hūnā ʻana i nā ʻano mea hoʻoponopono immune, nā kumu angiogenic a me nā kumu meaʻai, hiki iā lākou ke hōʻemi i nā hopena kūlohelohe ʻino a me ka mumū, a hoʻoponopono i nā pōʻino kino like ʻole i nā microenvironments like ʻole.Hiki i ka PRP ke pāʻani i kahi hana anti-inflammatory ma o nā ʻano hana like ʻole.Hiki iā ia ke ālai i ka hoʻokuʻu ʻana o nā cytokines pro-inflammatory mai nā cell Schwann, macrophages, neutrophils a me mast cell, a keʻakeʻa i ka hōʻike ʻana o nā mea hōʻailona pro-inflammatory factor ma o ka hoʻolaha ʻana i ka hoʻololi ʻana o nā ʻiʻo i hōʻino ʻia mai kahi mokuʻāina inflammatory i kahi kūlana anti-inflammatory.ʻOiai ʻaʻole hoʻokuʻu nā platelets i ka interleukin 10, hoʻemi nā platelets i ka hana ʻana o ka nui o ka interleukin 10 ma o ka hoʻoulu ʻana i nā cell dendritic immature γ- He hana anti-inflammatory ka hana ʻana o ka interferon.
Ka hopena analgesic
Hoʻokuʻu ʻia nā platelets i nā neurotransmitters pro-inflammatory a me nā anti-inflammatory, hiki ke hoʻoulu i ka ʻeha, akā e hoʻemi i ka ʻeha a me ka ʻeha.Ua moe nā platelets hou i hoʻomākaukau ʻia i PRP.Ma hope o ka hana pololei a ʻole ʻole paha, hoʻololi ka platelet morphology a paipai i ka platelet aggregation, e hoʻokuʻu ana i kāna intracellular α- Dense particles a me sensitized particles e hoʻoulu i ka hoʻokuʻu ʻana o 5-hydroxytryptamine, nona ka hopena hoʻoponopono ʻeha.I kēia manawa, ʻike ʻia nā mea loaʻa 5-hydroxytryptamine i nā aʻalolo peripheral.Hiki i ka 5-hydroxytryptamine ke hoʻopili i ka hoʻoili nociceptive i nā ʻiʻo a puni ma o 5-hydroxytryptamine 1, 5-hydroxytryptamine 2, 5-hydroxytryptamine 3, 5-hydroxytryptamine 4 a me 5-hydroxytryptamine 7 mau mea hoʻokipa.
Kāohi i ka hoʻoulu ʻana o Glial Cell
ʻO nā pūnaewele Glial e pili ana i ka 70% o nā pūnaewele o ke kikowaena pūnaewele, hiki ke hoʻokaʻawale ʻia i ʻekolu mau ʻano: astrocytes, oligodendrocytes a me microglia.Hoʻohana ʻia ka Microglia i loko o 24 mau hola ma hope o ka hōʻeha ʻana i ke aʻalolo, a ua hoʻāla ʻia nā astrocytes ma hope koke o ka hōʻeha ʻana o ke aʻalolo, a ua mau ka hoʻōla ʻana no 12 mau pule.A laila hoʻokuʻu ʻo Astrocytes a me microglia i nā cytokines a hoʻoulu i kahi ʻano o nā pane cellular, e like me ka upregulation o ka glucocorticoid a me ka glutamate receptors, e alakaʻi ana i nā loli i ka excitation spinal cord a me neural plasticity, kahi pili pili i ka hiki ʻana o ka ʻeha neuropathic.
