Kumvetsetsa Narrowband UVB Phototherapy

Chithandizo choyenera cha psoriasis, vitiligo ndi eczema

Narrowband UVB Phototherapy - Zoyambira

"Narrowband" UVB yakhala phototherapy t chifukwa imapereka kuchuluka kwakukulu kwa mafunde opindulitsa kwambiri a kuwala kwa UV, pomwe imachepetsa mafunde omwe angakhale ovulaza. 

ochiritsira "Broadband" Nyali za UVB zimatulutsa kuwala mosiyanasiyana pamtundu wa UVB, kuphatikiza mafunde achire ochizira matenda a khungu, kuphatikiza mafunde amfupi omwe amawotcha ndi dzuwa (erythema). Kuwotchedwa ndi dzuwa kuli ndi ubwino wochiritsira woipa, kumawonjezera chiopsezo cha khansa yapakhungu, kumayambitsa kusapeza bwino kwa odwala, ndipo kumachepetsa kuchuluka kwa mankhwala a UVB omwe angamwe.  

"Narrowband" Komano, nyali za UVB, zimatulutsa kuwala kumtunda waufupi kwambiri wamafunde omwe amakhazikika pazithandizo zamankhwala komanso pang'onopang'ono pakuwotchedwa ndi dzuwa, kumagwiritsa ntchito "malo okoma" pakati pa awiriwa mozungulira 311 nm. UVB-Narrowband ndiye kuti ndi yotetezeka komanso yothandiza kwambiri kuposa UVB-Broadband, koma imafunikira nthawi yayitali yochizira kapena zida zokhala ndi mababu ochulukirapo kuti mukwaniritse mlingo wokwanira, womwe umakhala wofiyira pang'ono pambuyo pa chithandizo, chomwe chimatchedwa "sub-erythema" . Mitundu ya UVB-Narrowband ya Solarc ili ndi chowonjezera cha "UVB-NB" mu nambala yachitsanzo, monga 1780UVB-NB. Mitundu ya UVB-Broadband ya Solarc ili ndi chowonjezera cha "UVB", monga 1740UVB. "Narrowband UVB" idapangidwa ndi Philips Lighting waku Holland ndipo amadziwikanso kuti: Narrow Band UVB, UVB Narrowband, UVB‑NB, NB‑UVB, TL/01, TL-01, TL01, 311 nm, ndi zina zotero, (komwe "01" ndi nambala ya phosphor ya Philips yophatikizidwa mu manambala a gawo la babu la UVB-Narrowband).

Ndipo kuti mumve zambiri: 

Kumvetsetsa Narrowband UVB Phototherapy

"Narrowband" UVB (UVB-NB) yakhala njira yochizira matenda a psoriasis, vitiligo, atopic dermatitis (eczema), ndi matenda ena akhungu. Kumvetsetsa ubwino wa "Narrowband" UVB motsutsana ndi "Broadband" UVB phototherapy kumafuna kumvetsetsa kuwala ndi njira zomwe zimakhudza.

Kuwala kwa kuwala kwa kuwala kumapangidwa ndi mafunde osiyanasiyana a "kuwala" kuyambira 100 nanometers (nm) mumtundu wa ultraviolet (UV) mpaka 1 millimeter (mm) mu infrared (IR). Kuwala kowoneka kumayambira pafupifupi 380 nm (violet) mpaka 780 nm (yofiira) ndipo amadziwika kuti "mitundu" yomwe timawona ndi maso athu. Ultraviolet ndi yosaoneka ndipo imachokera ku 380 nm mpaka 100 nm, ndipo imagawidwanso mu UVA (315-380 nm), UVB (280-315 nm), ndi UVC (100-280 nm).

CHITSANZO A imasonyeza mphamvu ya “kuunika” kwachilengedwe komwe kumafika padziko lapansi pambuyo posefa ndi mpweya wa dziko lapansi. Anthu adasinthika poyang'aniridwa ndi mafunde onsewa, kotero khungu lathu lapanga mayankho ogwiritsira ntchito kuwala kopindulitsa (Vitamini D) komanso kutiteteza kuti tisatengeke mopitirira muyeso (kutengera mtundu wa khungu ndi kutenthedwa). "UVB Narrowband" imawonetsedwa pa 311 nm ndipo imapezeka mwachilengedwe padzuwa, koma osati mochuluka. Mpweya wapadziko lapansi umasefa pafupifupi kuwala konse kochepera 300 nm.
kumvetsetsa narrowband uvb phototherapy
narrawband uvb phototherapy

Mafunde osiyanasiyana a "kuwala" amatulutsa zotsatira zosiyana pa zipangizo. Njira zambiri zofunika zaphunziridwa mwasayansi kuti zitsimikizire momwe gawo lililonse lawavelength limagwirira ntchito. Ma grafu otchedwa "action spectrum" amagwiritsidwa ntchito pofotokoza maubwenzi amenewa. Kuchuluka kwa "action spectrum sensitivity", m'pamenenso imayankha kwambiri ku kutalika kwake.

