#1
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Òåðàôëåêñ
Èçâèíèòå, ìîæåò áûòü çäåñü óæå çàäàâàëñÿ ýòîò âîïðîñ.
Ìåíÿ èíòåðåñóåò êàê äîëãî ìîæíî ïðèíèìàòü òåðàôëåêñ? ß ïüþ åãî óæå äâà ãîäà. |
#2
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Ïðîèçâîäèòåëü ðåêîìåíäóåò ïðèíèìàòü ïðåïàðàò äëèòåëüíî.... ò.å. ïîñòîÿííî. Íå ñåêðåò, ÷òî òàêèì îáðàçîì ïîëó÷àÿ ôèíàíñîâóþ âûãîäó. Íî! Ïîìíèòå î òîì, ÷òî ïðèìåíèòåëüíî ê ýòîìó "ëåêàðñòâó" ÎÒÑÓÒÑÒÂÓÞÒ âíÿòíûå äîêàçàòåëüñòâà ýôôåêòèâíîñòè ïðè ðàçëè÷íûõ âàðèàíòàõ ïðèìåíåíèÿ. ß íèêîãäà íå íàçíà÷àþ ñâîèì ïàöèåíòàì Òåðàôëåêñ è åãî "îäíîãðóïïíèêîâ". Âðà÷è â ÑØÀ âîîáùå íå çíÿþò- ÷òî òàêîå õîíäðîïðîòåêòîð. Âîò è ä-ð Ðåðð íà ìîé íåäàâíèé âîïðîñ î òîì, ÷òî îí ïîíèìàåò ïîä õîíäðîïðîòåêòîðàìè, îòâåòèë, ÷òî õîíäðîïðîòåêòèâíîå äåéñòâèå èìïëàíòàòîâ ñèíîâèàëüíîé æèäêîñòè. ( à íå òàáëåòîê õîíäðîèòèí ñóëüôàòà è ò.ä.) Ñîáñòâåííî ãîâîðÿ ïîäîáíàÿ ïàíàöåÿ "îò ñóñòàâîâ" ïðîäàåòñÿ íàãëûì îáðàçîì (ãäå ðîññèéñêàÿ FDA?!?) íà òåððèòîðèè áûâøåãî ÑÑÑÐ. Ëó÷øå äîëîæèòå ñóòü âàøåé ïðîáëåìû ñîãëàñíî ïðàâèëàì ôîðóìà. Òîãäà ñîâåò, âîçìîæíî, áóäåò ïðàêòè÷íåå.
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#3
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Öèòàòà:
Öèòàòà:
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#4
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Ñïàñèáî, ïðèíÿë ê ñâåäåíèþ. Îñòàëîñü òîëüêî óáåäèòü ïàöèåíòîâ ïðèíèìàòü òåðàôëåêñ ïî 1 òàáëåòêå 2 ðàçà â äåíü 2 ãîäà êàæäûé äåíü. È ïðè ýòîì íå çàáûâàòü ïðî ïðåñòàðèóì, èíäàïàìèä, íåáèâîëîë, íèòðî-ìàçè-àïïëèêàòîðû, êîíòðîëü äàâëåíèÿ è ïóëüñà 4 ðàçà â äåíü, ñàõàð íå çàáóäüòå... Ãîðñòü íà çàâòðàê, íà îáåä, íà ïîëäíèê. "Äîêòîð, à îíè òî÷íî â æåëóäêå ðàñòâîðÿþòñÿ, à íå êîïÿòñÿ? " Íåõàé ôàðìãèãàíòû ïðèäóìàþò ïðîëîíãèðîâàííóþ ôîðìó, ÷òîá 1 ðàç â ìåñÿö, òîãäà ÿ óâèæó çåðíî ðàçóìà. À òàê íàçíà÷åíèå òåðàôëåêñà ñàìî ïî ñåáå ñëîæíî ðàñöåíèâàòü êàê íåîáõîäèìîñòü. Êàê áû íå âûðàáîòàòü êîìïëåêñ ñóïåðáîëüíîãî ó áîëüíîãî. Ìîæåò áûòü ó íàñ ïðåïàðàòû õîíäðîèòèíà ëåâûå? ïîðÿäêà 30 æàëîá â ìîèõ íàáëþäåíèÿõ íà òî, ÷òî ìîíîïðèåì "Ñòðóêòóì", "òåðàôëåêñ" íå ïðèíåñ îáëåã÷åíèÿ íó íè íà éîòó. Íåò, êîíå÷íî íå ðàíäîìèçèðîâàííîå èññëåäîâàíèå, íî íè îäíà ñòàòüÿ íèêîãäà íå óáåäèò ìåíÿ èñïîëüçîâàòü ìåòîä ëå÷åíèÿ, åñëè ÿ âèäåë çíà÷èìîå äëÿ ìåíÿ ÷èñëî íåóäà÷ ýòîãî ìåòîäà. Êîíå÷íî ÿ çàäóìàþñü (è ñâåðþñü) ñ îðèãèíàëüíîé òåõíîëîãèåé... Íî âñå æå, ìîæåò ó íàñ õîíäðîèòèí ëåâûé? À àìåðèêàíñêèé â íàøèõ êðàÿõ íå ïîïàäàëñÿ.
