{"id":31037,"date":"2023-05-06T21:53:33","date_gmt":"2023-05-06T14:53:33","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31037"},"modified":"2023-05-06T21:53:33","modified_gmt":"2023-05-06T14:53:33","slug":"cap-nhat-chan-doan-dieu-tri-hoi-chung-chan-khong-yen","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/06\/cap-nhat-chan-doan-dieu-tri-hoi-chung-chan-khong-yen\/","title":{"rendered":"C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n \u2013 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean (Restless Leg Syndrome) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu trong ch\u00e2n v\u00e0 s\u1ef1 khao kh\u00e1t ph\u1ea3i di chuy\u1ec3n ch\u00e2n \u0111\u1ec3 gi\u1ea3m b\u1edbt c\u1ea3m gi\u00e1c n\u00e0y. B\u1ec7nh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u00e0o ban \u0111\u00eam, g\u00e2y ra kh\u00f3 ng\u1ee7 v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Nguy\u00ean nh\u00e2n c\u1ee7a b\u1ec7nh ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng, tuy nhi\u00ean c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ea5t dopamin trong n\u00e3o. C\u00e1c y\u1ebfu t\u1ed1 di truy\u1ec1n c\u0169ng \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 vai tr\u00f2 trong vi\u1ec7c ph\u00e1t tri\u1ec3n h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean.<\/a> Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh bao g\u1ed3m c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu trong ch\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 v\u00e0o bu\u1ed5i t\u1ed1i ho\u1eb7c \u0111\u00eam, v\u00e0 khao kh\u00e1t ph\u1ea3i di chuy\u1ec3n ch\u00e2n \u0111\u1ec3 gi\u1ea3m b\u1edbt c\u1ea3m gi\u00e1c n\u00e0y. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y nh\u1eb9 ho\u1eb7c n\u1eb7ng, v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng gi\u1ea5c ng\u1ee7 c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/strong><\/p>\n

\"C\u1eadp
C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n \u2013 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean<\/figcaption><\/figure>\n

Ba\u0300i vi\u00ea\u0301t “C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n \u2013 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean” 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: Nguy\u1ec5n H\u1ed3ng Qu\u00e2n<\/strong><\/em>
\nB\u1ec7nh vi\u1ec7n Trung \u01b0\u01a1ng Qu\u00e2n \u0111\u1ed9i 108<\/em><\/p>\n

1. Sinh b\u1ec7nh h\u1ecdc v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n

H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 l\u1ea7n \u0111\u1ea7u n\u0103m 1685 b\u1edfi b\u00e1c s\u0129 Thomas Willis. N\u0103m 1945, Karl-Axel Ekbom m\u00f4 t\u1ea3 chi ti\u1ebft \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh trong lu\u1eadn \u00e1n ti\u1ebfn s\u0129 c\u1ee7a m\u00ecnh v\u00e0 g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean (restless leg), v\u00ec v\u1eady b\u1ec7nh c\u00f2n c\u00f3 t\u00ean l\u00e0 b\u1ec7nh Willi \u2013 Ekbom. B\u1ec7nh \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 th\u00f4i th\u00fac v\u1eadn \u0111\u1ed9ng c\u1ee7a ch\u00e2n do c\u1ea3m gi\u00e1c kh\u00f4ng tho\u1ea3i m\u00e1i khi ngh\u1ec9 nh\u1ea5t l\u00e0 v\u1ec1 \u0111\u00eam, h\u1ebft ho\u1eb7c gi\u1ea3m nhi\u1ec1u khi v\u1eadn \u0111\u1ed9ng.
\nH\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean d\u00f9 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u1eeb r\u1ea5t s\u1edbm nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c quan t\u00e2m nhi\u1ec1u cho \u0111\u1ebfn nh\u1eefng n\u0103m 1990 nhi\u1ec1u nghi\u00ean c\u1ee9u cho th\u1ea5y \u0111\u00e2y l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng. N\u0103m 2003 nh\u00f3m qu\u1ed1c t\u1ebf v\u1ec1 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean \u0111\u01b0a ra b\u1ed9 ti\u00eau ch\u00ed v\u1ec1 ch\u1ea9n \u0111o\u00e1n \u0111\u1ea7u ti\u00ean v\u00e0 \u0111\u01b0\u1ee3c s\u1eeda \u0111\u1ed5i n\u0103m 2012. V\u1edbi vi\u1ec7c c\u01a1 ch\u1ebf b\u1ec7nh sinh ng\u00e0y c\u00e0ng s\u00e1ng t\u1ecf, nhi\u1ec1u h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb ra \u0111\u1eddi nh\u01b0 \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u, l\u00e2u d\u00e0i, \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb em, ph\u1ee5 n\u1eef mang thai, b\u1ed5 xung s\u1eaft, s\u1eed tr\u00ed v\u00e0 d\u1ef1 ph\u00f2ng bi\u1ebfn ch\u1ee9ng t\u0103ng n\u1eb7ng do d\u00f9ng dopaminergic k\u00e9o d\u00e0i\u2026
\nT\u1ef7 l\u1ec7 m\u1eafc h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean \u1edf ch\u00e2u \u00c2u v\u00e0 B\u1eafc M\u1ef9 kho\u1ea3ng 5-15%, trong khi ch\u00e2u \u00c1 v\u00e0 ch\u00e2u Phi m\u1eafc \u00edt h\u01a1n v\u1edbi t\u1ef7 l\u1ec7 l\u1ea7n l\u01b0\u1ee3t l\u00e0 1% v\u00e0 0,1%. Ph\u1ee5 n\u1eef m\u1eafc nhi\u1ec1u h\u01a1n nam gi\u1edbi v\u1edbi t\u1ef7 l\u1ec7 kho\u1ea3ng 2\/1, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ph\u1ee5 n\u1eef mang thai. B\u1ec7nh c\u00f3 xu h\u01b0\u1edbng t\u0103ng d\u1ea7n theo tu\u1ed5i, 33- 40% c\u00f3 kh\u1edfi ph\u00e1t tr\u01b0\u1edbc 20 tu\u1ed5i.<\/p>\n

