網誌文章搜尋建議

給多發性硬化症MS病友和親友的建議:
如要搜尋站內相關文章可多利用
"搜尋此網誌的文章內容"的功能,這樣就可以快速的找到你想要得資訊而不需要從第一篇開始看了.
有關CCSVI(靜脈血管窄化及手術的資訊)可在相關連結以及相關MS blog內

推薦頻道:Gimmy a break

2011年12月23日 星期五

再論腸阻塞/腸沾黏

之前我有一篇文章

MS病友要注意的事:體重下降

曾談到

腸沾黏是許多經歷過腹部手術患者的難言之隱。
腹痛、腹脹、嘔吐、便結等症狀,常使得患者萌生「不如不開刀」之感。

先天性的腸沾黏多為發育異常,或由胎糞性腹膜炎所引起,臨床上並不多見;
現代腸沾黏的主要原因為腹部手術、腹膜炎、創傷或腫瘤所引起。
由於以上多種原因造成原本無菌狀態的腹膜發炎
繼發纖維蛋白性的黏連,把腸壁鄰近組織癒合成一塊,
造成蠕動困難,就像被厚重的蜘蛛網纏住一樣,於是造成了腸沾黏。

腸沾黏的第一個症狀就是腹痛尤其以肚臍周圍的腹痛最多
伴隨著脹氣,常使患者失去工作能力及意願。
沾黏部位較高,還可能伴隨著嘔吐食物或胃液,並且可能造成排便或排氣停止
以上是 腸沾黏

首先呢…可以吃維他命B群,特別是維他命B1能促進腸道的蠕動。
適量的運動和愉悅的心情都可以幫助腸道的蠕動。
高纖維飲食還有一個要注意的問題就是維生素與礦物質的補充,
所以建議您可以在早餐飯後再補充一顆綜合維他命
在飲食上,建議或許可以吃清淡飲食、減少脹氣
目前也有研究認為,乳酸菌有促進腸蠕動的效果,可能幫助改善。
偶而作一些輕鬆的運動,如散步,打太極拳等也有助於促進腸胃之蠕動。



有病友會問:那我都走不了了,還散步?打太極拳?
那我再提供給各位一個也曾經做過血管擴張術病友提供的很好的建議:平甩功
他做了之後,更幫助他的腳活動能力。
我在聽了他的建議之後,也持續做了一個多月之久,我發現不論坐著或站著,在做至少半小時以上之後會促進放屁和排氣。

附上平甩功的參考




而中醫治療腸沾黏以「通」為原則,
發作期治療以通裡攻下為主,
兼以理氣開鬱、活血清熱為輔,在緩解期注意綜合調理,
使脾胃強健,預防復發,並根據病情發展,必要時,應轉手術治療。

可以用熱水淋浴肚臍周圍,再用手掌依右下→右上→左上→左下的順序用力按壓腹部
按壓的深部大約是3至5公分沾黏嚴重的患者常可以觸摸到一團團成塊狀的硬物,
會有些許的疼痛感
。雖然可以在家進行居家護理,但當嚴重發作時,還是要請醫師處理,
否則經常性的便秘,有誘發大腸癌的可能

中醫治療:

發作期的治療
●氣滯腑實:腹痛陣作,叩之有鼓音。腹痛時,腹部可見條索狀物隆起,伴隨噁心、嘔吐,治宜行氣通下,以硝菔通結湯加減大腹皮、姜半夏、桔梗主之。
●熱結腸腑:腹痛拒按、腹脹痞滿、發熱、口乾、唇燥、小便短赤,治宜瀉熱通下,以大承氣湯加減金銀花、蒲公英以清熱解毒。
●寒結腸腑:腹中突然絞痛,脘腹怕冷,腹脹便秘,面色青暗,治宜溫中通下,宜溫脾湯加減吳茱萸、細辛等,以溫陽散寒。
●腸腑血瘀:腹痛重於腹脹,痛有定處,脹無休止,局部拒按,可觸及痛處包塊,治宜祛瘀通下,以桃仁承氣湯加減田七、川芎。

☆緩解期的調養
●脾虛氣滯:腹陣痛時作,氣短乏力,大便不暢,治宜健脾行氣,方以陳夏六君子湯,加以火麻仁,重用黃耆以補氣潤腸。
●津虧腸燥:大便乾結、經常便秘、腹痛時作,治宜潤腸通便,以五仁湯加味。桃仁、柏子仁、郁李仁、瓜蔞仁、火麻仁為多汁潤腸之品,加以厚朴行氣調血,合奏潤腸通便功。氣陽不足者加太子參、麥冬,以益氣養陰。
平常可用艾灸足三里、內關、合谷穴,以達到健脾理中的效果。天樞、氣海、關元穴等,在這些穴位下針灸,即可針對剖腹產所產生的腸沾黏以及脹氣或便秘有所改善。


豐原醫院營養師鄭秀英表示,曾發生腸子沾黏導致腸阻塞或腸胃道功能欠佳的中老年人,飲食應採低刺激性、低渣,以減少阻塞發生,
更應避免食用油炸類、 奶製品、全穀類製品、堅果類、過於油膩食物及辛辣、刺激性的調味品,蔬菜應攝取葉的部份,避免根莖部,不宜同時段吃下大量高纖維食物。最近盛產甜柿,鄭秀英提醒老年人或腸胃道消化功能不好的人,不宜一次大量食用,飲食也需保持定時定量、細嚼慢嚥,避免引發腸阻塞。多喝水。
低渣飲食,例如過濾過的果汁,及補充電解質,避免吃產氣食物易引起脹氣,忌食牛奶及奶製品。


更多閱讀:其他由Google得到的參考資料
Share/Bookmark

3 則留言:

  1. Explosion in Treatment Advances for Multiple Sclerosis

    For three decades Tracy Ofri, 48, of Valley Stream, N.Y., suffered with multiple sclerosis.