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#5
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Öèòàòà:
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#6
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A multicenter study supported by the National Institutes of Health, the Glucosamine Chondroitin Arthritis Intervention Trial (GAIT), is in progress which is comparing glucosamine, chondroitin sulfate, the combination, and celecoxib with placebo in patients with knee OA... (C) Harrison
Óæå: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] "As compared with the rate of response to placebo (60.1 percent), the rate of response to combined treatment was 6.5 percentage points higher (P=0.09). The rate of response in the celecoxib control group was 10.0 percentage points higher than that in the placebo control group (P=0.008). For patients with moderate-to-severe pain at baseline, the rate of response was significantly higher with combined therapy than with placebo (79.2 percent vs. 54.3 percent, P=0.002)." Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain. Êîíå÷íî, ïëàöåáî-ýôôåêò ïðîñòî ïîòðÿñàþùèé: The study by Clegg et al. (Feb. 23 issue) suggests that glucosamine and chondroitin are not better than placebo for knee osteoarthritis. The most remarkable aspect of their study is perhaps the huge placebo effect — 60 percent of the patients noted at least a 20 percent decrease in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to week 24. The authors comment that "elevated rates of response to placebo have been reported in other osteoarthritis trials." However, the two references provided did not show long-term placebo effects after oral medication — one used intraarticular injections and the other had only 13 weeks of follow-up. The extraordinary response to oral placebo in the trial by Clegg et al. might explain its findings. That is, if placebo is effective in 60 percent of patients, it is difficult for other treatments to surpass this mark. The use of rescue medication seems to have increased during the trial period in all groups. No data were provided on other concomitant treatments, such as physiotherapy. Was the improvement in the placebo group the result of treatment or a true placebo response? Edzard Ernst, M.D., Ph.D. Peninsula Medical School Exeter EX2 4NT, United Kingdom Âîò íàì áû òàêîå ÍÏÂÑ ïëàöåáî, êîòîðîå âñåãî íà 10% óñòóïàåò öåëåêîêñèáó 200 - íèêàêèõ òåáå íè ÿçâ/ÿçâåííûõ êðîâîòå÷åíèé, íè ïîâûøåíèÿ ðèñêà ÈÁÑ Åñëè ïðèìåíÿòü "äîêàçàòåëüñòâà îò ïðîòèâíîãî", òî ñî÷åòàííîå ëå÷åíèå õîíäðî-ãëþêî (500 mg of glucosamine plus 400 mg of chondroitin sulfate three times daily) âñåãî íà 3,5% áûëî õóæå, ÷åì öåëåêîêñèáîì. Èíòåðåñíî, êàê òàì ïî öåíå 2,7 ã õîíäðî-ãëþêî â ñóòêè ïðîòèâ 0,2 öåëåêî: ó êîãî ïî íàøèì öåíàì cost-effifacy âûøå?
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#7
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Öèòàòà:
