{"id":29944,"date":"2023-05-06T22:03:57","date_gmt":"2023-05-06T15:03:57","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29944"},"modified":"2023-05-06T22:03:57","modified_gmt":"2023-05-06T15:03:57","slug":"chong-mat-co-che-duoc-ly-trong-dieu-tri-va-vai-tro-cua-nhom-thuoc-thuc-day-bu-tru-tien-dinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/chong-mat-co-che-duoc-ly-trong-dieu-tri-va-vai-tro-cua-nhom-thuoc-thuc-day-bu-tru-tien-dinh\/","title":{"rendered":"Cho\u0301ng m\u0103\u0323t – C\u01a1 ch\u1ebf d\u01b0\u1ee3c l\u00fd trong \u0111i\u1ec1u tri\u0323 v\u00e0 vai tr\u00f2 c\u1ee7a nh\u00f3m thu\u1ed1c th\u00fac \u0111\u1ea9y b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh"},"content":{"rendered":"

Cho\u0301ng m\u0103\u0323t\u00a0l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng r\u1ea5t ph\u1ed5 bi\u1ebfn m\u00e0 h\u1ea7u h\u1ebft m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u \u0111\u00e3 t\u1eebng tr\u1ea3i qua \u00edt nh\u1ea5t m\u1ed9t l\u1ea7n. Tri\u1ec7u ch\u1ee9ng n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c xoay v\u00f2ng, m\u1ea5t c\u00e2n b\u1eb1ng. Nguy\u00ean nh\u00e2n c\u1ee7a ch\u00f3ng m\u1eb7t<\/a> c\u00f3 th\u1ec3 l\u00e0 do nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 thi\u1ebfu m\u00e1u n\u00e3o, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a, r\u1ed1i lo\u1ea1n th\u1ea7n kinh ho\u1eb7c t\u00ecnh tr\u1ea1ng lo \u00e2u. \u0110\u1ec3 \u0111i\u1ec1u tr\u1ecb cho\u0301ng m\u0103\u0323t, c\u00e1c b\u00e1c s\u0129 th\u01b0\u1eddng \u0111\u01b0a ra c\u00e1c gi\u1ea3i ph\u00e1p kh\u00e1c nhau d\u1ef1a tr\u00ean nguy\u00ean nh\u00e2n g\u00e2y ra tri\u1ec7u ch\u1ee9ng. Ba\u0300i vi\u00ea\u0301t sau se\u0303 ba\u0300n v\u00ea\u0300 c\u01a1 ch\u1ebf d\u01b0\u1ee3c l\u00fd trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t v\u00e0 vai tr\u00f2 c\u1ee7a nh\u00f3m thu\u1ed1c th\u00fac \u0111\u1ea9y b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh.<\/p>\n

\"Cho\u0301ng
Cho\u0301ng m\u0103\u0323t<\/figcaption><\/figure>\n

Ba\u0300i vi\u00ea\u0301t tri\u0301ch ngu\u00f4\u0300n t\u01b0\u0300 H\u00f4\u0323i th\u00e2\u0300n kinh ho\u0323c Vi\u00ea\u0323t Nam<\/strong><\/em><\/p>\n

Ta\u0301c gia\u0309:<\/strong><\/em><\/p>\n

Nguy\u1ec5n H\u1ea3i Anh 1,3, V\u00f5 H\u1ed3ng Kh\u00f4i 1,2,3<\/strong>
\nTrung t\u00e2m Th\u1ea7n kinh, B\u1ec7nh vi\u1ec7n B\u1ea1ch Mai 1
\nB\u1ed9 m\u00f4n Th\u1ea7n kinh, \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i 2
\nB\u1ed9 m\u00f4n Th\u1ea7n kinh, \u0110\u1ea1i h\u1ecdc Y d\u01b0\u1ee3c \u0110\u1ea1i h\u1ecdc Qu\u1ed1c gia H\u00e0 N\u1ed9i 3<\/p>\n

Cho\u0301ng m\u0103\u0323t l\u00e0 m\u1ed9t trong nh\u1eefng tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng v\u1edbi nguy\u00ean nh\u00e2n \u0111\u01b0\u1ee3c chia th\u00e0nh hai nh\u00f3m ch\u00ednh g\u1ed3m t\u1ed5n th\u01b0\u01a1ng ngo\u1ea1i bi\u00ean v\u00e0 trung \u01b0\u01a1ng. C\u00e1c b\u1ec7nh l\u00fd ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i bi\u00ean ph\u1ed5 bi\u1ebfn nh\u1ea5t bao g\u1ed3m Ch\u00f3ng m\u1eb7t t\u01b0 th\u1ebf k\u1ecbch ph\u00e1t l\u00e0nh t\u00ednh, M\u00e9ni\u00e8re, Vi\u00eam d\u00e2y th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh, Migraine ti\u1ec1n \u0111\u00ecnh v\u00e0 U d\u00e2y th\u1ea7n kinh s\u1ed1 VIII. Trong khi \u0111\u00f3, ch\u00f3ng m\u1eb7t trung \u01b0\u01a1ng c\u00f3 th\u1ec3 l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a c\u00e1c B\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u n\u00e3o, Vi\u00eam nhi\u1ec5m, Ch\u1ea5n th\u01b0\u01a1ng, Tho\u00e1i h\u00f3a,\u2026
\nHi\u1ec7n t\u1ea1i, c\u00e1c nh\u00f3m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb cho\u0301ng m\u0103\u0323t bao g\u1ed3m nh\u00f3m kh\u00e1ng cholinergic, kh\u00e1ng histamine, benzodiazepine, \u0111\u1ed1i v\u1eadn k\u00eanh calci, \u0111\u1ed1i v\u1eadn dopamine v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u00f3m thu\u1ed1c k\u00edch th\u00edch kh\u1ea3 n\u0103ng b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh c\u00f3 li\u00ean quan \u0111\u1ebfn h\u1ec7 glutamate \u0111ang \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng nhi\u1ec1u tr\u00ean l\u00e2m s\u00e0ng. C\u00e1c thu\u1ed1c n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng t\u00e1c \u0111\u1ed9ng l\u00ean nhi\u1ec1u c\u01a1 ch\u1ebf kh\u00e1c nhau. Ch\u00fang c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh m\u1ee9c \u0111\u1ed9 b\u1ec7nh (v\u00ed d\u1ee5: \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh) ho\u1eb7c t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn ch\u00ednh nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh (nh\u01b0 tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i v\u1eadn k\u00eanh calci \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb Migraine ti\u1ec1n \u0111\u00ecnh). \u0110a s\u1ed1 c\u00e1c nh\u00f3m thu\u1ed1c n\u00e0y, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c thu\u1ed1c g\u00e2y an th\u1ea7n, \u0111\u1ec1u c\u00f3 kh\u1ea3 n\u0103ng \u0111i\u1ec1u ho\u00e0 m\u1ee9c \u0111\u1ed3 b\u00f9 tr\u1eeb sau t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n \u0111\u00ecnh. Trong nh\u1eefng n\u0103m g\u1ea7n \u0111\u00e2y, b\u00ean c\u1ea1nh vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c, c\u00e1c li\u1ec7u ph\u00e1p ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng ti\u1ec1n \u0111\u00ecnh c\u0169ng \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng nh\u01b0 m\u1ed9t trong nh\u1eefng b\u01b0\u1edbc c\u01a1 b\u1ea3n c\u1ee7a qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. Hi\u1ec3u bi\u1ebft v\u1ec1 d\u01b0\u1ee3c l\u00fd c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb cho\u0301ng m\u0103\u0323t s\u1ebd gi\u00fap b\u00e1c s\u0129 c\u00f3 c\u00e1i nh\u00ecn t\u1ed5ng qu\u00e1t v\u00e0 l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c nh\u00f3m thu\u1ed1c ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh nh\u00e2n c\u1ee7a m\u00ecnh. Trong ph\u1ea1m vi b\u00e0i b\u00e1o ng\u00e0y h\u00f4m nay, ch\u00fang t\u00f4i xin ph\u00e9p \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y v\u1ec1 t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb cho\u0301ng m\u0103\u0323t, \u0111\u1eb7c bi\u1ec7t l\u00e0 c\u00e1c thu\u1ed1c hi\u1ec7n c\u00f3 s\u1eb5n t\u1ea1i th\u1ecb tr\u01b0\u1eddng Vi\u1ec7t Nam.<\/p>\n