1.1. Sinh b\u1ec7nh h\u1ecdc<\/strong><\/h3>\n

Sinh b\u1ec7nh h\u1ecdc c\u1ee7a h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean cho \u0111\u1ebfn hi\u1ec7n t\u1ea1i v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u bi\u1ebft \u0111\u1ea7y \u0111\u1ee7 d\u00f9 c\u00f3 nhi\u1ec1u b\u1eb1ng ch\u1ee9ng cho th\u1ea5ycos nh\u1eefng b\u1ea5t th\u01b0\u1eddng \u1edf th\u1ea7n kinh trung \u01b0\u01a1ng v\u00e0 ngo\u1ea1i vi. M\u1eb7c d\u00f9 l\u00e0 b\u1ec7nh c\u00f3 xu h\u01b0\u1edbng m\u00e3n t\u00ednh v\u1edbi nh\u1eefng \u0111\u1ee3t b\u00f9ng ph\u00e1t nh\u01b0ng kh\u00f4ng ph\u1ea3i l\u00e0 b\u1ec7nh tho\u00e1i h\u00f3a ti\u1ebfn tri\u1ec3n c\u1ee7a th\u1ea7n kinh.
\n\u2013 C\u00e1c thay \u0111\u1ed5i c\u1ee7a h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng:
\nGi\u1ea3m d\u1ef1 tr\u1eef s\u1eaft \u1edf th\u1ea7n kinh trung \u01b0\u01a1ng l\u00e0 ph\u00e1t hi\u1ec7n quan tr\u1ecdng v\u00e0 nh\u1ea5t qu\u00e1n trong c\u00e1c nghi\u00ean c\u1ee9u: c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 \u0111\u1ecbnh l\u01b0\u1ee3ng ferritin trong d\u1ecbch n\u00e3o t\u1ee7y, ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb n\u00e2ng cao v\u00e0 si\u00eau \u00e2m h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng \u0111\u1ec1u cho th\u1ea5y c\u00f3 gi\u1ea3m ferritin \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean so v\u1edbi nh\u00f3m ch\u1ee9ng nh\u1ea5t l\u00e0 \u1edf c\u00e1c v\u1ecb tr\u00ed: th\u1ec3 v\u00e2n, \u0111\u1ed3i th\u1ecb, ch\u1ea5t \u0111en, nh\u00e2n \u0111\u1ecf\u2026 C\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 gi\u1ea3i ph\u1eabu b\u1ec7nh cho th\u1ea5y kh\u00f4ng ch\u1ec9 gi\u1ea3m ferritin m\u00e0 c\u00f2n gi\u1ea3m th\u1ee5 th\u1ec3 transferrin. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ed5 xung s\u1eaft \u1edf c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 thi\u1ebfu h\u1ee5t cho th\u1ea5y c\u1ea3i thi\u1ec7n r\u00f5 r\u1ec7t t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng.
\nM\u1ed1i li\u00ean quan gi\u1eefa h\u1ec7 th\u1ed1ng dopaminergic v\u00e0 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u bi\u1ebft \u0111\u1ea7y \u0111\u1ee7 v\u00e0 ch\u01b0a th\u1ea5y c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 thi\u1ebfu h\u1ee5t dopamin nh\u01b0ng tr\u00ean l\u00e2m s\u00e0ng vi\u1ec7c \u0111i\u1ec1u tr\u1ecb dopaminergic cho th\u1ea5y c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng b\u1ec7nh nhanh ch\u00f3ng v\u00e0 r\u00f5 r\u1ec7t.
\nV\u00f9ng \u0111\u1ed3i th\u1ecb v\u00e0 m\u1ed9t s\u1ed1 ch\u1ea5t trung gian d\u1eabn truy\u1ec1n th\u1ea7n kinh nh\u01b0 opioids n\u1ed9i sinh, glutamate, glutamine, histamine, GABA c\u0169ng \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 li\u00ean quan t\u1edbi c\u01a1 ch\u1ebf b\u1ec7nh sinh.
\n\u2013 M\u1ed1i li\u00ean quan c\u1ee7a th\u1ea7n kinh ngo\u1ea1i vi:
\nM\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean quan r\u00f5 r\u00e0ng nh\u01b0ng m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u cho th\u1ea5y c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng t\u0103ng c\u1ea3m gi\u00e1c \u0111au, thay \u0111\u1ed5i d\u00f2ng m\u00e1u \u0111\u1ebfn b\u1eafp c\u01a1, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng n\u1ed9i m\u00f4 \u1edf ch\u00e2n b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean.
\n\u2013 C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1.
\n+ Y\u1ebfu t\u1ed1 gia \u0111\u00ecnh: 40-60% b\u1ec7nh nh\u00e2n m\u1eafc c\u00f3 y\u1ebfu t\u1ed1 gia \u0111\u00ecnh, m\u1ed9t s\u1ed1 gen c\u00f3 li\u00ean quan nh\u01b0: MEIS1, BTBDP, MAP2K5\/ LBOXCOR1, PRPRD, TOX3\u2026
\n+ D\u1ef1 tr\u1eef s\u1eaft th\u1ea5p (s\u1eaft huy\u1ebft thanh <45-50 ng\/mL), feritin, \u0111\u1ed9 b\u00e3o h\u00f2a transferin gi\u1ea3m.
\n+ T\u0103ng ure: 20 -70% b\u1ec7nh nh\u00e2n l\u1ecdc th\u1eadn m\u1eafc b\u1ec7nh, gh\u00e9p th\u1eadn cho th\u1ea5y c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng r\u00f5 r\u1ec7t.
\n+ B\u1ec7nh l\u00fd th\u1ea7n kinh (t\u1ed5n th\u01b0\u01a1ng t\u1ee7y, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi, x\u01a1 c\u1ee9ng r\u1ea3i r\u00e1c, parkinson\u2026) \u0111\u1ec1u cho th\u1ea5y t\u0103ng nguy c\u01a1 m\u1eafc.
\n+ Mang thai: kho\u1ea3ng 25% s\u1ed1 b\u1ec7nh nh\u00e2n mang thai m\u1eafc v\u00e0 c\u00f3 xu h\u01b0\u1edbng gi\u1ea3m nhi\u1ec1u sau thai k\u1ef3 kho\u1ea3ng 1 th\u00e1ng.
\n+ M\u1ed9t s\u1ed1 b\u1ec7nh kh\u00e1c: Migraine, \u0111au x\u01a1 c\u01a1, b\u1ec7nh kh\u1edbp\u2026<\/p>\n

