Uma ukhuluma ngakho “Ukhilimu wezinso” abantu abaningi abawubheka njengomkhiqizo oyisimangaliso ezikwazi ukuhlanza umzimba noma ukuvuselela lezi zitho cishe ngendlela eyisimangaliso. Iqiniso lihlukile kakhulu: izinso ziyizakhiwo zangaphakathi ezibucayi kakhulu, futhi akukho ukhilimu ofakwa esikhumbeni ozozilungisa uma sezivele zonakele. Lokho izimonyo noma imithi yamakhambi engakwenza ukunikeza umuzwa wokukhululeka kwendawo engezansi komhlane, kodwa okuncane kakhulu.
Qonda Iyini ngempela into ebizwa ngokuthi ukhilimu wezinso, yiziphi izinzuzo zayo ezicatshangelwayo, futhi yiziphi izingozi zangempela? Lokhu kuhilela ukuxoxa ngokujulile ngokusebenza kwezinso, imithi ezithinta kabi kakhulu, nokuthi ungazivikela kanjani nsuku zonke. Ngaphezu kwalokho, kubalulekile ukuphikisa ezinye izinganekwane eziyingozi: kusukela ekuzelapheni ngezinhlungu kuya emuzweni wokulondeka ongamanga onikezwa "yimikhiqizo yemvelo" engalimaza nezinso, naphezu kokubukeka kwayo okubonakala kungenangozi.
Ziyini izinso futhi kungani ukhilimu ungazelaphi?
Izinso ziyizitho ezimbili ezimise okwebhontshisi ezitholakala ngemuva kwesisu, ezibangela hlunga igazi, ukhiphe ubuthi futhi ulawule ibhalansi yamanzi, usawoti kanye nesisekelo se-asidiKonke esikudlayo, esikuphuzayo, noma esikuphefumulayo, okuhlanganisa nemithi, kugcina kudlula kukho ngokushesha noma kamuva.
Umsebenzi wayo oyinhloko ukusebenza njenge- "isihlungi" esikhulu esinquma ukuthi yiziphi izinto ezikhishwa ngomchamo nokuthi yiziphi ezihlala emzimbeni. Ziphinde zikhiqize ama-hormone alawula umfutho wegazi, akhuthaze ukukhiqizwa kwamangqamuzana abomvu egazi, futhi alondoloze impilo yamathambo.
Ngenxa yale ndima yokuhlunga, izinso ziyasebenza. isengozini enkulu yezinto ezinobuthi kanye nemithi ethileUma ukuchayeka kumuthi noma entweni eyingozi kuthatha isikhathi eside noma kudlulele, umonakalo ungavela buthule, ngaphandle kokubonisa izimpawu kuze kube yizigaba ezithuthukile kakhulu.
Konke lokhu kwenza umqondo we- Ukufaka "ukhilimu wezinso" esikhumbeni somhlane kubonakala, okungenani, kuwubuwula.Izithako ezisebenzayo kukhilimu ofakwe endaweni ethintekile azingeni kakhulu ezingxenyeni ezingaphezulu zesikhumba futhi ngokuqinisekile azifinyeleli ezicutshini zezinso ngobuningi obukhulu. Nakuba amafutha aqukethe i-menthol, i-arnica, noma izithako ezifanayo anganikeza ukukhululeka kwemisipha emhlane ongezansi, lokho akusho ukuthi kuyaphulukisa izinso.
Ukuthanda ukhilimu wezinso: lokho ekuthembisayo nalokho engakwenza ngempela
Eminyakeni yamuva nje ziye zavela ku-inthanethi imikhiqizo ethengiswa ngokuthi “ukhilimu wezinso” noma “ukhilimu wezinso”, ngokuvamile ngaphakathi ezweni izidakamizwa zemvelo noma ukwelapha ngamakhambi. Ukukhangisa kwabo kuvame ukuthembisa ukunciphisa ukuvuvukala kwezinso, "kuzihlanze", noma ukukhulisa amandla azo, kuxuba imiqondo yemithi yendabuko, ukuhlanza umzimba, kanye nokumaketha okunamandla.