1. Sinh l\u00fd h\u1ecdc Cho\u0301ng m\u0103\u0323t<\/strong><\/h2>\n

Ch\u00f3ng m\u1eb7t l\u00e0 c\u1ea3m gi\u00e1c chuy\u1ec3n \u0111\u1ed9ng dao \u0111\u1ed9ng. Tr\u00ean l\u00e2m s\u00e0ng, c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y ch\u00f3ng m\u1eb7t th\u01b0\u1eddng \u0111\u01b0\u1ee3c cho r\u1eb1ng \u0111\u1ebfn t\u1eeb h\u1ec7 th\u1ed1ng tai, g\u00e2y ra b\u1edfi r\u1ed1i lo\u1ea1n kh\u1ea3 n\u0103ng ti\u1ebfp nh\u1eadn v\u1eadn t\u1ed1c t\u1ea1i tai trong, c\u1ee5 th\u1ec3 l\u00e0 c\u00e1c \u1ed1ng b\u00e1n khuy\u00ean. Tuy v\u1eady, nguy\u00ean nh\u00e2n g\u00e2y cho\u0301ng m\u0103\u0323t c\u00f3 th\u1ec3 \u0111\u1ebfn t\u1eeb c\u00e1c b\u1ed9 ph\u1eadn kh\u00e1c. \u0110\u1ec3 duy tr\u00ec t\u01b0 th\u1ebf b\u00ecnh th\u01b0\u1eddng, m\u1ed7i c\u01a1 th\u1ec3 c\u1ea7n ba h\u1ec7 th\u1ed1ng ti\u1ebfp nh\u1eadn c\u1ea3m gi\u00e1c bao g\u1ed3m h\u1ec7 ti\u1ec1n \u0111\u00ecnh (tai trong), th\u1ecb gi\u00e1c v\u00e0 c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3, ch\u00fang c\u00f9ng nhau ph\u1ed1i h\u1ee3p \u0111\u1ec3 gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng s\u1ef1 chuy\u1ec3n \u0111\u1ed9ng c\u1ee7a \u0111\u1ea7u v\u00e0 c\u01a1 th\u1ec3 trong kh\u00f4ng gian. Khi c\u00f3 s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng hai b\u00ean g\u00e2y ra b\u1edfi r\u1ed1i lo\u1ea1n c\u00e1c h\u1ec7 th\u1ed1ng n\u00e0y, cho\u0301ng m\u0103\u0323t s\u1ebd x\u1ea3y ra.
\nV\u1ec1 m\u1eb7t l\u00fd thuy\u1ebft, b\u1ea5t th\u01b0\u1eddng c\u1ee7a m\u1ed9t trong ba h\u1ec7 th\u1ed1ng ti\u1ec1n \u0111\u00ecnh (tai trong), th\u1ecb gi\u00e1c v\u00e0 c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y ra cho\u0301ng m\u0103\u0323t. Tuy nhi\u00ean tr\u00ean l\u00e2m s\u00e0ng, th\u1ecb gi\u00e1c v\u00e0 c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 ch\u1ee7 y\u1ebfu \u0111\u00f3ng g\u00f3p vai tr\u00f2 trong vi\u1ec7c c\u1ea3m nh\u1eadn v\u1ecb tr\u00ed, ch\u00f3ng m\u1eb7t \u00edt khi g\u00e2y ra khi ch\u1ec9 t\u1ed5n th\u01b0\u01a1ng m\u1ed9t trong hai h\u1ec7 th\u1ed1ng n\u00e0y. Cho\u0301ng m\u0103\u0323t do c\u0103n nguy\u00ean th\u1ecb gi\u00e1c th\u01b0\u1eddng ch\u1ec9 x\u1ea3y ra khi c\u00f3 b\u1ea5t th\u01b0\u1eddng nh\u00e3n c\u1ea7u \u0111i k\u00e8m m\u00e0 c\u1ee5 th\u1ec3 l\u00e0 rung gi\u1eadt nh\u00e3n c\u1ea7u. C\u00e1c r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c th\u01b0\u1eddng g\u1eb7p kh\u00e1c, bao g\u1ed3m gi\u1ea3m th\u1ecb l\u1ef1c, nh\u00ecn \u0111\u00f4i ho\u1eb7c r\u1ed1i lo\u1ea1n kh\u1ea3 n\u0103ng \u0111i\u1ec1u ti\u1ebft th\u01b0\u1eddng kh\u00f4ng g\u00e2y ra ch\u00f3ng m\u1eb7t. T\u01b0\u01a1ng t\u1ef1, ch\u00f3ng m\u1eb7t li\u00ean quan \u0111\u1ebfn c\u1ea3m gi\u00e1c b\u1ea3n th\u1ec3 ch\u1ec9 x\u1ea3y ra v\u1edbi ch\u00f3ng m\u1eb7t c\u1ed5 (cervical vertigo, ch\u00f3ng m\u1eb7t g\u00e2y ra do c\u00f3 nh\u1eefng ch\u00e8n \u00e9p \u0111\u1ebfn c\u1ed9t sau t\u1ea1i v\u00f9ng c\u1ed5). Ch\u00f3ng m\u1eb7t do c\u0103n nguy\u00ean trung \u01b0\u01a1ng th\u01b0\u1eddng g\u1eb7p h\u01a1n nh\u01b0ng v\u1eabn t\u01b0\u01a1ng \u0111\u1ed1i hi\u1ebfm n\u1ebfu so v\u1edbi ch\u00f3ng m\u1eb7t do nguy\u00ean nh\u00e2n ti\u1ec1n \u0111\u00ecnh.
