Izithasiselo ze-Oral Glutamine ze-Radiation-Induced Swillowing Zinkinga Ezigulini Zomdlavuza WeLung

Amaphuzu avelele

Izifundo zomtholampilo ezenziwa ngamaqembu ahlukene ocwaningo zaphenya ngomphumela wokudla ngomlomo izengezo ze-glutamine, i-amino acid engabalulekile, kusilinganiso sezigameko i-esophagitis ebangelwa imisebe ebukhali noma ubunzima bokugwinya nokuncipha kwesisindo Ezigulini Zomdlavuza Wamaphaphu. Imiphumela yalezi zifundo ibonise ukuthi ukwenyuka kwe-glutamine yomlomo kungase kuzuze amaphaphu umdlavuza iziguli ngokunciphisa izehlakalo zokuvuvukala komminzo, izinkinga zokugwinya/ubunzima kanye nokuncipha kwesisindo okuhlobene.

I-Esophagitis ezigulini zomdlavuza wamaphaphu

Umdlavuza wamaphaphu uyimbangela ehamba phambili yokufa okuhlobene nomdlavuza kubesilisa nabesifazane emhlabeni jikelele futhi ubalwa ngaphezu kwe-18% yabantu ababulawa umdlavuza (GLOBOCAN, 2018). Ngokuthuthuka kwakamuva kokwelashwa, inani lamaphaphu amasha umdlavuza amacala abelokhu ehla kule minyaka embalwa edlule (American Cancer Society, 2020). Ngokusekelwe ohlotsheni nesigaba somdlavuza, ukusebenza kwamaphaphu kanye nempilo yonke yesiguli, ukwelashwa kwesiguli somdlavuza wamaphaphu kunqunywa ngezindlela ezahlukene okuhlanganisa i-radiotherapy, i-chemotherapy, i-immunotherapy, ukwelashwa okuhlosiwe nokuhlinzwa. Kodwa-ke, eziningi zalezi zindlela zokwelapha zihlotshaniswa nemiphumela emibi yesikhathi eside neyesikhashana. Omunye wemiphumela evame kakhulu, engathandeki futhi ebuhlungu ebonwa ezigulini ezinomdlavuza wamaphaphu ezithole ukwelashwa ngemisebe endaweni yesifuba i-esophagitis. 

I-Esophagitis ukuvuvukala komphimbo, ishubhu elingenalutho lomsipha elixhuma umphimbo nesisu. Ngokuvamile, ukuqala kwe-esophagitis ebangelwa imisebe ebukhali (i-ARIE) kwenzeka ezinyangeni ezintathu ngemuva kwe-radiotherapy futhi kungaholela ezinkingeni ezinkulu zokugwinya. Ngakho-ke, kwenziwa ucwaningo olunzulu ukuhlola izindlela zokuvimbela nokuphatha i-esophagitis eyenziwe ngemisebe ezigulini zomdlavuza. Ucwaningo oluningi olushicilelwe muva nje luqokomise ukusetshenziswa kwezithasiselo ezifana ne-glutamine ukuvimbela noma ukubambezela imisebe ebangelwa i-esophagitis. I-L-Glutamine, ngokuvamile ebizwa nge-Glutamine iyi-amino acid engabalulekile ekhiqizwa ngumzimba futhi ingatholwa kokudla okuhlukahlukene okubandakanya imithombo yezilwane njengobisi, imikhiqizo yobisi, amaqanda nenyama, nemithombo yezitshalo efana njengeklabishi, ubhontshisi, isipinashi, iparsley no-beet imifino. Kodwa-ke, i-glutamine, eyenza ama-aminoacid angama-3% akhona emisipheni yethu yamathambo, ivame ukuncipha kakhulu ezigulini zomdlavuza eziholela ekwehliseni isisindo nokukhathala. 

Izifundo ezihlotshaniswa ne-Oral Glutamine Supplements & Radiation-Induced Swillowing Zinkinga Kumdlavuza WeLung

Ucwaningo ngeSibhedlela Esikude Sesikhumbuzo, eTaiwan

Ocwaningweni olusanda kwenziwa lomtholampilo olwenziwe ngabaphenyi eFar Eastern Memorial Hospital, eTaiwan phakathi kukaSepthemba 2014 kuya kuSepthemba 2015, idatha evela ezigulini ezingama-60 ezingezona ezincane zomdlavuza wamaphaphu wamaphaphu kubandakanya amadoda angama-42 nabesifazane abangu-18, abaneminyaka yobudala engama-60.3, yahlolwa . (Chang SC et al, Medicine (Baltimore), 2019) Lezi ziguli zithole ama-regimens asekelwe ku-platinum kanye ne-radiotherapy ngasikhathi sinye, ngokuxhaswa noma ngaphandle komlomo kwe-glutamine unyaka ongu-1. Abaphenyi bathole ukuthi ngemuva kwesikhathi esilandelwayo sokulandela izinyanga ezingama-26.4, ukwengezwa kwe-glutamine kwehlise izinga lezehlakalo zebanga 2/3 eline-radiation esophagitis / ubunzima bokugwinya kwaba ngu-6.7% uma kuqhathaniswa no-53.4% ​​ezigulini ezingatholanga izithasiselo ze-glutamine. Kuphinde kwabonwa ukuthi izinga lezehlakalo zokwehla kwesisindo lehle laya ku-20% kwiziguli ezilawulwa yi-glutamine uma kuqhathaniswa ne-73.3% ezigulini ezingayitholanga i-glutamine. Ukwengezwa kweGlutamine kuphinde kwabambezela ukuqala kwe-esophagitis ebangelwa imisebe ebucayi yezinsuku ze-5.8 (I-Chang SC et al, iMedicine (iBaltimore), i-2019).