Empeleni, iningi lalawa makhilimu Amalungiselelo enziwe ngezitshalo ezinomthelela omncane wokudambisa ubuhlungu noma wokulwa nokuvuvukala (menthol, eucalyptus, i-arnicaAmakhambi (i-rosemary, njll.) angaqeda ukungakhululeki kwemisipha emhlane ongezansi. Lo muzwa wokufudumala noma ukuphola uvame ukuchazwa kabi njengokuthuthukiswa kokusebenza kwezinso, kanti empeleni kuthinta imisipha nesikhumba kuphela.
Inkinga iwukuthi, ngokuthembela kulezi zinhlobo zemikhiqizo, abanye abantu Bayaphuza ukufuna iseluleko sezokwelapha uma benezimpawu ezibonisa isifo sezinso.Izimpawu ezinjengokuvuvukala ezinyaweni nasemaqakaleni, ukukhathala okukhulu, ukwehla komthamo womchamo, noma izinguquko kumbala womchamo zingase zenzeke. Lokhu kubambezeleka kungavumela umonakalo ukuthi uqhubeke futhi ube yisifo esingamahlalakhona.
Enye ingozi ukukholelwa ukuthi, ngoba "kungokwemvelo," ukhilimu noma ukulungiswa kwezitshalo akunangozi. Kuyaziwa ukuthi Amanye amatiye, izithasiselo zamakhambi, kanye nezingxube zezitshalo kungaba yingozi ezinso.ikakhulukazi uma idliwa isikhathi eside noma kubantu abanezici eziyingozi ezikhona kakade (isifo sikashukela, umfutho wegazi ophakeme, isifo sezinso esingamahlalakhona, ukuguga, ukukhulelwa, njll.).
Kufanele kukhunjulwe lokho Akukho muthi noma ukhilimu othize "ovikela izinso" kweminye imithiOkungenziwa ukulungisa imithamo, ukugwema ukuzelapha, nokuqapha ukusebenza kwezinso ngokuhlolwa kwegazi njalo lapho uthatha imithi eyingozi kakhulu.
Izidakamizwa ezilimaza izinso: indima yemithi yokuqeda izinhlungu kanye nemithi yokulwa nokuvuvukala
Esinye sezitha ezinkulu zezinso, esiyingozi kakhulu kunanoma yimuphi ukhilimu,... izidakamizwa ezingezona eze-steroidal ezilwa nokuvuvukala (ama-NSAID)njenge-ibuprofen, i-naproxen noma i-acetylsalicylic acid (i-aspirin) ngemithamo ethile kanye nokusetshenziswa isikhathi eside.
Le mithi isetshenziswa njalo ikhanda elibuhlungu, izinhlungu zemisipha, isifo samathambo, izinhlungu zokuya esikhathini, noma ukulimala kwezemidlaloUkusebenza kwazo ngokushesha, iqiniso lokuthi eziningi zithengiswa ngaphandle kwemithi kadokotela, kanye nezincomo zomlomo kusho ukuthi zidliwa ngokushesha okukhulu, ngokuvamile amasonto noma izinyanga.
Ngokusho kwemithombo efana neMedlinePlus, ama-NSAID asebenza ngokuvimbela ama-enzyme ahilelekile ekuvuvukeni, kodwa ngesikhathi esifanayo Zishintsha ukugeleza kwegazi ezinso kanye nekhono lazo lokuhlunga imfucuza.Ukusetshenziswa isikhathi eside noma imithamo ephezulu kungabangela umonakalo wangaphakathi njenge-papillary necrosis noma i-interstitial nephritis.
Kuye kwabhalwa phansi ukuthi thatha amaphilisi ayisithupha noma ngaphezulu okubulala izinhlungu ngosuku cishe iminyaka emithathu Kukhulisa kakhulu ingozi yokulimala kwezinso okungapheli. Lesi simo, esaziwa ngokuthi i-analgesic nephropathy, sivame ukunganakwa isikhathi eside futhi, kwezinye izimo, singaholela ekuhlulekeni kwezinso esigabeni sokugcina okudinga i-dialysis noma ukufakelwa.