\nKhi l\u00ean k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, ch\u00f3ng m\u1eb7t c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ph\u00e2n bi\u1ec7t v\u1edbi c\u1ea3m gi\u00e1c n\u00f4n nao (motion sickness) v\u1edbi bi\u1ec3u hi\u1ec7n l\u00e0 m\u1ec7t m\u1ecfi v\u00e0 n\u00f4n th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n ngay sau khi c\u00f3 ch\u00f3ng m\u1eb7t th\u1ef1c s\u1ef1. C\u1ea7n ph\u1ea3i ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c ch\u00f3ng m\u1eb7t v\u00e0 n\u00f4n nao. V\u00ed d\u1ee5, n\u00f4n nao th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n sau khi b\u1ec7nh nh\u00e2n ch\u01a1i \u0111u quay ho\u1eb7c do \u0111i t\u00e0u xe. Tr\u00ean l\u00e2m s\u00e0ng, n\u00f4n nao th\u01b0\u1eddng k\u00e9o d\u00e0i l\u00e2u h\u01a1n v\u00e0 ch\u00fang g\u00e2y ra c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu h\u01a1n cho ng\u01b0\u1eddi b\u1ec7nh. B\u00ean c\u1ea1nh \u0111\u00f3, m\u1eb7c d\u00f9 c\u00e1c r\u1ed1i lo\u1ea1n ti\u1ec1n \u0111\u00ecnh l\u00e0 gi\u1ed1ng nhau gi\u1eefa c\u00e1c ng\u01b0\u1eddi b\u1ec7nh, m\u1ee9c \u0111\u1ed9 tr\u1ea7m tr\u1ecdng c\u1ee7a tri\u1ec7u ch\u1ee9ng l\u1ea1i bi\u1ebfn thi\u00ean r\u1ea5t l\u1edbn gi\u1eefa c\u00e1c c\u00e1 th\u1ec3 kh\u00e1c nhau. Vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t v\u00e0 n\u00f4n nao c\u0169ng c\u00f3 nhi\u1ec1u \u0111i\u1ec3m kh\u00e1c bi\u1ec7t.
\nKhi l\u00ean k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb, qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i v\u00e0 b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c ch\u00fa \u00fd. B\u1ea5t c\u1ee9 k\u00edch th\u00edch ti\u1ec1n \u0111\u00ecnh n\u00e0o c\u0169ng \u0111\u1ec1u c\u00f3 th\u1ec3 kh\u1edfi \u0111\u1ed9ng m\u1ed9t qu\u00e1 tr\u00ecnh thay \u0111\u1ed5i s\u1ef1 b\u00f9 tr\u1eeb. Th\u00f4ng th\u01b0\u1eddng, c\u00e1c thu\u1ed1c l\u00e0m gi\u1ea3m ch\u00f3ng m\u1eb7t ho\u1eb7c n\u00f4n nao \u0111\u1ec1u c\u00f3 t\u00e1c d\u1ee5ng g\u00e2y \u1ee9c ch\u1ebf b\u00f9 tr\u1eeb. Khi \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t, c\u00f3 hai nguy\u00ean t\u1eafc ch\u00ednh m\u00e0 m\u1ed7i b\u00e1c s\u0129 n\u00ean c\u00e2n nh\u1eafc tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c: v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng m\u1ea5t c\u00e2n b\u1eb1ng ti\u1ec1n \u0111\u00ecnh dai d\u1eb3ng (v\u00ed d\u1ee5 nh\u01b0 sau Vi\u00eam d\u00e2y th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh m\u1ee9c \u0111\u1ed9 n\u1eb7ng), vi\u1ec7c k\u00edch th\u00edch b\u00f9 tr\u1eeb trung \u01b0\u01a1ng c\u00f3 th\u1ec3 \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3 \u0111\u00e1ng mong \u0111\u1ee3i. Ng\u01b0\u1ee3c l\u1ea1i, v\u1edbi c\u00e1c m\u1ea5t c\u00e2n b\u1eb1ng ti\u1ec1n \u0111\u00ecnh tho\u00e1ng qua (nh\u01b0 trong b\u1ec7nh M\u00e9ni\u00e8re) c\u1ea7n tr\u00e1nh s\u1ef1 b\u00f9 tr\u1eeb kh\u00f4ng c\u1ea7n thi\u1ebft v\u00e0 th\u1eadm ch\u00ed c\u00f3 th\u1ec3 g\u00e2y ph\u1ea3n t\u00e1c d\u1ee5ng.<\/p>\n

2. C\u00e1c ch\u1ea5t d\u1eabn truy\u1ec1n trung gian tham gia v\u00e0o c\u01a1 ch\u1ebf g\u00e2y Cho\u0301ng m\u0103\u0323t<\/strong><\/h2>\n

