Comorbidity muKudya Matambudziko: Chaiye kana Asina Manyepo?

Zvemukati

• Kunetseka Kudya Kwakakosha Kuverengwa
• Nei Kushungurudzika Kudya Kwakasimudzwa Kupfuura COVID-19

Comorbidity inyaya yakaoma, zvine musoro uye zvekurapa. Tsananguro ye comorbidity kubva padanho rekufunga inoreva mamiriro ezvinhu umo "chikamu chakasiyana chemakiriniki chinoonekwa panguva yechirwere" - semuenzaniso kana murwere ane chirwere cheshuga achirwara nechirwere cheParkinson. Mune ino kesi, kune maviri akasarudzika makiriniki masangano uye iyo yehupenyu pfungwa inoshandiswa.

Tsananguro yekukanganiswa kubva kuchipatara nzvimbo yekutarisa inoreva, pachinzvimbo, kune mamiriro umo "maviri kana anopfuura akasarudzika emakiriniki masangano anogara pamwe chete." Mune ino kesi, kuwanda kwe comorbidity kunoenderana nedudziro yezvinetso (kureva, iyo yekumisikidza system uye yayo yekuongorora mitemo).

Mumunda wehutano hwepfungwa, uko pasina chaiwo biomarkers akawanikwa kusvika parizvino, zvinokakahadzika kana matambudziko maviri epfungwa ari "akasarudzika" makiriniki masangano, kana zvingori mhedzisiro yezvazvino kupatsanurwa kwekushushikana kwepfungwa izvo, zvichibva pachiratidzo chakapihwa, chinokurudzira iko kuiswa kweakawanda psychiatric diagnoses mumurwere mumwe chete.

Matambudziko ane chekuita nedudziro yekukanganisa anogona kuve nemhedzisiro yemakiriniki anokanganisa kurapwa. Semuenzaniso, hunhu hwekushungurudzika hwakajairika kune varwere vane kusagadzikana kwekudya asi inogona kuve humbowo hweanenge aripo aripo kuchipatara kuora mwoyo ('chaiko comorbidity') kana mhedzisiro yakanangana nehuremu hwepasi muanorexia nervosa kana binge kudya mu bulimia nervosa ('kutsamwa comorbidity ') (ona Mufananidzo 1). Muchiitiko chekutanga, kiriniki yekushushikana inofanirwa kurapwa zvakananga, nepo mune yechipiri kesi kurapwa kwechirwere chekudya kunofanirwa kutungamira mukuregererwa mune zvinoshungurudza maficha.

Comorbidity mumatambudziko ekudya

Kuongorora kunoitika kweongororo dzeEuropean kwakapedzisa kuti vanopfuura makumi manomwe muzana% vevanhu vane dambudziko rekudya vanogamuchira kuongororwa kwechirwere chepfungwa. Matambudziko anowanzoitika aripo pamwe panjodzi kushungurudzika kwekushushikana (> 50%), kusagadzikana kwepfungwa (> 40%), kuzvikuvadza (> 20%), uye kusagadzikana kwekushandisa zvinodhaka (> 10%).

Izvo zvinofanirwa kusimbiswa kuti dhata kubva kuongororo dzakaitwa dzinopa musiyano wakakura mune chiyero chepfungwa dzepfungwa mukukanganisa kwekudya; semuenzaniso, kuwanda kwehupenyu hwehupenyu hwekushushikana kwekushushikana kwakataurwa mune mashoma se25% kusvika kune vakawanda se75% yematambudziko. Range iri zvinokanda kusahadzika kukuru pane kuvimbika kwezviitiko izvi. Saizvozvowo, zvidzidzo zvakaongorora kuwanda kwehunhu hunetso huripo pamwe nedambudziko rekudya zvakaratidza mutsauko unotonyanya kukura, kubva pa27% kusvika pa93%!

Matambudziko e Methodological

Zvidzidzo zvakaongorora kukonzeresa mumatambudziko ekudya zvinotambura nematambudziko akakomba enzira. Semuenzaniso, mutsauko hauna kugara uchiitwa kuti "comorbid" kusagadzikana kwakaitika pamberi kana mushure mekusagadzikana kwekudya; iwo masampuli akaongororwa kazhinji idiki uye / kana anosanganisira ekuongorora zvikamu zvekusagadzikana kwekudya muzvikamu zvakasiyana; hombe uye yakasarudzika nhamba yekubvunzurudza kwekubvunzurudza uye kuzvipa-kwakazvimirira bvunzo kwakashandiswa kuongorora comorbidity. Nekudaro, dambudziko rakakosha nderekuti zvidzidzo zvakawanda hazvina kuongorora kana hunhu hwe comorbidity hwaive hwechipiri kune huremu hwepasi kana kukanganiswa mukudya.

Comorbidity kana akaomarara kesi?

Pfungwa yekuti panongova nechikamu che "makesi akaomarara" haigone kushandiswa kumatambudziko ekudya Chokwadi, vangangoita varwere vese vane dambudziko rekudya vanogona kutorwa seyakaomarara nyaya. Mazhinji, sezvakatsanangurwa pamusoro, anosangana nematanho ekuongororwa kweimwe kana kupfuura matambudziko epfungwa. Zvinetso zvepanyama zvakajairika, uye vamwe varwere vane huripo uye vanobatana nezvirwere zvehutano. Kusangana kwehukama ndizvo zvakajairika, uye iyo isingagumi kosi yechirwere ichi inogona kukanganisa zvakanyanya kukura nekudyidzana kushanda kwemunhu. Zvese izvi zvinoratidza kuti kune varwere vane dambudziko rekudya, kuomarara ndiwo mutemo pane kungosara.

Iko kupatsanurwa kweyakaomarara mamiriro emakiriniki muzvidimbu zvidiki zvechirwere chepfungwa zvinogona kuve nemhedzisiro yakaipa yekudzivirira nzira yakazara yekurapa nekusimudzira kushandiswa kusine mvumo kwemishonga yakati wandei kana kupindira kurapa zvidimbu chimwechete chepikicha yakawandisa uye yakaoma kunzwisisa. Zvakare, iyo isina kukodzera kuongororwa uye manejimendi e-co-morbidities inogona kuve nemhedzisiro yekukanganisa kurapwa kubva pazvinhu zvakakosha izvo zvinochengetedza chirwere chekudya psychopathology uye kuendesa kune varwere zvisina basa uye zvinogona kukuvadza kurapwa.

Maitiro pragmatic kumatambudziko akaoma

Mune kiriniki yangu tsika, ini ndinotora nzira ine pragmatic yekugadzirisa psychiatric comorbidity inosanganisirwa nedambudziko rekudya. Ini ndinoona uye pakupedzisira ndinogadzirisa comorbidity chete kana ichinge yakakosha uye ine zvimiro zvekiriniki. Kusvika izvi, bhuku rekusimudzira kugona kwehunhu maitiro (CBT-E) yezvinetso zvekudya zvinopatsanura comorbidities mumapoka matatu:

Kunetseka Kudya Kwakakosha Kuverengwa

Nei Kushungurudzika Kudya Kwakasimudzwa Kupfuura COVID-19