Ingozi iyanda uma idliwa inhlanganisela yemithi yokunciphisa ubuhlungu enezithako eziningana ezisebenzayo Futhi uma kunokusetshenziswa isikhathi eside (iminyaka engaphezu kwemithathu) kubantu abanezinhlungu ezingapheli, isifo samathambo, izinkinga zemisipha, noma izindlela zokuphila ezingaphilile. Ngokuvamile, okuwukuphela kwento ekhombisa ukuthi kukhona okungahambi kahle izimpawu ezingezona eziqondile njengokukhathala, ukuqunjelwa, umchamo onegwebu noma igazi, noma ukwehla kokukhishwa komchamo.
Eminye imithi evamile enobungozi be-nephrotoxic
Ngaphezu kwemithi yokulwa nokuvuvukala, kukhona amanye amaqembu amaningi emithi ekwazi ukulimaza izinso uma zingasetshenziswa ngendlela efanele noma kubantu abasengozini. Akukhona ngokuzenza amademoni, kodwa ngokuzisebenzisa ngendlela efanele nangaphansi kokuqondisa kwezokwelapha.
Imithi yokulwa nokutheleleka (ama-antibiotic, ama-antifungal, ama-antiviral)
Amanye ama-antibiotic aziwa kakhulu ngemiphumela yawo emibi. ingozi eyengeziwe yokubangela ukulimala kwezinsoLokhu kufaka phakathi ama-aminoglycosides, ama-beta-lactam athile, i-vancomycin, ama-fluoroquinolones athile, kanye nama-tetracycline amaningi. Ukusetshenziswa kwawo kuvame ukugcinelwa izifo ezinzima noma ezithile, ngenxa yalobu buthi obungaba khona.
Phakathi kwemithi yokulwa ne-antifungal kukhona imithi efana ne- i-amphotericin B noma i-itraconazole, okungaba nolaka futhi ngokusebenza kwezinso. Kwenzeka okufanayo nakweminye imithi yokulwa nesifo sofuba (i-rifampicin, i-ethambutol, i-isoniazid), imithi yokulwa nezibungu (njenge-pentamidine) kanye nemithi yokulwa namagciwane (i-acyclovir, i-foscarnet, i-ganciclovir, i-tenofovir, i-adefovir, i-indinavir, i-atazanavir, i-cidofovir, phakathi kwezinye).
Kuzo zonke lezi zimo, isihluthulelo Lungisa umthamo ukuze uvumelane nokusebenza kwezinso kwesiguli ngasinye bese uqapha izinga lokuhlunga le-creatinine kanye ne-glomerular.Uma kutholakala ukuthi ukuwohloka, kungadingeka ukuyeka umuthi noma ukuwushintsha ukuze uthole ongewona oyingozi kangako.
Imithi yenhliziyo nemithambo yegazi kanye ne-metabolic
Ngokumangalisayo, eminye imithi esetshenziswa ukuvikela inhliziyo noma ukwehlisa i-cholesterol nayo ine- umthelela ongaba khona ezinsoLokhu kunjalo ngezinye izidakamizwa ezilwa ne-calcium, i-hydralazine, ama-statin, ezinye izidakamizwa zokukhipha isisu noma i-clofibrate, kanye nemithi eqeda ukuvuvukala efana ne-noradrenaline noma i-dopamine.
Kukhona nemithi ewusizo kakhulu ye- isifo sikashukela sohlobo 2 kanye nesifo sezinso esingamahlalakhona ezidinga ukusetshenziswa okuqondiswayo: i-metformin, i-sodium-glucose cotransporter 2 inhibitors (i-SGLT2 noma i-gliflozins), ama-agonist e-GLP-1 receptor, kanye ne-finerenone (umphikisi we-non-steroidal mineralocorticoid receptor).