C\u00f3 \u00edt nh\u1ea5t s\u00e1u ch\u1ea5t d\u1eabn truy\u1ec1n trung gian h\u00f3a h\u1ecdc c\u1ee7a h\u1ec7 th\u1ed1ng ti\u1ec1n \u0111\u00ecnh li\u00ean quan \u0111\u1ebfn c\u01a1 ch\u1ebf g\u00e2y ch\u00f3ng m\u1eb7t. Glutamate l\u00e0 ch\u1ea5t d\u1eabn truy\u1ec1n g\u00e2y k\u00edch th\u00edch c\u00f3 m\u1eb7t \u1edf h\u1ea7u h\u1ebft c\u00e1c neuron. Th\u1ee5 th\u1ec3 c\u1ee7a glutamate bao g\u1ed3m AMPA (acid alpha-amino-3-hydroxy-5-methylisoxazole-4-proprionic) c\u00f3 vai tr\u00f2 gi\u00e1n ti\u1ebfp trong synap. Trong khi \u0111\u00f3 th\u1ee5 th\u1ec3 NMDA (N-methyl-D-aspartate) c\u00f3 vai tr\u00f2 trong duy tr\u00ec \u0111i\u1ec7n th\u1ebf ngh\u1ec9 c\u1ee7a neuron ti\u1ec1n \u0111\u00ecnh trung \u01b0\u01a1ng c\u0169ng nh\u01b0 \u0111i\u1ec1u ho\u00e0 d\u00e0i h\u1ea1n v\u1eadn chuy\u1ec3n qua synap t\u1ea1i c\u00e1c c\u1ea5u tr\u00fac ti\u1ec1n \u0111\u00ecnh trung \u01b0\u01a1ng.
\nAcetylcholine l\u00e0 \u0111\u1ed3ng v\u1eadn c\u1ee7a th\u1ee5 th\u1ec3 muscarinic \u1edf c\u1ea3 ngo\u1ea1i bi\u00ean v\u00e0 trung \u01b0\u01a1ng. Tuy nhi\u00ean, acetylcholine ngo\u1ea1i bi\u00ean c\u00f3 vai tr\u00f2 kh\u00f4ng r\u00f5 r\u00e0ng. \u1ede trung \u01b0\u01a1ng, acetylcholine c\u00f3 vai tr\u00f2 nh\u01b0 m\u1ed9t ch\u1ea5t d\u1eabn truy\u1ec1n trung gian g\u00e2y h\u01b0ng ph\u1ea5n. C\u1ea3 th\u1ee5 th\u1ec3 c\u1ee7a nicotinic v\u00e0 muscarinic \u0111\u1ec1u c\u00f3 m\u1eb7t \u1edf nh\u00e2n ti\u1ec1n \u0111\u00ecnh v\u1edbi m\u1eadt \u0111\u1ed9 cao.
\nGABA l\u00e0 ch\u1ea5t d\u1eabn truy\u1ec1n trung gian g\u00e2y \u1ee9c ch\u1ebf th\u00f4ng quan m\u00e9p tr\u1eafng (commisures) gi\u1eefa c\u00e1c nh\u00e2n ti\u1ec1n \u0111\u00ecnh gi\u1eefa. Ngo\u00e0i ra, ch\u00fang c\u0169ng \u1ee9c ch\u1ebf gi\u1eefa t\u1ebf b\u00e0o Purkinje ti\u1ec3u n\u00e3o v\u00e0 nh\u00e2n ti\u1ec1n \u0111\u00ecnh b\u00ean. K\u00edch th\u00edch c\u1ea3 hai nh\u00f3m th\u1ee5 th\u1ec3 c\u1ee7a GABA, GABA A v\u00e0 GABA B \u0111\u1ec1u \u0111em l\u1ea1i hi\u1ec7u qu\u1ea3 \u1ee9c ch\u1ebf tr\u00ean con \u0111\u01b0\u1eddng ti\u1ec1n \u0111\u00ecnh. C\u00e1c ch\u1ea5t \u0111\u1ed3ng v\u1eadn c\u1ee7a GABA B nh\u01b0 baclofen l\u00e0m gi\u1ea3m th\u1eddi gian \u0111\u00e1p \u1ee9ng ti\u1ec1n \u0111\u00ecnh \u1edf \u0111\u1ed9ng v\u1eadt. GABA c\u0169ng tham gia v\u00e0o \u1ee9c ch\u1ebf h\u1ec7 th\u1ed1ng ti\u1ec1n \u0111\u00ecnh \u2013 m\u1eaft theo chi\u1ec1u d\u1ecdc, trong khi glycine tham gia v\u00e0o h\u1ec7 th\u1ed1ng n\u00e0y theo chi\u1ec1u ngang.
\nC\u01a1 ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c ch\u1ea5t d\u1eabn truy\u1ec1n trung gian kh\u00e1c trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t c\u00f2n ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5. Histamine \u0111\u01b0\u1ee3c t\u00ecm th\u1ea5y \u1edf h\u1ea7u h\u1ebft c\u00e1c c\u1ea5u tr\u00fac c\u1ee7a h\u1ec7 ti\u1ec1n \u0111\u00ecnh trung \u01b0\u01a1ng, c\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1ng histamine trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t ch\u1ee7 y\u1ebfu li\u00ean quan \u0111\u1ebfn v\u1ecb tr\u00ed n\u00e0y. K\u00edch th\u00edch c\u00e1c th\u1ee5 th\u1ec3 H1 v\u00e0 H2 g\u00e2y h\u01b0ng ph\u1ea5n c\u00e1c neuron ti\u1ec1n \u0111\u00ecnh gi\u1eefa. Noradenaline gi\u00fap \u0111i\u1ec1u ho\u00e0 c\u01b0\u1eddng \u0111\u1ed9 ph\u1ea3n \u1ee9ng trung \u01b0\u01a1ng c\u1ee7a c\u00e1c k\u00edch th\u00edch ti\u1ec1n \u0111\u00ecnh v\u00e0 t\u0103ng c\u01b0\u1eddng qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb. C\u00e1c thu\u1ed1c thu\u1ed9c h\u1ec7 adrenergic trung \u01b0\u01a1ng nh\u01b0 amphetamine v\u00e0 ephedrien c\u00f3 vai tr\u00f2 d\u1ef1 ph\u00f2ng ch\u1ed1ng l\u1ea1i c\u1ea3m gi\u00e1c n\u00f4n nao (khi \u0111i t\u00e0u xe). Dopamine t\u0103ng c\u01b0\u1eddng qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh, trong khi c\u00e1c thu\u1ed1c ch\u1eb9n dopamine c\u00f3 th\u1ec3 tr\u00ec ho\u00e3n qu\u00e1 tr\u00ecnh ph\u1ee5c h\u1ed3i.<\/p>\n