Nā mea pili i ka hoʻomaha ʻana a i ʻole ka hoʻopau ʻana i ka ʻeha neuropathic i loko o ka platelet rich plasma
1) Angiopoietin:
Hoʻoulu i ka angiogenesis;Hoʻoulu i ka neʻe ʻana o nā cell endothelial a me ka hoʻonui;Kākoʻo a hoʻopaʻa i ka hoʻomohala ʻana o nā kīʻaha koko ma o ka ʻimi ʻana i nā pericytes
2) Ka mea hoʻonui i ka ʻiʻo pili:
Hoʻoulu i ka neʻe ʻana o ka leukocyte;Hoʻonui i ka angiogenesis;Hoʻoulu i ka myofibroblast a hoʻoulu i ka extracellular matrix deposition a me ka hoʻoponopono hou
3) Ke kumu ulu o Epidermal:
Hoʻoikaika i ka ho'ōlaʻana i kaʻeha a hoʻoulu i ka angiogenesis ma o ka hoʻonuiʻana i ka hoʻonui, ka neʻeʻana a me ka hoʻokaʻawaleʻana o nā macrophages a me nā fibroblasts;Hoʻoulu i nā fibroblasts e hūnā i ka collagenase a hoʻohaʻahaʻa i ka matrix extracellular i ka wā o ka hoʻoponopono hou ʻana i nā ʻeha;Hoʻoikaika i ka hoʻonui ʻana o nā keratinocytes a me nā fibroblasts, e alakaʻi ana i ka re epithelization.
4) Ke kumu ulu fibroblast:
No ka hoʻouluʻana i ka chemotaxis o nā macrophages, fibroblasts a me nā pūnaewele endothelial;Hoʻoulu i ka angiogenesis;Hiki iā ia ke hoʻoulu i ka granulation a me ka hoʻoponopono hou ʻana o ka ʻiʻo a komo i ka ʻeha ʻeha.
5) Hepatocyte ulu kumu:
Hoʻoponopono i ka ulu a me ka neʻe ʻana o nā epithelial/endothelial cell;Hoʻoikaika i ka hoʻoponopono epithelial a me ka angiogenesis.
6) ʻO ka mea ulu e like me ka insulin:
E hōʻuluʻulu i nā pūnaewele fiber e hoʻoulu i ka synthesis protein.
7) He kumu ulu ka platelet:
Hoʻoulu i ka chemotaxis o nā neutrophils, macrophages a me fibroblasts, a hoʻoulu i ka hoʻonui ʻana o nā macrophages a me nā fibroblasts i ka manawa like;Kōkua ia i ka hoʻoheheʻe ʻana i ka collagen kahiko a me ka hoʻoponopono ʻana i ka hōʻike ʻana o ka matrix metalloproteinases, e alakaʻi ana i ka mumū, ka hoʻokumu ʻana o ka ʻiʻo granulation, ka hoʻonui ʻana o ka epithelial, ka hana ʻana o ka matrix extracellular a me ka hoʻoponopono hou ʻana o ke kino;Hiki iā ia ke hoʻoikaika i ka hoʻonui ʻia ʻana o nā pūnaewele i loaʻa mai adipose kanaka a kōkua i ka hana i ka hana hou ʻana i ke aʻalolo.
8) ʻO ka mea i loaʻa mai i ka cell Stromal:
Kāhea i nā pūnaewele CD34 + e hoʻoulu i ko lākou homing, hoʻonui a me ka hoʻokaʻawaleʻana i nā pūnaewele progenitor endothelial, a hoʻoulu i ka angiogenesis;E hōʻiliʻili i nā pūpū mesenchymal a me nā leukocytes.
9) Hoʻololi i ka mea ulu β:
I ka wā mua, loaʻa iā ia ka hopena o ka hoʻoulu ʻana i ka mumū, akā hiki ke hoʻoikaika i ka hoʻololi ʻana o ka ʻāpana ʻeha i ke kūlana anti-inflammatory;Hiki iā ia ke hoʻonui i ka chemotaxis o nā fibroblasts a me nā ʻiʻo maʻemaʻe;Hoʻoponopono i ka hōʻike o collagen a me collagenase, a hoʻoikaika i ka angiogenesis.
10) Ke kumu ulu endothelial vascular:
Kākoʻo a hoʻoikaika i ka ulu ʻana o nā aʻalolo i hoʻōla hou ʻia ma o ka hoʻohui ʻana i ka angiogenesis, neurotrophic a me neuroprotection, i mea e hoʻihoʻi ai i ka hana nerve.