Le mithi ingase ukubambezela ukuqhubeka kwesifo sezinso nokuthuthukisa ukulawulwa kwe-glycemicKodwa-ke, kumele zinqunywe futhi zilungiswe udokotela ecabangela izinga lokuhlunga kwe-glomerular kanye nokuba khona kwezinye izinkinga (ukwehluleka kwenhliziyo, i-hyperkalemia, njll.).
Imithi ye-psychotropic, imithi yokucindezela amasosha omzimba kanye nokwelashwa komdlavuza
Phakathi kwezidakamizwa zengqondo, okulandelayo kuvelele: I-Lithium, evame ukusetshenziswa enkingeni ye-bipolarokungadala izinkinga zezinso uma amazinga egazi engaqashelwa kahle. I-sevoflurane yokubulala izinzwa ejwayelekile nayo ihlotshaniswa nobuthi obuthile ezimweni ezithile.
Emkhakheni wokucindezela amasosha omzimba, i-cyclosporine yaziwa ngoba Ukusabela kwayo okuyinhloko okubi kakhulu ubuthi obuyingozi.Noma kunjalo, umuthi oyisisekelo ekufakweni kwezitho zomzimba kanye nakwezinye izifo ezihlasela amasosha omzimba, ngakho-ke ukusetshenziswa kwawo kwenziwa ngokuqapha okukhulu.
Imithi yomdlavuza yakudala, njenge i-cisplatin, i-methotrexate, i-cyclophosphamide, noma i-carmustineLe mithi ingalimaza izinso ngenxa yokususwa kwazo kanye nokusetshenziswa kwazo ngendlela ehlelekile. Nakuba kuye kwavela izindlela zokwelapha eziningi ezikhethiwe ezinemiphumela embalwa engathandeki eminyakeni yamuva nje, eziningi zazo azinazo nhlobo izinkinga ezingaba khona zezinso.
Kulesi simo, kuthuthukiswe amathuluzi athile, njenge- Uhlelo lokusebenza lwe-Nefrotox oluvela ku-Spanish Society of Nephrologyokusiza odokotela ukuthi bahlole iphrofayili yemithi yomdlavuza enobuthi futhi balungise kangcono iziqondiso zokunciphisa izingozi.
Ama-radiological contrast agents kanye nama-proton pump inhibitors
Ukuphathwa kwe ama-radiological contrast agents, njengamanye ama-gadolinium compounds Uma isetshenziswa ekuthathweni kwezithombe ze-magnetic resonance, ingabangela ukulimala kwezinso kumaphesenti amakhulu eziguli (kulinganiselwa phakathi kuka-1% no-20%, kuye ngohlobo lwe-contrast agent kanye nesimo sangaphambilini sezinso).
Izinkinga zezinso nazo zichazwe ngokuhambisana ama-proton pump inhibitors (njenge-omeprazole kanye nemithi efanayo), ikakhulukazi uma isetshenziswa isikhathi eside ngaphandle kwesibonakaliso esiqinile noma ukulandelwa okwanele kwezokwelapha.
Isifo sezinso esingamahlalakhona: imithi yokuselapha kanye nezinyathelo zokuphepha
Isifo sezinso esingamahlalakhona (CKD) sikhona namuhla. esinye sezimbangela eziyishumi eziphezulu zokufa emhlabeniImithi eminingi idlala indima ekabili: ngakolunye uhlangothi iyasiza ekulawuleni i-CKD nezinkinga zayo, kanti ngakolunye uhlangothi ingayibhebhethekisa kakhulu uma isetshenziswa ngokunganaki noma ngaphandle kokulungisa umthamo.
Izindlela zokwelapha ezivamile kubantu abane-CKD zifaka phakathi imithi yokwelapha isifo sikashukela, umfutho wegazi ophakeme, ukwehluleka kwenhliziyo, i-cholesterol ephezulu, i-anemia, i-metabolic acidosis, kanye ne-hyperparathyroidism yesibiliZonke zidinga ukubhekwa eduze ngoba izinso ezigulayo azihlungi kahle futhi zivame ukuqongelela imithi.