3. C\u00e1c nh\u00f3m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb Cho\u0301ng m\u0103\u0323t<\/strong><\/h2>\n

3.1. Thu\u1ed1c \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh<\/strong><\/em><\/h3>\n\n\n\n\n\n\n\n\n\n\n\n\n
C\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh<\/strong><\/td>\n<\/tr>\n
T\u00ean thu\u1ed1c<\/strong><\/td>\nLi\u1ec1u d\u00f9ng<\/strong><\/td>\nT\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd<\/strong><\/td>\nT\u00e1c d\u1ee5ng ph\u1ee5<\/strong><\/td>\n<\/tr>\n
Meclozine<\/strong><\/td>\nU\u1ed1ng, 12,5-50mg\/4-6h<\/td>\nKh\u00e1ng histamine, kh\u00e1ng cholinergic<\/td>\nAn th\u1ea7n, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi ph\u00ec \u0111\u1ea1i TLT<\/td>\n<\/tr>\n
Clonazepam *<\/strong><\/td>\nU\u1ed1ng, 0,5mg, 02l\u1ea7n\/ng\u00e0y<\/td>\nBZD<\/td>\nAn th\u1ea7n nh\u1eb9, ph\u1ee5 thu\u1ed9c thu\u1ed1c<\/td>\n<\/tr>\n
Scopolamine<\/strong><\/td>\n0,5mg d\u00e1n m\u1ed7i 3 ng\u00e0y<\/td>\nKh\u00e1ng cholinergic<\/td>\nD\u1ecb \u1ee9ng m\u1eaft, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi b\u1ec7nh glaucoma, nh\u1ecbp nhanh, ph\u00ec \u0111\u1ea1i TLT<\/td>\n<\/tr>\n
Dimenhydrinate<\/strong><\/td>\nU\u1ed1ng, 50mg\/4-6h<\/td>\nKh\u00e1ng histamine kh\u00e1ng cholinergic<\/td>\nAn th\u1ea7n, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi ph\u00ec \u0111\u1ea1i TLT<\/td>\n<\/tr>\n
Diazepam *<\/strong><\/td>\n2-10mg\/l\u1ea7n, u\u1ed1ng, TTM ho\u1eb7c TB khi x\u1eed tr\u00ed c\u1ea5p ho\u1eb7c 2mg 02 l\u1ea7n\/ng\u00e0y<\/td>\nBZD<\/td>\nAn th\u1ea7n, \u1ee9c ch\u1ebf h\u00f4 h\u1ea5p, ph\u1ee5 thu\u1ed9c thu\u1ed1c, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi b\u1ec7nh glaucoma<\/td>\n<\/tr>\n
Lorazepam<\/strong><\/td>\n0,5mg, 02l\u1ea7n\/ng\u00e0y<\/td>\nBZD<\/td>\nAn th\u1ea7n nh\u1eb9, ph\u1ee5 thu\u1ed9c thu\u1ed1c<\/td>\n<\/tr>\n
Diphenhydramine *<\/strong><\/td>\n25-50mg\/6-8h<\/td>\nKh\u00e1ng histamine<\/td>\nAn th\u1ea7n, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi ph\u00ec \u0111\u1ea1i TLT<\/td>\n<\/tr>\n
TTM: ti\u00eam t\u0129nh m\u1ea1ch, TB: ti\u00eam b\u1eafp, BZD: benzodiazepine, TLT: ti\u1ec1n li\u1ec7t tuy\u1ebfn*d\u1ec5 ti\u1ebfp c\u1eadn \u1edf Vi\u1ec7t Nam<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thu\u1ed1c \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh l\u00e0 nh\u00f3m thu\u1ed1c gi\u00fap l\u00e0m gi\u1ea3m rung gi\u1eadt nh\u00e3n c\u1ea7u g\u00e2y ra b\u1edfi m\u1ea5t c\u00e2n b\u1eb1ng ti\u1ec1n \u0111\u00ecnh, bao g\u1ed3m ba nh\u00f3m ch\u00ednh: kh\u00e1ng cholinergic, kh\u00e1ng histamine v\u00e0 benzodizepine. B\u00ean c\u1ea1nh \u0111\u00f3, nh\u00f3m thu\u1ed1c \u0111\u1ed1i v\u1eadn k\u00eanh calci c\u0169ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 trong \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh.<\/p>\n

3.2. Thu\u1ed1c kh\u00e1ng cholinergic<\/strong><\/h3>\n

Thu\u1ed1c kh\u00e1ng cholinergic c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh trung \u01b0\u01a1ng th\u00f4ng qua c\u01a1 ch\u1ebf \u1ee9c ch\u1ebf ph\u00e1t xung c\u1ee7a nh\u00e2n ti\u1ec1n \u0111\u00ecnh tr\u00ean \u0111\u1ed9ng v\u1eadt v\u00e0 gi\u1ea3m thi\u1ec3u v\u1eadn t\u1ed1c c\u1ee7a rung gi\u1eadt nh\u00e3n c\u1ea7u \u1edf ng\u01b0\u1eddi. Thu\u1ed1c kh\u00e1ng cholinergic r\u1ea5t hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng n\u00f4n nao, \u0111\u1eb7c bi\u1ec7t trong say t\u00e0u xe. Scopolamine c\u00f3 vai tr\u00f2 l\u00e0m t\u0103ng t\u00ednh th\u00edch \u1ee9ng khi di chuy\u1ec3n, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi d\u1ea1ng mi\u1ebfng d\u00e1n.<\/p>\n

3.3. Thu\u1ed1c kh\u00e1ng histamine<\/strong><\/h3>\n

T\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1ng histamine \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t c\u0169ng c\u00f3 hi\u1ec7u qu\u1ea3 tr\u00ean h\u1ec7 cholinergic. Tr\u00ean l\u00e2m s\u00e0ng c\u1ea7n ch\u00fa \u00fd c\u00e1c thu\u1ed1c kh\u00e1ng histamine kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng \u0111i qua h\u00e0ng r\u00e0o m\u00e1u n\u00e3o c\u0169ng s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t.<\/p>\n