Zochita za psoriasis zaphunziridwa1,2 kudziwa kuti mafunde achire kwambiri ndi 296 mpaka 313 nm. Monga zikuwonetsedwa mu CHITSANZO B, nyali zamtundu wa UVB-Broadband zimaphimba izi ndipo zakhala zikugwiritsidwa ntchito bwino kwa zaka zoposa 60.

Zochita za "kuwotcha" khungu la munthu, zomwe zimadziwikanso kuti "erythema", zaphunziridwanso.11 Erythema imayang'aniridwa ndi mafunde otsika (osakwana 300 nm) amtundu wa UVB. Tsoka ilo, nyali zamtundu wa UVB-Broadband zimatulutsa "kuwala" kwakukulu mumtundu uwu wa erythemogenic. Mafundewa amawotcha ndipo amakhala ndi chithandizo chochepa. Kuphatikiza apo, kuyambika kwa kuyaka kumachepetsa mlingo wa UVB3 ndipo erythema ndi chiopsezo cha khansa yapakhungu. Erythema imayambitsanso kusapeza bwino kwa odwala, zomwe zingalepheretse odwala ena kuti asamalandire chithandizo. Chigawo cha mthunzi wotuwa mkati CHITSANZO C imapereka chithunzithunzi cha kuchuluka kwa erythemogenic mu UVB-Broadband.

uvbbroadband erythema kumvetsetsa narrowband uvb phototherapy

"Ndiye bwanji osapanga gwero lowala lomwe limatulutsa zambiri mu psoriasis action sipekitiramu ndi kuchepetsa kuwala kwa erythema action sipekitiramu?"

uvbnarrowband erythema kumvetsetsa narrowband uvb phototherapy

Chakumapeto kwa zaka za m'ma 1980, Philips Lighting waku Holland adapanga nyali yotereyi, yomwe imadziwika kuti "TL-01" kapena "UVB Narrowband". Malo ang'onoang'ono amthunzi wotuwa mkati CHITSANZO D zikuwonetsa kuti nyali za UVB-Narrowband zili ndi zotulutsa zochepa kwambiri (zoyaka dzuwa) kuposa nyali wamba za UVB-Broadband. Izi zikutanthauza kuti UVB yochiritsira yochulukirapo imatha kuperekedwa chikangano chisanachitike, ndipo popeza erythema ndiyomwe imayambitsa khansa yapakhungu, nyali zatsopanozi ziyenera kukhala zocheperako chifukwa chamankhwala omwewo.4,5,6,7. Kuphatikiza apo, komanso kofunika kwambiri pakuchita bwino komwe kumawonedwa ndi UVB-Narrowband phototherapy yakunyumba, zimakhala zotheka kwambiri kuti matendawa azitha kuwongoleredwa osafika pachiwopsezo cha erythemogenic.9,10, yomwe nthawi zonse inali vuto ndi chithandizo cha UVB-Broadband. Ndizosangalatsa kudziwa kuti nsonga ya nsonga ya UVB-Narrowband yokhotakhota ndiyokwera pafupifupi nthawi khumi kuposa mapindikidwe a UVB-Broadband, motero gwero la dzina loti "Narrowband".

Kafukufuku waposachedwa watsimikizira zomwe apezazi ndipo adatsimikizanso kuti UVB-Narrowband ili ndi zochitika zochepa zoyaka komanso nthawi yayitali yokhululukidwa kuposa UVB-Broadband. Poyerekeza ndi PUVA (Psoralen + UVA-1 kuwala), UVB-Narrowband ili ndi zotsatira zochepa kwambiri ndipo yalowa m'malo mwake nthawi zambiri.8.

Kuipa kumodzi kwa UVB-Narrowband ndikuti, chifukwa mlingo wochuluka umachepa ndi kuyamba kwa erythema pang'ono, ndipo UVB-Narrowband imakhala yochepa kwambiri kuposa UVB-Broadband, nthawi yayitali yochizira imafunika. Izi zitha kulipidwa powonjezera kuchuluka kwa mababu mu chipangizocho4,5,6,7. Mwachitsanzo, pogwiritsa ntchito phototherapy ya kunyumba ya Solarc pambuyo potsatira malonda a UVB-Broadband, 4-bulb 1740UVB imapereka nthawi zoyenera zothandizira; pomwe UVB-Narrowband, 8-bulb 1780UVB-NB ndi chisankho chofala. The theoretical ratio of erythemogenic potential of UVB-Broadband to UVB-Narrowband ili mu 4:1 mpaka 5:1.

Matenda ena monga vitiligo, eczema, mycosis fungoides (CTCL), ndi ena ambiri adachiritsidwa bwino ndi UVB-Narrowband, makamaka pazifukwa zomwezo zomwe tafotokozazi za psoriasis.