Isibonelo, ekucindezelekeni kwegazi okuphezulu, kusetshenziswa okulandelayo: ama-angiotensin-converting enzyme (ACE) inhibitors kanye nama-angiotensin II receptor antagonists (ARBs)ezivikela inhliziyo nezinso futhi ezinganciphisa ukuqhubeka kwe-CKD, ngisho nakubantu abangenayo i-hypertension ephawulekayo.
Uma inhliziyo ihluleka, odokotela basebenzisa ama-diuretics, ama-beta-blockers, ama-ACE inhibitors, ama-aldosterone antagonists, kanye nama-potassium chelatorsKonke lokhu kungathinta ukusebenza kwezinso, ngakho-ke kubalulekile ukuhlola njalo i-creatinine, i-potassium, kanye nezinye izilinganiso.
Ezinye izinkinga ezivamile ku-CKD, njenge i-cholesterol ephezulu, i-anemia, i-metabolic acidosis, noma i-hyperparathyroidism yesibiliZiphinde zelashwe ngemithi ethile (ama-statin, izikhuthazi ze-erythropoiesis, izithasiselo zensimbi, i-sodium bicarbonate yomlomo, i-calcimimetics, i-calcium noma i-vitamin D), okuye kwabonakala kuthuthukisa ukwenzeka kwesifo, uma nje zisetshenziswa ngaphansi kokuqashwa.
Kungani izinso zihlushwa kangaka yimithi?
UDkt. Armando Vázquez, udokotela wezinzwa, uchaza ukuthi imithi, kungakhathaliseki ukuthi ithathwa ngomlomo noma ngomjovo, Kumelwe zilandele indlela efanayo ngaso sonke isikhathi: ukumuncwa, ukusatshalaliswa, isenzo, imetabolism, kanye nokususwa kwayoLesi sigaba sokugcina senzeka ikakhulukazi ngesibindi nezinso.
Ngoba izinso zithola ingxenye enkulu yokugeleza kwegazi, hhayi nje kuphela ukuze kondliwe, kodwa futhi ukuze “ukusebenza” egazini nokulihlanzaZizwela kakhulu kunoma yiluphi ushintsho kulolo mjikelezo wegazi noma ekuqongeleleni kwezinto ezinobuthi endaweni.
Kunemithi esetshenziswa Zinciphisa umthamo wegazi ofinyelela ezinso.Lokhu kunciphisa amandla azo okuhlunga. Ezinye zilimaza ngqo amangqamuzana ezinso, njengomugqa wokuhlanganisa lapho izingxenye ziwohloka khona kancane kancane. Futhi ngezinye izikhathi, inkinga iphakama ngoba umuthi, esikhundleni sokususwa, uyanqwabelana, wandise ubuthi bawo.
Kungenzeka futhi ukuthi umzimba uzokhula ukusabela kokungezwani komzimba okutholakala ezinsookwaziwa ngokuthi i-acute nephritis. Uma ukuvezwa kukhulu kakhulu noma kuthatha isikhathi eside, le nqubo yokuvuvukala ingakhula ibe yisifo sezinso esingamahlalakhona.
Ungakukhohlwa lokho Ingozi inkulu kubantu asebevele benezinso "ezonakele".Iziguli ezinezinso ezisebenza kahle eyodwa kuphela, izinso ezingasebenzi kahle, umfutho wegazi ophakeme kakhulu, isifo senhliziyo esithuthukile, isifo sikashukela, ukukhulelwa, noma ukuguga. Kulezi ziguli, noma yikuphi ukucindezeleka kwemithi kunesisindo esiphindwe kabili.
