Nguyn tc iu tr bnh Gout - Chng vim khp trong cc t cp.

- H acid uric mu phng nhng t vim khp cp ti pht, ngn nga bin chng. - iu tr cc bnh l km theo c bit l nhm cc bnh l ri lon chuyn ha nh: tng huyt p, i tho ng, tng m mu, bo ph

- Cn iu tr vim khp cp trc. Ch sau khi tnh trng vim khp ht hoc thuyn gim mi bt u dng thuc h aicd uric mu. iu tr c hiu qu cn thng xuyn kim tra acid uric mu v niu, kim tra chc nng thn. iu tr cn gt (gout) cp tnh Thuc iu tr t gout cp l Thuc chng vim khng steroid, colchicin, corticosteroid, trong Thuc chng vim khng steroid c u tin la chn hng u. S dng thuc ty theo bnh nhn v cc bnh l km theo nh bnh thn hay d dy t trng. Thuc chng vim khng steroid: y l thuc c la chn hng u iu tr t gout cp hu ht bnh nhn. Tuy nhin, i vi ngi cao tui v ngi c bnh km theo, cn thn trng, cn nhc khi dng, ch nn s dng thuc ny trong thi gian ngn v vi liu thp. Thuc cn trnh dng i vi bnh nhn b bnh thn, vim lot d dy, t trng hay bnh nhn ang dng thuc chng ng. - Colchicin: Ngi ta s dng chit xut t loi c ny iu tr gout t 600 nm trc cng nguyn. TRUNG TM IU TR BNH GOUT www.benhgout.com

Do thuc c i lc c bit vi bch cu a nhn trung tnh nn n lm gim s di chuyn ca cc bch cu, c ch thc bo cc vi tinh th mui urat v do lm ngng s to thnh cc acid lactic, gi cho pH ti ch c bnh thng, bi v pH l yu t to iu kin cho cc tinh th urat mononatri kt ta ti cc m khp. Thuc khng c tc dng ln s thi tr acid uric theo nc tiu cng nh ln nng , ha tan hay kh nng gn vi protein huyt thanh ca acid uric hay urat nn khng lm thay i nng acid uric mu. Tuy nhin thuc c nhiu tc dng ph khng mong mun, ng u l cc ri lon d dy, rut nh tiu chy, nn, au bng. Him gp hn l cc phn ng d ng da, rng tc, cc bnh c. Vic dng thuc ko di c th dn ti suy ty xng. - Corticosteroid : Trong mt s trng hp c bit, vi mc ch iu tr cn gout cp c th s dng corticoid ng ung ngn ngy hoc ng tim ni khp. Nhng do thuc c nhiu tc dng ph v do tnh trng lm dng thuc nc ta nn thuc ny khng c khuyn khch s dng. iu tr d phng cn gout cp ti pht Mc tiu iu tr d phng cn gout cp l gim acid uric mu, hn ch s lng ng urat trong m v t chc t hn ch c cc cn gout ti pht v ngn nga hnh thnh gout mn tnh.

Nguyn tc iu tr bnh Gout - Chng vim khp trong cc t cp. - H acid uric mu phng nhng t vim khp cp ti pht, ngn nga bin chng. - iu tr cc bnh l km theo c bit l nhm cc bnh l ri lon chuyn ha nh: tng huyt p, i tho ng, tng m mu, bo ph

TRUNG TM IU TR BNH GOUT www.benhgout.com

- Cn iu tr vim khp cp trc. Ch sau khi tnh trng vim khp ht hoc thuyn gim mi bt u dng thuc h aicd uric mu. iu tr c hiu qu cn thng xuyn kim tra acid uric mu v niu, kim tra chc nng thn. iu tr cn gt (gout) cp tnh thuc iu tr t gout cp l thuc chng vim khng steroid, colchicin, corticosteroid, trong thuc chng vim khng steroid c u tin la chn hng u. S dng thuc ty theo bnh nhn v cc bnh l km theo nh bnh thn hay d dy t trng. Thuc chng vim khng steroid: y l thuc c la chn hng u iu tr t gout cp hu ht bnh nhn. Tuy nhin, i vi ngi cao tui v ngi c bnh km theo, cn thn trng, cn nhc khi dng, ch nn s dng thuc ny trong thi gian ngn v vi liu thp. thuc cn trnh dng i vi bnh nhn b bnh thn, vim lot d dy, t trng hay bnh nhn ang dng thuc chng ng. - Colchicin: Ngi ta s dng chit xut t loi c ny iu tr gout t 600 nm trc cng nguyn. Do thuc c i lc c bit vi bch cu a nhn trung tnh nn n lm gim s di chuyn ca cc bch cu, c ch thc bo cc vi tinh th mui urat v do lm ngng s to thnh cc acid lactic, gi cho pH ti ch c bnh thng, bi v pH l yu t to iu kin cho cc tinh th urat mononatri kt ta ti cc m khp. Thuc khng c tc dng ln s thi tr acid uric theo nc tiu cng nh ln nng , ha tan hay kh nng gn vi protein huyt thanh ca acid uric hay urat nn khng lm thay i nng acid uric mu. Tuy nhin, thuc c nhiu tc dng

TRUNG TM IU TR BNH GOUT www.benhgout.com

ph khng mong mun, ng u l cc ri lon d dy, rut nh tiu chy, nn, au bng. Him gp hn l cc phn ng d ng da, rng tc, cc bnh c. Vic dng thuc ko di c th dn ti suy ty xng. - Corticosteroid : Trong mt s trng hp c bit, vi mc ch iu tr cn gout cp c th s dng corticoid ng ung ngn ngy hoc ng tim ni khp. Nhng do thuc c nhiu tc dng ph v do tnh trng lm dng thuc nc ta nn thuc ny khng c khuyn khch s dng. iu tr d phng cn gout cp ti pht Mc tiu iu tr d phng cn gout cp l gim acid uric mu, hn ch s lng ng urat trong m v t chc t hn ch c cc cn gout ti pht v ngn nga hnh thnh gout mn tnh. - Colchicin : c s dng ln u nm 1936 d phng cn gout cp ti pht nhng khng d phng c lng ng urat v sau hay s pht trin cc ht tophi. - Cc thuc h acid uric mu: C nhiu loi thuc h acid uric mu. Ty theo c ch tc dng ca thuc tc ng vo khu no ca qu trnh chuyn ha acid uric trong c th m ngi ta chia ra 3 nhm: Nhm c ch tng hp, nhm tng thi v nhm lm tiu acid uric. iu tr gout mn tnh Mc tiu iu tr gout mn tnh l iu tr gim acid uric mu trnh bin chng suy thn mn. Thng s dng nhm thuc c ch tng hp acid uric v c th kt hp dng thm colchicin ty theo trng hp. C th s dng thuc chng vim khng steroid cho nhng bnh nhn vim khp cn ang tin trin. Nu c tn thng thn phi ch n tnh trng nhim khun (vim thn k), tnh trng suy thn tim tng, cao huyt p, si thn, tin lng ca bnh gout ty thuc vo mc tn thng thn. mt s u cc (tphi) qu to cn tr vn ng c th ch nh phu thut ct b (tphi ngn chn ci khng i giy c, khuu tay kh mc o,).

TRUNG TM IU TR BNH GOUT www.benhgout.com