1.2. Ph\u00e2n lo\u1ea1i v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/strong><\/h3>\n

\u2013 H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean c\u00f3 th\u1ec3 ph\u00e2n lo\u1ea1i th\u00e0nh 2 nh\u00f3m ch\u00ednh l\u00e0 nguy\u00ean ph\u00e1t (khi kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n) v\u00e0 th\u1ee9 ph\u00e1t.
\n\u2013 Ch\u1ea9n \u0111o\u00e1n: Ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c \u1ee9ng d\u1ee5ng r\u1ed9ng r\u00e3i nh\u1ea5t l\u00e0 b\u1ed9 ti\u00eau ch\u00ed c\u1ee7a nh\u00f3m qu\u1ed1c t\u1ebf v\u1ec1 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean n\u0103m 2003 sau \u0111\u00f3 \u0111\u01b0\u1ee3c s\u1eeda \u0111\u1ed5i n\u0103m 2012 v\u1edbi vi\u1ec7c b\u1ed5 sung th\u00eam ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb v\u00e0 ch\u1ea9n \u0111o\u00e1n m\u1ed9t s\u1ed1 th\u1ec3 \u0111\u1eb7c bi\u1ec7t.<\/p>\n

B\u1ea3ng 1. Ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n c\u1ee7a nh\u00f3m qu\u1ed1c t\u1ebf v\u1ec1 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean n\u0103m 2012<\/em><\/p>\n\n\n\n\n\n\n\n
2012 Revised IRLSSG Diagnostic Criteria for RLS<\/strong><\/p>\n