    At age 19, Ofri lost sight in one eye. Her unpredictable monthlong bouts of blurred vision, painful breathing and numbness throughout her body weighed her down.

    And within her body, white blood cells attacked the fatty substances that protected the nerves in her brain, spinal cord and optic nerves. Like many others who have the type of MS Ofri does -- relapsing and remitting MS -- the condition had her riding its ups and downs.

    "When the doctor came into the room, he told me that there was no treatment, and that I had a disease with no medicine, and no cure," said Ofri, who was diagnosed in 1987. "I didn't even get a pamphlet. I had no information."

    Then in 2007, Ofri enrolled in a clinical trial for a new drug that was soon hailed as the first oral MS medication to hit the market. Studies for the drug, Gilenya, showed that it prevented the disease from relapsing by keeping the white blood cells under control.

    And for Ofri, it did just that. She hasn't relapsed since she started taking Gilenya, a drug approved just last year to reduce the frequency of clinical relapses and reduce inflammation in cells found in the central nervous system.
    Common Causes Of Nerve Pain? Watch Video
    Political Booster Watch Video
    Gingrich, Romney Spouses in Focus Watch Video

    Experts say that the solo drug is not the only saving grace for many people with MS. The past decade has offered the greatest advances in MS, so much so that it may be difficult to believe that at one time the chances of successfully combating the condition were slim.

    Twenty years ago, treatments for MS meant managing symptoms like urinary complications and joint pain. Now there are eight disease-modifying drugs approved for MS, half of which were approved within the past five years.

    Three new disease-modifying treatments will be presented for FDA approval this year.

    "We went from a time when one of my early mentors told me the attitudes for people with MS were 'diagnose and adios.' We had nothing to offer them," said Dr. Aaron Miller, director of the MS Center at Mt. Sinai Hospital in New York and chief medical officer for the National MS Society. "We've had an incredible explosion of new treatments."

    The transformation is also due in part to the emergence of magnetic resonance imaging – MRI – that's not only used to diagnose the disease but to predict how the disease will progress.

    "With MRI, we can also define the response to therapy," said Dr. Robert Fox, neurologist and medical director of the Mellen MS Center at the Cleveland Clinic.

    Imaging also helps specialists segment patients to the right type of therapy based on their risk, Fox said.

    回覆刪除
  2. Therapeutic progress in MS is almost exclusive to the relapsing and remitting form, or stage, of the disease. Before the development of disease-modifying therapies, about three-quarters of patients with this form of the disease developed a progressive form of MS.

    Still, the challenge remains for the nearly 10 percent of patients who have primary and secondary progressive types of MS, where there are currently no therapies.

    Unlike the relapsing and remitting form, the progressive form of the disease worsens more steadily without ever getting better.

    "The number of trials in relapsing outnumbers the progressive form by 10 to 1," said Fox. "What we lack in progressive MS is understanding the basic biology of it; we lack imaging markers of it."

    But that's not stopping research into emerging therapies for the disease, including stem cell transplantation.

    While still in trial phase, researchers hope that transplanting mesenchymal stem cells, which are taken from a specific part of the bone marrow, may offer ways to keep white blood cells from attacking tissues in the central nervous system, and restore tissue already damaged in the brain and spinal cord.
    Common Causes Of Nerve Pain? Watch Video
    Political Booster Watch Video
    Gingrich, Romney Spouses in Focus Watch Video

    Some experts said at best, the next renaissance -- this time one of understanding the condition's progressive forms and subsequent therapies – may be another generation out.

    But for an area of research that once underwent a dry spell, the experts said, the coming decade offers a new and unpredictable spring.

    "It's so gratifying now that we have so many options," said Miller. "And to know that as the years go on, we're seeing drugs that are not only easier to take – oral drugs rather than injectable drugs – but that have a higher degree of effectiveness."

    回覆刪除
    回覆
    1. 在MS治療的進展幾乎多重於復發緩解型。前期疾病的治療中,約四分之三會逐步形成退化的MS。

      儘管如此,面臨的挑戰是仍然有第一和第2的漸進退化類型的MS,目前沒有療法的患者近10%。

      不像復發緩解型,漸進退化類型的惡化沒有變得更好更穩定。

      “試驗在復發租稅逐步形成由10至1,”福克斯說。 “我們缺乏漸進的質譜的是了解它的基本生物學,我們缺乏它的成像標記。”

      但是,這並不能阻止進入新興療法的疾病的研究,包括幹細胞移植。

      雖然仍處於試驗階段,研究人員希望移植間充質幹細胞,這是從骨髓中的一個特定部分,可提供的方式,以防止攻擊白血細胞在中樞神經系統的組織,並恢復受損的組織已經在大腦和脊髓。
      神經性疼痛的常見原因?觀看視頻
      政治助推器觀看視頻
      金里奇,羅姆尼聚焦觀看視頻配偶

      一些專家說,最好的,未來這段時間的認識條件的漸進形式和後續的治療之一 - 可能一代又一代。

      但對一個領域的研究,一旦經歷了乾旱,有關專家表示,在未來十年提供了一個新的和不可預知的的春天。

      “它是如此令人欣慰,現在我們有這麼多的選擇,”米勒說。 “要知道,隨著歲月的流逝,我們看到的藥物,不僅容易採取 - 口服藥物,而不是注射藥物 - 但有一個程度較高的有效性。”

      刪除

留言