Ubwino winanso wosangalatsa wa UVB-Narrowband ndikuti mwina ndi mtundu wabwino kwambiri wa nyali wa fulorosenti popanga Vitamini D (CHITSANZO E) pakhungu la munthu, kuti agwiritse ntchito m'malo mwa kuwala kwa dzuwa (komwe kumaphatikizapo UVA yovulaza), kapena kwa omwe sangathe kuyamwa Vitamin D (mapiritsi) okwanira chifukwa cha mavuto a m'matumbo. Nkhani ya Vitamini D yalandira chidwi chachikulu posachedwapa, ndipo pazifukwa zomveka. Vitamini D ndi wofunikira pa thanzi la munthu, komabe anthu ambiri alibe, makamaka omwe amakhala kumtunda, kutali ndi equator ya dziko lapansi. Pali umboni wochuluka wosonyeza kuti Vitamini D imateteza ku chitukuko cha matenda ambiri aakulu, kuphatikizapo khansa (m'mawere, colorectal, prostate), matenda a mtima, multiple sclerosis, osteomalacia, osteoporosis, type 1 shuga mellitus, nyamakazi, matenda oopsa, ndi kuvutika maganizo. Kuti mudziwe zambiri, chonde pitani pamasamba awa: Vitamini D Phototherapy FAQ & Nyali za Vitamini D.

uvbnarrowband vitamind kumvetsetsa narrowband uvb phototherapy

Lingaliro lomwe lilipo mdera la dermatology ndikuti UVB-Narrowband pamapeto pake idzalowa m'malo mwa UVB-Broadband ngati njira yochizira, makamaka yojambula kunyumba. Izi zimathandizidwa bwino ndi machitidwe a Solarc Systems pakugulitsa zida zapakhomo, ndi malonda a zida za UVB-NB tsopano akuposa malonda a UVB-BB pafupifupi 100: 1. Mitundu ya UVB-Narrowband ya Solarc ili ndi chowonjezera cha "UVB-NB" mu nambala yachitsanzo, monga 1780UVB-NB. Mitundu ya UVB-Broadband ya Solarc ili ndi chowonjezera cha "UVB", monga 1740UVB.

Solarc Systems ikufuna kuthokoza anthu abwino ku Philips Lighting popanga mzere wa mankhwala a UVB-Narrowband, ndikuthandizira ambiri aife padziko lonse lapansi kuthana ndi vuto la khungu lathu mosamala komanso moyenera. Zindikirani: Ziwerengero zomwe zagwiritsidwa ntchito m'chikalatachi ndi zitsanzo zosavuta. Mapiritsi a UVB-Broadband amachokera ku Solarc/SolRx 1740UVB ndipo UVB-Narrowband curve amachokera ku Solarc/SolRx 1760UVB-NB.

Tikukulimbikitsani kuti mufufuzenso nkhani yofunikayi.

Zothandizira:

1 PARRISH JA, JAENICKE KF (1981) Action Spectrum for phototherapy ya psoriasis. J Invest Dermatol. 76 359
2 FISCHER T, ALSINS J, BERNE B (1984) Ultraviolet-action spectrum ndi kuyesa nyali za ultraviolet za machiritso a psoriasis. Int. J. Dermatol. 23 633
3 BOER I, SCHOTHORST AA, SUURMOND D (1980) UVB phototherapy ya psoriasis. Dermatological 161 250
4 VAN WEELDEN H, BAART DE LA FAILLE H, YOUNG E, VAN DER LEUN JC, (1988) Chitukuko chatsopano mu UVB phototherapy ya psoriasis. British Journal of Dermatology 119
5 KARVONEN J, KOKKONEN E, RUOTSALAINEN E (1989) 311nm UVB nyali pochiza psoriasis ndi Ingram regimen. Acta Derm Venereol (Stockh) 69
6 JOHNSON B, GREEN C, LAKSHMIPATHI T, FERGUSON J (1988) Ultraviolet radiation phototherapy ya psoriasis. Kugwiritsa ntchito nyali yatsopano yopapatiza ya UVB fulorosenti. Proc. 2 yura. Photobiol. Congr., Padua, Italy
7 GREEN C, FERGUSON J, LAKSHMIPATHI T, JOHNSON B 311 UV phototherapy - Chithandizo cha psoriasis. Dipatimenti ya Dermatology, University of Dundee
8 TANEW A, RADAKOVIC-FIJAN S, SC
HEMPER M, HONIGSMANN H (1999) Narrowband UV-B phototherapy vs photochemotherapy pochiza plaque-type psoriasis. Arch Dermatol 1999; 135:519-524
9 WALTERS I, (1999) Suberythematogenic yopapatiza-band UVB ndiyothandiza kwambiri kuposa UVB wamba pochiza psoriasis vulgaris. J Am Acad Dermatol 1999; 40:893-900
10 HAYKAL KA, DESGROSEILLIERS JP (2006) Kodi Narrow-band Ultraviolet B Home Units Ndi Njira Yotheka Yochiritsira Kupitilira kapena Kusamalira Matenda a Khungu Ojambula zithunzi? Journal of Cutaneous Medicine & Surgery, Volume 10, Nkhani 5: 234-240
11 Erythema reference action sipekitiramu ndi muyezo erythema mlingo ISO-17166:1999(E) | CIE S 007/E-1998
12 Action Spectrum for Production Previtamin D3 mu Human Skin CIE 174: 2006