3.4. Benzodiazepine<\/strong><\/h3>\n

Benzodiazepine \u0111i\u1ec1u ho\u00e0 h\u1ec7 GABA, c\u00f3 t\u00e1c d\u1ee5ng ch\u00ednh trong \u1ee9c ch\u1ebf \u0111\u00e1p \u1ee9ng ti\u1ec1n \u0111\u00ecnh. V\u1edbi li\u1ec1u l\u01b0\u1ee3ng th\u1ea5p, BDZ c\u00f3 hi\u1ec7u qu\u1ea3 c\u1ef1c k\u1ef3 t\u1ed1t trong qu\u1ea3n l\u00fd ch\u00f3ng m\u1eb7t v\u00e0 d\u1ef1 ph\u00f2ng say do t\u00e0u xe. Tuy v\u1eady, s\u1eed d\u1ee5ng BDZ c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn nh\u1eddn thu\u1ed1c, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn tr\u00ed nh\u1edb v\u00e0 t\u0103ng nguy c\u01a1 ng\u00e3 c\u1ee7a b\u1ec7nh nh\u00e2n. M\u1eb7c d\u00f9 nhi\u1ec1u \u00fd ki\u1ebfn cho r\u1eb1ng s\u1eed d\u1ee5ng BDZ c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng b\u00f9 tr\u1eeb sau t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n \u0111\u00ecnh, c\u00e1c d\u1eef li\u1ec7u t\u1eeb th\u1eed nghi\u1ec7m ch\u01b0a cho th\u1ea5y k\u1ebft c\u1ee5c tr\u00ean.<\/p>\n

3.5. Ch\u1ea5t \u0111\u1ed1i v\u1eadn k\u00eanh calci<\/strong><\/h3>\n

Ch\u1ea5t \u0111\u1ed1i v\u1eadn k\u00eanh calci c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t v\u1edbi hai nh\u00f3m ch\u00ednh l\u00e0 flunarizine v\u00e0 cinnarizine. Trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y, nimodipine c\u0169ng cho th\u1ea5y hi\u1ec7u qu\u1ea3 tr\u00ean M\u00e9ni\u00e8re v\u00e0 m\u1ed9t s\u1ed1 r\u1ed1i lo\u1ea1n ti\u1ec1n \u0111\u00ecnh ngo\u1ea1i bi\u00ean kh\u00e1c. V\u1ec1 c\u01a1 ch\u1ebf t\u00e1c \u0111\u1ed9ng, c\u00e1c ch\u1ea5t \u0111\u1ed1i v\u1eadn k\u00eanh calci \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh th\u00f4ng qua vi\u1ec7c thay \u0111\u1ed5i s\u1ef1 t\u1eadp trung c\u1ee7a ion n\u1ed9i d\u1ecbch. Tr\u00ean l\u00e2m s\u00e0ng, nhi\u1ec1u thu\u1ed1c \u0111\u1ed1i v\u1eadn k\u00eanh calci nh\u01b0 verapamil g\u00e2y t\u00e1c d\u1ee5ng t\u00e1o b\u00f3n m\u1ea1nh, do \u0111\u00f3 c\u00f3 th\u1ec3 h\u1eefu d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb ti\u00eau ch\u1ea3y g\u00e2y ra b\u1edfi r\u1ed1i lo\u1ea1n ti\u1ec1n \u0111\u00ecnh. Ngo\u00e0i ra, c\u00e1c thu\u1ed1c kh\u00e1ng k\u00eanh calci c\u0169ng c\u00f3 hi\u1ec7u qu\u1ea3 \u0111\u1ed1i kh\u00e1ng v\u1edbi cholinergic v\u00e0 histamine.
\nThu\u1ed1c ch\u1ed1ng n\u00f4n<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
C\u00e1c thu\u1ed1c ch\u1ed1ng n\u00f4n<\/strong><\/td>\n<\/tr>\n
T\u00ean thu\u1ed1c<\/strong><\/td>\nLi\u1ec1u<\/strong><\/td>\nT\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd<\/strong><\/td>\nT\u00e1c d\u1ee5ng ph\u1ee5<\/strong><\/td>\n<\/tr>\n
Granisetron<\/strong><\/td>\n1mg, u\u1ed1ng ho\u1eb7c TTM<\/td>\nKh\u00e1ng seretonin<\/td>\n\u0110au \u0111\u1ea7u<\/td>\n<\/tr>\n
Meclozine<\/strong><\/td>\nU\u1ed1ng, 12,5-50mg\/4-6h<\/td>\nKh\u00e1ng histamine, kh\u00e1ng cholinergic<\/td>\nAn th\u1ea7n, th\u1eadn tr\u1ecdng tr\u00ean ng\u01b0\u1eddi ph\u00ec \u0111\u1ea1i TLT<\/td>\n<\/tr>\n
Metoclopramide *<\/strong><\/td>\n10mg, 03l\u1ea7n\/ng\u00e0y ho\u1eb7c 10mg TB<\/td>\nKh\u00e1ng dopamine, k\u00edch th\u00edch nhu \u0111\u1ed9ng ti\u00eau h\u00f3a<\/td>\nNg\u1ee7 g\u00e0, ngo\u1ea1i th\u00e1p<\/td>\n<\/tr>\n
Ondansetron *<\/strong><\/td>\n4mg u\u1ed1ng ho\u1eb7c TTM<\/td>\nKh\u00e1ng seretonin<\/td>\n\u0110au \u0111\u1ea7u, ti\u00eau ch\u1ea3y, s\u1ed1t<\/td>\n<\/tr>\n
Prochlorperazine<\/strong><\/td>\n5-10mg TB ho\u1eb7c u\u1ed1ng m\u1ed7i 6-8h ho\u1eb7c 25mg NHM m\u1ed7i 12h<\/td>\nPhenothiazine<\/td>\nAn th\u1ea7n, ngo\u1ea1i th\u00e1p<\/td>\n<\/tr>\n
Promethazine<\/strong><\/td>\n25mg NHM m\u1ed7i 12h ho\u1eb7c 25mg u\u1ed1ng m\u1ed7i 6-8h<\/td>\nKh\u00e1ng histamine<\/td>\nAn th\u1ea7n, ngo\u1ea1i th\u00e1p<\/td>\n<\/tr>\n
Trimethobenzamide<\/strong><\/td>\n250mg u\u1ed1ng 03l\u1ea7n\/ng\u00e0y<\/td>\nT\u01b0\u01a1ng t\u1ef1 Phenothiazine<\/td>\nAn th\u1ea7n, ngo\u1ea1i th\u00e1p<\/td>\n<\/tr>\n
TTM: ti\u00eam t\u0129nh m\u1ea1ch, TB: ti\u00eam b\u1eafp, NHM: nh\u00e9t h\u1eadu m\u00f4n, TLT: ti\u1ec1n li\u1ec7t tuy\u1ebfn*d\u1ec5 ti\u1ebfp c\u1eadn \u1edf Vi\u1ec7t Nam<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