Ukufundwa yiNecmettin Erbakan University Meram Medicine School, eTurkey

Kolunye ucwaningo lomtholampilo olwenziwe abacwaningi base-Necmettin Erbakan University Meram Medicine School, eTurkey, phakathi kuka-2010 no-2014, idatha evela ku-122 Stage 3 yamaphaphu angewona amancanyana. umdlavuza iziguli zahlaziywa (UKanyilmaz Gul et al, Umtholampilo Wezempilo., 2017). Lezi ziguli zithole ukwelashwa ngamakhemikhali kanyekanye (ngeCisplatin / carboplatin + pactitaxel noma iCisplatin + Etoposide, noma iCisplatin + Vinorelbine) kanye ne-radiotherapy, noma ngaphandle komlomo okwengeza i-glutamine. Ingqikithi yeziguli ezingama-56 (46%) zengezwe nge-glutamine yomlomo. Abaphenyi bathole ukuthi ngemuva kwesikhathi esimaphakathi sokulandela izinyanga eziyi-13.14, ukwengezwa kwe-glutamine kwehlise izinga lezehlakalo zebanga le-2-3 elibuhlungu elenzelwa imisebe / ukugwinya ubunzima laya ku-30% uma kuqhathaniswa ne-70% kulabo abangatholanga izithasiselo ze-glutamine. Baphinde babona ukuthi izinga lezehlakalo zokwehla kwesisindo lehle laya ku-53% ezigulini ezinikezwe i-glutamine uma kuqhathaniswa ne-86% ezigulini ezingayitholanga i-glutamine. Ucwaningo lukhombise nokuthi ukwengezwa kwe-glutamine akubanga nomthelela omubi ekulawuleni isimila nasemiphumeleni yokusinda (UKanyilmaz Gul et al, Clin Nutr., 2017).

Ngabe ukwengezwa kwe-Oral Glutamine Kunganciphisa i-Esophagitis noma Ukugwinya Ubunzima ezigulini ezinomdlavuza weLung?

Kafushane, lezi zifundo zibonisa ukuthi ukuthathwa kwezithako ze-glutamine zomlomo kungazuzisa iziguli ezinomdlavuza wamaphaphu okungewona amancanyana ngokunciphisa izehlakalo ze-radiation-induced esophagitis/ubunzima bokugwinya kanye nokuncipha kwesisindo, ngaleyo ndlela kuthuthukise izinga lempilo yazo. Kodwa-ke, njengoba ucwaningo lwangaphambilini lwe-in vitro luphakamise ukuthi i-glutamine ingase isekele ukukhula kwamangqamuzana omdlavuza, izazi ze-oncologists zazivame ukungabaza ukuphatha i-glutamine umdlavuza iziguli ukuze kugwenywe noma yiziphi izinkinga (Kanyilmaz Gul et al, Asian Pacific Journal of Cancer Prevention, 2015), nakuba izifundo zamuva nje zemitholampilo zingabonisanga umthelela omubi ekulawuleni isimila kanye nemiphumela yokusinda nge-glutamine supplementation. (Kanyilmaz Gul et al, Clin Nutr., 2017) Ngakho-ke, ngenkathi izifundo ezifingqiwe kule bhulogi ziqokomisa izinzuzo ze-glutamine kumdlavuza wamaphaphu, iziguli kufanele zihlale zixoxa nodokotela wazo ngaphambi kokuthatha noma yiziphi izithasiselo zomdlavuza wazo.

Ukudla okudlayo nokuthi yikuphi okunezelayo okwenzayo yisinqumo osithathayo. Isinqumo sakho kufanele sifake ukucutshungulwa kwezakhi zofuzo zomdlavuza, okuwumdlavuza, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imininingwane yokuphila, isisindo, ubude nemikhuba.

Ukuhlelela okunomsoco komdlavuza kusuka ku-addon akususelwa ekusesheni kwe-inthanethi. Kwenzela wena ukuthathela izinqumo ngokuya ngesayensi yamangqamuzana eyenziwe ososayensi bethu nonjiniyela be-software. Kungakhathalekile ukuthi ngabe uyakukhathalela ukuqonda okuyisisekelo kwamakhemikhali amakhemikhali noma cha - wokuhlelela umsoco ukuhlela lokho kudinga ukuqonda.

Qalisa MANJE ngokuhlela kwakho okunomsoco ngokuphendula imibuzo egameni lomdlavuza, ukuguquka kwezakhi zofuzo, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imikhuba, indlela yokuphila, iqembu lobudala nobulili.

Iziguli ezinomdlavuza ngokuvamile kufanele zibhekane nokuhlukile imiphumela emibi ye-chemotherapy okuthinta ikhwalithi yempilo yabo futhi babheke ezinye izindlela zokwelapha umdlavuza. Ukuthatha ukudla okunomsoco nezithasiselo ezisuselwa ekucabangeni kwesayensi (ukugwema ukuqagela nokukhetha okungahleliwe) yikhambi elingcono kakhulu lemvelo lomdlavuza nemiphumela emibi ehlobene nokwelashwa.

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