Indlela yokunakekela izinso zakho nsuku zonke: ngale kwama-creams
Uma isifo sezinso noma izici ezibalulekile eziyingozi sezivele zikhona, kubalulekile thatha isinyathelo ngokushesha ukuze umise umonakalo futhi uvimbele ukusabalala kwawoUkulinda uze ube nezimpawu ezibucayi ngokuvamile kusho ukuthi inkinga isithuthukile kakhulu.
Esinye sezinyathelo ezibaluleke kakhulu gcina umfutho wegazi ngaphakathi kwezigaba ezinempilo, ngokuvamile ngaphansi kuka-140/90 mm Hg, noma ngesibalo esinconywe udokotela ngokwesimo ngasinye. ukudla okunosawoti ophansiUkuvivinya umzimba njalo, ukuyeka ukubhema, ukulala ngokwanele, kanye nokuthatha imithi yokwehlisa umfutho wegazi njengoba kuyalelwe kuyizinto eziyisisekelo.
Kubantu abanesifo sikashukela, ukunakekela izinso kuhilela ukufeza ukulawula okuhle kwe-glucose egaziniKubalulekile ukulinganisa njalo i-glucose ye-capillary kanye nokuqapha i-glycated hemoglobin (A1C). Ukugcina i-A1C ingaphansi komgomo okuvunyelwene ngawo nodokotela (ngokuvamile ingaphansi kuka-7%) kusiza ukubambezela noma ukuvimbela ukulimala kwezinso okubangelwa yisifo sikashukela.
Kubalulekile futhi sebenzisana nethimba lezempilo ukuze kuqashwe ukusebenza kwezinsoIzinga lokuhlunga le-glomerular elilinganiselwe (i-GFR), ukuba khona kwe-albumin emchameni, i-creatinine, i-potassium, njll. Ukuqhathanisa imiphumela yamanje neyangaphambilini kusenza sibone ukuthi lesi sifo siyathuthuka yini futhi silungise ukwelashwa.
Lokhu kuqapha kuhilela ochwepheshe abahlukahlukene: udokotela wokunakekelwa okuyisisekelo, isazi sezinzwa, umhlengikazi okhethekile, isazi sokudla kwezinso, umfundisi wesifo sikashukela, usokhemisi kanye, uma kudingeka, isisebenzi sezenhlalakahleNgayinye inikela ngengxenye yephazili ukuze kulondolozwe ikhwalithi engcono kakhulu yokuphila.
Ukusetshenziswa okuphephile kwemithi kanye nezinye izindlela ezingezona ezemithi zobuhlungu
Isincomo esihlanganisa konke yilesi Ungaziniki imithi ngokwakho, ikakhulukazi ngama-painkiller, ama-antibiotic, kanye nemithi "yemvelo".Noma yiliphi iphilisi noma isithasiselo kufanele sihlolwe uchwepheshe owazi isimo sezinso sesiguli.
Labo abadinga imithi eminingana nsuku zonke kufanele bazi ukuthi Iziqondiso zingashintsha ngokuhamba kwesikhathi njengoba ukuhlunga kuba kubi kakhulu: imithamo iyancishiswa, imithamo ihlukaniswa, noma imithi ithathelwa indawo ngeminye enganamandla kangako ezinso.
Kubalulekile futhi ukuqaphela Imithi yobuhlungu, umkhuhlane, noma umkhuhlane etholakala ngaphandle kwemvume kadokotelaNgoba eziningi ziqukethe ama-NSAID (ibuprofen, naproxen, njll.). Ukufunda isembozo sephakheji ngokucophelela nokubuza usokhemisi wakho noma udokotela ukuthi aphephile yini kuwumkhuba omuhle, ikakhulukazi uma unesifo sezinso esingamahlalakhona, isifo sikashukela, noma umfutho wegazi ophakeme.
Njengendlela yokusebenzisa ama-NSAID isikhathi eside ebuhlungu obuncane kuya kobuphakathi, okulandelayo kuyanconywa: amasu okungezona ezemithi Njengokuzivocavoca umzimba, ukuvivinya umzimba ngokuphumula, ukusebenzisa ukushisa noma ukubanda kwendawo, amasu okuphefumula, ukuzindla, noma ukulawula ukucindezeleka. Konke lokhu kungasiza ngaphandle kokucindezela izinso ngokweqile.