L\u1ef1a ch\u1ecdn thu\u1ed1c ch\u1ed1ng n\u00f4n c\u1ea7n c\u00e2n nh\u1eafc \u0111\u01b0\u1eddng d\u00f9ng v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5. C\u00e1c thu\u1ed1c \u0111\u01b0\u1eddng u\u1ed1ng th\u01b0\u1eddng s\u1eed d\u1ee5ng tr\u00ean b\u1ec7nh nh\u00e2n n\u00f4n nh\u1eb9. Vi\u00ean \u0111\u1eb7t h\u1eadu m\u00f4n cho th\u1ea5y hi\u1ec7u qu\u1ea3 tr\u00ean nh\u00f3m b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 u\u1ed1ng do r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a. Trong khi \u0111\u00f3, nh\u00f3m b\u1ec7nh nh\u00e2n c\u1ea5p c\u1ee9u ho\u1eb7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng d\u1ea1ng ti\u00eam \u0111\u1ec3 mang l\u1ea1i l\u1ee3i \u00edch t\u1ed1i \u01b0u.
\nM\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1ng histamine cho th\u1ea5y hi\u1ec7u qu\u1ea3 tr\u00ean c\u1ea3 \u1ee9c ch\u1ebf ti\u1ec1n \u0111\u00ecnh v\u00e0 ch\u1ed1ng n\u00f4n. C\u00e1c ch\u1ea5t \u0111\u1ed1i v\u1eadn dopamine nh\u01b0 promethazine ki\u1ec3m so\u00e1t n\u00f4n r\u1ea5t t\u1ed1t nh\u01b0ng th\u01b0\u1eddng g\u00e2y t\u00e1c d\u1ee5ng ph\u1ee5 tr\u00ean h\u1ec7 ngo\u1ea1i th\u00e1p. B\u00ean c\u1ea1nh \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng ch\u1ea5t \u0111\u1ed1i v\u1eadn dopamine c\u0169ng c\u00f3 th\u1ec3 l\u00e0m ch\u1eadm l\u1ea1i qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh. M\u1ed9t lo\u1ea1i kh\u00e1ng dopamine kh\u00e1c hay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng l\u00e0 metoclopramide c\u00f3 t\u00e1c d\u1ee5ng ch\u1ee7 y\u1ebfu trong vi\u1ec7c \u0111\u1ea9y m\u1ea1nh qu\u00e1 tr\u00ecnh l\u00e0m r\u1ed7ng d\u1ea1 d\u00e0y. C\u00e1c ch\u1ea5t \u0111\u1ed1i v\u1eadn 5-HT3 (serotonin) c\u00f3 hi\u1ec7u qu\u1ea3 ch\u1ed1ng n\u00f4n r\u1ea5t t\u1ed1t v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong d\u1ef1 ph\u00f2ng say t\u00e0u xe. Tuy nhi\u00ean, nh\u01b0\u1ee3c \u0111i\u1ec3m c\u1ee7a ch\u00fang l\u00e0 gi\u00e1 th\u00e0nh \u0111\u1eaft v\u00e0 kh\u00f3 ti\u1ebfp c\u1eadn.<\/p>\n

3.6. C\u00e1c thu\u1ed1c t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn kh\u1ea3 n\u0103ng b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh<\/h3>\n

