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Thong tin nay chi mang tinh giao duc. Khong phai loi khuyen y te. Luon tham kham bac si chuyen khoa.
Dau man tinh anh huong den hon 20% nguoi truong thanh tren toan the gioi. Tim hieu ve cac loai dau, thang dau WHO, duoc tri lieu va cac phuong phap khong dung thuoc.
Dau man tinh — duoc dinh nghia la dau keo dai hon ba thang — la mot trong nhung tinh trang y te pho bien nhat va lam suy nhuoc nhat tren the gioi. Hiep hoi Quoc te Nghien cuu Dau (IASP) uoc tinh rang khoang mot trong nam nguoi truong thanh song voi dau man tinh, khien no tro thanh nguyen nhan hang dau gay tan phe va giam chat luong cuoc song.
Dau thu cam (nociceptive) phat sinh tu ton thuong mo thuc su hoac tiem tang va duoc trung gian boi cac thu cam the dau o da, co, khop va noi tang. Vi du: viem xuong khop, dau lung man tinh. Dau than kinh (neuropathic) la ket qua cua ton thuong hoac benh ly cua he than kinh cam giac — benh than kinh ngoai vi do dai thao duong, dau than kinh sau zona, dau day than kinh sinh ba. Dau nociplastic — mot phan loai moi duoc IASP cong nhan — chi dau phat sinh tu su thay doi thu cam dau ma khong co bang chung ro rang ve ton thuong mo hoac than kinh. Dau co xuong khop (fibromyalgia) va hoi chung ruot kich thich la cac tinh trang nociplastic dien hinh.
Dau man tinh co the bat nguon tu cac roi loan co xuong khop, tinh trang than kinh, hoi chung dau sau phau thuat, ung thu va cac benh viem man tinh. Cac yeu to nguy co co the thay doi bao gom beo phi, loi song it van dong, hut thuoc va stress tam ly khong duoc kiem soat.
Chan doan dua tren tien su lam sang chi tiet, kham the chat va cac xet nghiem phu hop. Danh gia vi tri, chat luong, cuong do (thang NRS, VAS), kieu thoi gian va tac dong chuc nang. Cac dau hieu canh bao phai duoc loai tru. Danh gia sinh tam ly xa hoi la tieu chuan vang.
Bac 1 su dung thuoc giam dau khong opioid: paracetamol la thuoc dau tien cho dau nhe (toi da 4 g/ngay). NSAIDs nhu ibuprofen (200-400 mg moi 4-6 gio) va naproxen (250-500 mg hai lan moi ngay) cung cap tac dung giam dau va chong viem. Bac 2 them opioid yeu — tramadol (50-100 mg moi 4-6 gio). Bac 3 bao gom opioid manh. Thuoc bo tro co the duoc them o moi bac.
Pregabalin (lieu khoi dau 75 mg hai lan/ngay, tang dan den 150-300 mg hai lan/ngay) va gabapentin (bat dau 300 mg/ngay, tang dan den 1800-3600 mg/ngay) la thuoc dau tien cho dau than kinh. Duloxetine (60-120 mg/ngay) hieu qua trong benh than kinh do dai thao duong, fibromyalgia va dau co xuong khop man tinh. Amitriptyline (10-75 mg truoc khi ngu) la lua chon hieu qua ve chi phi voi loi ich bo sung cai thien giac ngu.
Vat ly tri lieu, lieu phap nhan thuc hanh vi (CBT), TENS, cham cuu, chanh niem, yoga va thai cuc quyen la cac lua chon dua tren bang chung. Cac thu thuat can thiep — phong be than kinh, tiem ngoai mang cung, dot song co bang song radio va kich thich tuy song — co the duoc xem xet khi cac bien phap bao ton that bai.
De biet them thong tin ve cac loai thuoc duoc thao luan trong bai viet nay, hay xem cac trang PillsCard: paracetamol, ibuprofen, naproxen, tramadol, pregabalin, gabapentin, duloxetine va amitriptyline. Luon tham khao y kien bac si hoac duoc si truoc khi thay doi thuoc giam dau.
Bai viet nay chi mang tinh giao duc. Khong phai loi khuyen y te. Luon tham kham bac si.
Dr. Mark Richter is a board-certified internal medicine physician with a focus on preventive care and chronic disease management. He contributes evidence-based health content to help readers make informed decisions about their wellbeing.
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