Óâàæàåìûé Àíäðåé. Ïðåïàðàòû, îñíîâàííûå íà ïðîòàìèí è õîíîäðîèòèí ñóëüôàò, íå ÿâëÿþòñÿ õîíäðîïðîòåêòîðàìè. Õîíäðîèòèí -ýòî åñëè ÿ íå îøèáàþñü ñîñòàâëÿþùåå ïðîòåîãëèêàíîâ, îðãàíèçóþùèåñÿ â ãëþêîçàìèí è ÿâëÿþùååñÿ îñíîâîé õðÿùà. ß ïîëüçîâàëñÿ íåñêîëüêèìè èç íèõ. Ýòî Êàðòèëÿãî, Ìåãàãëþôëåêñ è ïð. Íà ñâîåì îïûòå, äà è ðàçãîâàðèâàÿ ñ äðóãèìè îðòîïåäàìè, èç âñåé ãðóïïû ýòèõ ïðåïàðàòîâ ëó÷øèé ýòî ÊÎÇÀÌÈÍ. Îïÿòü æå ýòî íàøå ëè÷íîå ìíåíèå. Èíîãäà ïðèìåíÿåøü ýòè ïðåïàðàòû è îíè íå ïîìîãàþò. Ìåíÿåøü ïðåïàðàò íà ÊÎÇÀÌÈÍ ÄÈ ÑÈ, è áîëè óõîäÿò.  ëþáîì ñëó÷àå, ó ïàöèåíòîâ ñ 4 ñòàäèåé àðòðèòà ýòî íå äåéñòâóåò îäíîçíà÷íî.  ëèòåðàòóðå òàê è îïèñûâàåòñÿ, ïðèìåíÿòü â ðàííèõ ñòàäèÿõ àðòðèòà. ß æå ïðèìåíÿþ ýòè ïðåïàðàòû òàêèì îáðàçîì. Åñëè ÷åëîâåê íå ðåàãèðóåò íà ïðèìåíåíèå ïðåïàðàòà, òî ÷åðåç 3 ìåñÿöà ãîâîðþ åìó, ÷òî áû ïðåêðàùàë. Äàëüøå òîëêó íå áóäåò, Ýòî äîñòàòî÷íîå âðåìÿ ÷òî áû ïîíÿòü, ðàáîòàåò ïðåïàðàò èëè íåò. Êñòàòè, êòî-òî çäåñü ïðîèçíåñ, ÷òî ÕÀÐÈÑÎÍ ÈÍÒÅÐÍÀË ÌÅÄÈÑÈÍ ýòî êíèãà íå ïðèçíàâàåìàÿ â ÑØÀ. Ãîñïîäà-ýòî íàñòîëüíûé ó÷åáíèê âñåõ òåðàïåâòîâ è íå òîëüêî, íî è ìíîãèõ äðóãèõ ñïåöèàëüíîñòåé â Øòàòàõ. Ó÷åáíèê îáúåäèíÿåò âñå çàáîëåâàíèÿ, êîòîðûå òîëüêî ìîæíî, ëó÷øåãî ÿ íå âñòðå÷àë. Ñåãîäíÿ îí ÿâëÿåòñÿ ó÷åáíèêîì íîìåð 1 è â åâðîïåéñêèõ ñòðàíàõ. |
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#8
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Âû ìåæäó ñîáîé ðàçãîâàðèâàåòå?...
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#9
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2 DEM Îòâåò íà âîïðîñ, çðÿ ëè Âû ïðèíèìàëè òåðàôëåêñ- èùèòå â äèñêóññèè. Íà âîïðîñ î ñãèáàòåëüíîé êîíòðàêòóðå ïî òàêîé ñêóäíîé èíôîðìàöèè ñêàçàòü âîîáùå íè÷åãî íåëüçÿ.
2 Ðåðð- ñïàñèáî. |
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Ïî ïîâîäó ìàëîèçâåñòíîãî ÕÈÌ ÿâíî ïî-äîáðîìó ñúÿçâèëè.
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#11
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Öèòàòà:
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#12
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Èññëåäîâàíèå, íà êîòîðîå Âû ññûëàåòåñü - ìÿãêî ãîâîðÿ, ñîäåðæèò ìíîãî íåäîñòàòêîâ â ñâåì äèçàéíå è íå ìîæåò ñ÷èòàòüñÿ îáúåêòèâíûì.
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#14
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Ïåðâîå ëå÷åíèå íà÷àëîñü 8 ëåò íàçàä è çàòåì âî âîçðàñòàþùåé: îò äèêëîôåíàêà, ñ 1 òàáë, îðòîôíåà îò 1 ò., à çàêîí÷èëà ïî 7 øò â äåíü !!!, Êàæäûå ïîëãîäà - â ñòàöèîíàðå, èí"åêöèè â êîëåííûé ñóñòàâ - àëôëóòîï, õîíäðîëîí, ðóìàëîí, êñåôîêàì, óëó÷øåíèÿ ìàêñèìóì íà 1 ìåñ. Çàòåì è ýòî íå ïîìîãàëî, ïåðåøëà íà ïàëî÷êó ( â50 ëåò!!), ñîêðàòèëà ïîëíîñòüþ ïåðåäâèæåíèÿ, áîëè, ìó÷åíèÿ â äâèæåíèè íå äëÿ õîäüáû, ïîíÿëà, ÷òî âñå èäåò ê îáåçäâèæèâàíèþ.....
À âîò õèðóðãè âåðíóëè ðàäîñòü äâèæåíèÿ, òåïåðü ýòî öåíèòñÿ îñîáî!! Êîíå÷íî, â êîíöå äíÿ ÷óâñòâóåòñÿ áîëåçíåííîñòü, óñòàëîñòü íîã, íî ýòî âñå ìåëî÷è, â ñðàâíåíèè ñ òåì, ÷òî áûëî. ß ïðåäóïðåæäàþ âñåõ - ÍÅ ÏÎÄÄÀÂÀÉÒÅÑÜ ÍÀ ÐÅÊËÀÌÛ ÏÎ ÐÀÄÈÎ,ÍÅ ÒÐÀÒÜÒÅ ÇÐß ÑÂÎÈ ÄÅÍÜÃÈ ÍÀ ÁÀÄÛ! |