\u1ede c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng ti\u1ec1n \u0111\u00ecnh v\u0129nh vi\u1ec5n, v\u00ed d\u1ee5 nh\u01b0 b\u1ec7nh nh\u00e2n b\u1ecb u d\u00e2y th\u1ea7n kinh s\u1ed1 VIII ho\u1eb7c vi\u00eam th\u1ea7n kinh ti\u1ec1n \u0111\u00ecnh dai d\u1eb3ng, vi\u1ec7c th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh l\u00e0 c\u1ea7n thi\u1ebft. Ng\u01b0\u1ee3c l\u1ea1i, v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng ch\u00f3ng m\u1eb7t tho\u00e1ng qua nh\u01b0 trong M\u00e9ni\u00e8re, b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng v\u00e0 n\u00ean c\u00e2n nh\u1eafc tr\u01b0\u1edbc khi c\u00f3 b\u1ea5t c\u1ee9 can thi\u1ec7p y khoa n\u00e0o. Tr\u00ean l\u00e2m s\u00e0ng, c\u00e1c thu\u1ed1c g\u00e2y k\u00edch th\u00edch nh\u01b0 glutamate hay noradrenaline th\u01b0\u1eddng \u0111\u1ea9y m\u1ea1nh qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh, trong khi nh\u00f3m thu\u1ed1c an th\u1ea7n th\u01b0\u1eddng l\u00e0m ch\u1eadm l\u1ea1i qu\u00e1 tr\u00ecnh n\u00e0y.
\nVi\u1ec7c can thi\u1ec7p v\u00e0o qu\u00e1 tr\u00ecnh b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh lu\u00f4n l\u00e0 th\u1eed th\u00e1ch v\u1edbi c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng nhi\u1ec1u n\u0103m nay, trong \u0111\u00f3, \u0111a s\u1ed1 c\u00e1c d\u01b0\u1ee3c ch\u1ea5t \u0111\u1ec1u c\u1ed1 g\u1eafng t\u1eadp trung v\u00e0o th\u00fac \u0111\u1ea9y h\u1ec7 glutamate.
\n\u0110\u1ec3 b\u1ea3o \u0111\u1ea3m cho s\u1ef1 d\u1eabn truy\u1ec1n th\u1ea7n kinh, c\u00e1c neuron ch\u1ec9 t\u1eadp trung v\u00e0o vi\u1ec7c nh\u1eadn v\u00e0 d\u1eabn truy\u1ec1n c\u00e1c xung th\u1ea7n kinh (s\u1ef1 chuy\u00ean bi\u1ec7t) trong khi c\u00e1c t\u1ebf b\u00e0o h\u00ecnh sao (astrocyte) s\u1ebd l\u00e0m nhi\u1ec7m v\u1ee5 chuy\u1ec3n h\u00f3a v\u00e0 cung c\u1ea5p n\u0103ng l\u01b0\u1ee3ng. M\u1ed9t trong nh\u1eefng vai tr\u00f2 thi\u1ebft y\u1ebfu c\u1ee7a c\u00e1c t\u1ebf b\u00e0o h\u00ecnh sao l\u00e0 t\u1ea1o ra glutamate. Trong t\u1ebf b\u00e0o h\u00ecnh sao s\u1ebd c\u00f3 qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a c\u00e1c acid amin m\u1ea1ch nh\u00e1nh (branched-chain amino acid-BCAA) nh\u01b0: Isouleucine, Valine v\u00e0 Leucine v\u00e0 2-oxoglurarate th\u00e0nh c\u00e1c apha-keto acid v\u00e0 glutamate th\u00f4ng qua men branched-chain aminotransferase (BCAT), khi s\u1eed d\u1ee5ng N-acetyl-DL-leucine th\u00ec acid amin isoulecine s\u1ebd \u0111\u01b0\u1ee3c t\u1ebf b\u00e0o h\u00ecnh sao t\u1ea1o th\u00e0nh c\u00e1c glutamate do t\u00e1c d\u1ee5ng c\u1ee7a men BCAT. Khi l\u01b0\u1ee3ng glutamate t\u1ea1i c\u00e1c s\u1ee3i ti\u1ec1n synapse t\u0103ng l\u00ean th\u00ec ch\u1ec9 c\u1ea7n m\u1ed9t xung \u0111i\u1ec7n nh\u1ecf c\u0169ng l\u00e0m gi\u1ea3i ph\u00f3ng c\u00e1c glutamate v\u00e0o trong khe synapse v\u00e0 ch\u00fang s\u1ebd t\u00e1c \u0111\u1ed9ng l\u00ean k\u00eanh calci. B\u1eb1ng c\u00e1ch t\u00e1c \u0111\u1ed9ng nh\u01b0 tr\u00ean th\u00ec N-acetyl-DL-leucine gi\u00fap t\u0103ng d\u1eabn truy\u1ec1n c\u00e1c t\u00edn hi\u1ec7u th\u1ea7n kinh t\u1eeb ti\u1ec1n \u0111\u00ecnh c\u1ee7a b\u00ean t\u1ed5n th\u01b0\u01a1ng v\u1ec1 trung \u01b0\u01a1ng do \u0111\u00f3 gi\u00fap l\u1eadp l\u1ea1i s\u1ef1 c\u00e2n b\u1eb1ng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a ti\u1ec1n \u0111\u00ecnh b\u00ean l\u00e0nh c\u0169ng nh\u01b0 b\u00ean b\u1ec7nh gi\u00fap c\u1eaft \u0111\u01b0\u1ee3c tri\u1ec7u ch\u1ee9ng ch\u00f3ng m\u1eb7t. Trong c\u00e1c s\u1ea3n ph\u1ea9m N-acetyl-DL-leucine \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng hi\u1ec7n n\u00e0y, Tanganil cho th\u1ea5y hi\u1ec7u qu\u1ea3 v\u00e0 d\u1ec5 ti\u1ebfp c\u1eadn trong \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng ch\u00f3ng m\u1eb7t.
\nM\u1eb7c d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u h\u00e0ng ngh\u00ecn n\u0103m, \u0111i\u1ec1u tr\u1ecb ch\u00f3ng m\u1eb7t m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3 v\u1eabn lu\u00f4n th\u1eed th\u00e1ch c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng. B\u00ean c\u1ea1nh vi\u1ec7c gi\u1ea3i quy\u1ebft nguy\u00ean nh\u00e2n, kh\u1eafc ph\u1ee5c \u0111\u01b0\u1ee3c t\u00ecnh tr\u1ea1ng ch\u00f3ng m\u1eb7t l\u00e0 v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng gi\u00fap ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh s\u1edbm \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n, v\u00e0 \u0111i\u1ec1u \u0111\u00f3 ch\u1ec9 c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c khi c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng s\u1eed d\u1ee5ng v\u00e0 ph\u1ed1i h\u1ee3p c\u00e1c nh\u00f3m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3.<\/p>\n","protected":false},"excerpt":{"rendered":"

Cho\u0301ng m\u0103\u0323t\u00a0l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng r\u1ea5t ph\u1ed5 bi\u1ebfn m\u00e0 h\u1ea7u h\u1ebft m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u \u0111\u00e3 t\u1eebng tr\u1ea3i qua \u00edt nh\u1ea5t m\u1ed9t l\u1ea7n. Tri\u1ec7u ch\u1ee9ng n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c xoay v\u00f2ng, m\u1ea5t c\u00e2n b\u1eb1ng. Nguy\u00ean nh\u00e2n c\u1ee7a ch\u00f3ng m\u1eb7t c\u00f3 th\u1ec3 l\u00e0 do nhi\u1ec1u y\u1ebfu t\u1ed1 kh\u00e1c nhau, ch\u1eb3ng h\u1ea1n nh\u01b0 thi\u1ebfu […]<\/p>\n","protected":false},"author":42,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nCho\u0301ng m\u0103\u0323t - C\u01a1 ch\u1ebf d\u01b0\u1ee3c l\u00fd trong \u0111i\u1ec1u tri\u0323 v\u00e0 vai tr\u00f2 c\u1ee7a nh\u00f3m thu\u1ed1c th\u00fac \u0111\u1ea9y b\u00f9 tr\u1eeb ti\u1ec1n \u0111\u00ecnh - Vinmec<\/title>\n<meta name=\"description\" content=\"Cho\u0301ng m\u0103\u0323t l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng ph\u1ed5 bi\u1ebfn m\u00e0 h\u1ea7u h\u1ebft m\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u \u0111\u00e3 t\u1eebng tr\u1ea3i qua, th\u01b0\u1eddng \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u00e0 c\u1ea3m gi\u00e1c xoay v\u00f2ng, m\u1ea5t c\u00e2n b\u1eb1ng.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cho\u0301ng m\u0103\u0323t - 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