11) Ke kumu ulu aʻalolo:
Hoʻokani ia i kahi hana neuroprotective ma ka hāpai ʻana i ka ulu ʻana o nā axons a me ka mālama ʻana a me ke ola ʻana o nā neurons.
12) ʻO ke kumu neurotrophic i loaʻa iā Glial:
Hiki iā ia ke hoʻololi a hoʻololi i nā protein neurogenic a pāʻani i kahi hana neuroprotective.
Ka hopena
1) Loaʻa i ka platelet rich plasma nā hiʻohiʻona o ka hoʻolaha ʻana i ka ho'ōla a me ka anti-inflammatory.ʻAʻole hiki iā ia ke hoʻoponopono wale i nā ʻiʻo nerve i hōʻino ʻia, akā hoʻomaha maikaʻi hoʻi i ka ʻeha.He ala lapaʻau koʻikoʻi ia no ka ʻeha neuropathic a loaʻa iā ia nā hiʻohiʻona nani;
2) Ke hoʻopaʻapaʻa mau nei ke ʻano o ka hoʻomākaukau ʻana o ka platelet rich plasma, e koi ana i ka hoʻokumu ʻana i kahi ʻano hoʻomākaukau maʻamau a me kahi maʻamau loiloi ʻāpana hui;
3) He nui nā haʻawina e pili ana i ka platelet rich plasma i ka ʻeha neuropathic i hoʻokumu ʻia e ka ʻeha o ke kuamoʻo, ka ʻeha aʻalolo peripheral a me ka hoʻopili ʻana i ke aʻalolo.Pono e aʻo hou ʻia ka mīkini a me ka maikaʻi o ka platelet rich plasma i nā ʻano ʻeha neuropathic ʻē aʻe.
ʻO ka ʻeha neuropathic ka inoa maʻamau o kahi papa nui o nā maʻi lapaʻau, kahi mea maʻamau i ka hana lapaʻau.Eia nō naʻe, ʻaʻohe ʻano lāʻau lapaʻau kūikawā i kēia manawa, a mau makahiki ka ʻeha a i ʻole ke ola ma hope o ka maʻi, ke kaumaha nui nei i nā maʻi, nā ʻohana a me ke kaiāulu.ʻO ka lāʻau lapaʻau ka papahana lapaʻau kumu no ka ʻeha neuropathic.Ma muli o ka pono o ka lāʻau lōʻihi, ʻaʻole maikaʻi ka hoʻokō ʻana o nā mea maʻi.ʻO ka lāʻau lapaʻau lōʻihi e hoʻonui i nā hopena ʻino a hoʻopilikia nui i ke kino a me ka noʻonoʻo i nā maʻi.Ua hōʻoia nā hoʻokolohua maʻamau a me nā noiʻi lapaʻau e hiki ke hoʻohana ʻia ka PRP e mālama i ka ʻeha neuropathic, a ʻo ka PRP mai ka mea maʻi ponoʻī, me ka ʻole o ka hopena autoimmune.He mea maʻalahi ke kaʻina hana, me ka liʻiliʻi o nā hopena ʻino.Hiki ke hoʻohana pū ʻia ʻo PRP me nā pūnana pū, nona ka mana ikaika o ka hoʻoponopono ʻana i ke aʻalolo a me ka hoʻōla hou ʻana o ka ʻiʻo, a loaʻa iā ia nā manaʻo noi ākea i ka mālama ʻana i ka ʻeha neuropathic i ka wā e hiki mai ana.
（Paʻi hou ʻia nā mea o kēia ʻatikala, ʻaʻole mākou e hāʻawi i ka hōʻoiaʻiʻo a i ʻole ka hōʻoia ʻana no ka pololei, hilinaʻi a i ʻole ka piha o nā mea i loko o kēia ʻatikala, a ʻaʻole kuleana no nā manaʻo o kēia ʻatikala, e ʻoluʻolu e hoʻomaopopo.)
Ka manawa hoʻouna: Dec-20-2022