Icebo elilula lokugwema ukwesabisa yileli ukugxila ekukhishweni kwemithi ekhemisi elilodwaLokhu kuvumela usokhemisi ukuthi afinyelele uhlu oluphelele futhi abone ukuxhumana okungenzeka noma inhlanganisela eyingozi. Ukuletha uhlu olusesikhathini lwazo zonke izidakamizwa kanye nezithasiselo ezinqumweni zokwelashwa nakho kwenza umsebenzi kadokotela ube lula.
Indlela yokuphila enempilo yezinso
Ngaphandle kwemithi, izinqumo eziningi zansuku zonke zithinta impilo yezinso. Isibonelo, gcina i-hydration enhle Ukuphuza amanzi angenashukela (cishe amalitha ama-2 ngosuku, ajwayele isimo sezulu kanye nomsebenzi womzimba) kusiza izinso ukuqeda ubuthi ukuze zingaqongelelani.
Ukusebenza nodokotela wezokudla ochwepheshe bezifo zezinso kungenza umehluko, njengoba kusiza vumelanisa ukudla nesigaba se-CKD, amazinga e-potassium, i-phosphorus, i-sodium kanye nokuba khona kwesifo sikashukela noma ezinye izifo.Ukupheka ekhaya nokunciphisa ukudla okucutshungulwe kakhulu kuvame ukuba yisinyathelo esibalulekile.
Ukuvivinya umzimba njalo, okunye Imizuzu engama-30 iningi lezinsuku zesontoKuyasiza ukulawula isisindo, ukwehlisa umfutho wegazi kanye namazinga kashukela egazini, kanye nokunciphisa ukucindezeleka. Akudingeki wenze imidlalo ekhethekile: ukuhamba ngokushesha, ukugibela ibhayisikili kancane, noma ukubhukuda konke kuyamukeleka ngokuphelele.
Ukuthola isisindo esinempilo kunciphisa umthwalo womsebenzi ezinso. Amathuluzi aku-inthanethi afana nokuhlela isisindo angaba usizo, kodwa into ebalulekile ukuthi hlanganisa ukudla okulinganiselayo, ukuzivocavoca kanye nokungaguquguqukiUkuphumula ebusuku (amahora angu-7-8) nakho kusiza ekulawuleni ama-hormone, umfutho wegazi kanye nesifiso sokudla.
Ekugcineni, ukuyeka ukubhema kungenye yezipho ezinhle kakhulu ongazinika izinso zakho. Kulimaza imithambo yegazi, kubhebhethekise umfutho wegazi ophakeme, futhi kusheshise ukuqhubeka kwesifo sezinso.Ukufuna usizo lochwepheshe noma ukusebenzisa izinhlelo zokuyeka ukubhema kwandisa kakhulu amathuba okuphumelela.
Ukulawula ukucindezeleka kanye nokucindezeleka okungenzeka okuhambisana nesifo esingamahlalakhona nakho kubalulekile. Ukusekelwa kwengqondo, amaqembu eziguli, abangani noma umndeni ongakhuluma nawo Kungenza inqubo ibe lula futhi kukhuthaze umuntu ukuba alandele izincomo zezokwelapha.
Ukuqonda lokho okwenziwa yizinso ngempela, ukuthi imithi ehlukene izithinta kanjani, kanye nendima yemikhuba yansuku zonke kusisiza siqonde ukuthi kungani Akukho "khilimu wezinso" ozothatha indawo yokubhekwa kwezokwelapha, ukuhlolwa kwegazi njalo, kanye nokusetshenziswa kwemithi ngendlela efanele.Ukunakekela lezi zitho kuhilela ukwenza izinqumo ezinolwazi, ukuhlonipha imithi kadokotela, nokwamukela indlela yokuphila enciphisa umthwalo wazo womsebenzi kunokuba iwungeze.