Restless legs syndrome (RLS), a neurological sensorimotor disease often profoundly disturbing sleep and quality of life has variable expression influenced by genetic, environmental, and medical factors. The symptoms vary considerably in frequency from less than once a month or year to daily and severity from mildly annoying to disabling. Symptoms may also remit for various periods of time. RLS is diagnosed by ascertaining symptom patterns that meet the following five essential criteria adding clinical specifiers where appropriate.<\/td>\n<\/tr>\n

Essential Diagnostic Criteria (all must be met)<\/strong><\/p>\n

An urge to move the legs usually but not always accompanied by or felt to be caused by uncomfortable and unpleasant sensations in the legs.1, 2<\/sup><\/p>\n

The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting.<\/p>\n

The urge to move the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.\u00a03<\/sup><\/p>\n

The urge to move the legs and any accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening or night than during the day.4<\/sup><\/p>\n

The occurrence of the above features is not\u00a0solely accounted for\u00a0as symptoms primary to another medical or a behavioral condition (e.g., myalgia, venous stasis, leg edema, arthritis, leg cramps, positional discomfort, habitual foot tapping).\u00a05<\/sup><\/td>\n<\/tr>\n

Specifiers for Clinical Course of RLS<\/strong>6<\/sup><\/p>\n

A. Chronic-persistent RLS: Symptoms when not treated would occur on average at least twice weekly for the past year.<\/p>\n

B. Intermittent RLS: symptoms when not treated would occur on average < 2\/week for the past year, with at least 5 lifetime events.<\/td>\n<\/tr>\n

Specifier for Clinical Significance of RLS<\/strong><\/p>\n

The symptoms of RLS cause significant distress or impairment in social, occupational, educational, or other important areas of functioning by the impact on sleep, energy\/vitality, daily activities, behavior, cognition or mood.<\/td>\n<\/tr>\n

Footnotes:<\/p>\n

1<\/sup>Sometimes the urge to move the legs is present without the uncomfortable sensations and sometimes the arms or other parts of the body are involved in addition to the legs.<\/p>\n

2<\/sup>For children, the description of these symptoms should be in the child s own words.<\/p>\n

3<\/sup>When symptoms are very severe, relief by activity may not be noticeable but must have been previously present.<\/p>\n

4<\/sup>When symptoms are very severe, the worsening in the evening or night may not be noticeable but must have been previously present.<\/p>\n

5<\/sup>These conditions, often referred to as \u201cRLS mimics\u201d, have been commonly confused with RLS particularly in surveys because they produce symptoms that meet or at least come very close to meeting criteria 1-4. The list here gives some examples of this that have been noted as particularly significant in epidemiological studies and clinical practice. RLS may also occur with any of these conditions, but the RLS symptoms will then be more in degree, conditions of expression or character than those usually occurring as part of the other condition.<\/p>\n

6<\/sup>The clinical course criteria do not apply for pediatric cases nor for some special cases of provoked RLS such as pregnancy or drug-induced RLS where the frequency may be high but limited to duration of the provocative condition.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u2013 \u0110\u1ed1i v\u1edbi tr\u1ebb em v\u1ec1 ti\u00eau ch\u00ed ch\u1ea9n \u0111o\u00e1n kh\u00f4ng thay \u0111\u1ed5i tuy nhi\u00ean c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 ng\u00f4n ng\u1eef v\u00e0 nh\u1eadn th\u1ee9c v\u00ec th\u1ebf c\u1ea7n hi\u1ec3u ng\u00f4n ng\u1eef v\u00e0 h\u1ecfi b\u1ec7nh theo ng\u00f4n ng\u1eef c\u1ee7a tr\u1ebb. Ph\u1ea3i \u0111\u1ec3 tr\u1ebb t\u1ef1 di\u1ec5n \u0111\u1ea1t tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u00ecnh.
\nC\u0169ng nh\u01b0 ng\u01b0\u1eddi l\u1edbn, b\u1ec7nh \u1ea3nh h\u01b0\u1edfng t\u1edbi gi\u1ea5c ng\u1ee7, t\u00e2m tr\u1ea1ng v\u00e0 nh\u1eadn th\u1ee9c. Tuy nhi\u00ean, \u1edf tr\u1ebb em c\u00e1c tri\u1ec7u ch\u1ee9ng \u1ea3nh h\u01b0\u1edfng t\u1edbi gi\u00e1o d\u1ee5c v\u00e0 h\u00e0nh vi nhi\u1ec1u h\u01a1n.<\/p>\n

1.3. C\u00e1c ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n

\u2013 C\u00e1c b\u1ec7nh c\u00f3 th\u00f4i th\u00fac v\u1eadn \u0111\u1ed9ng
\nDo c\u00e1c thu\u1ed1c an th\u1ea7n kinh.
\nH\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf (tri\u1ec7u ch\u1ee9ng ch\u1ec9 c\u00f3 khi \u0111\u1ee9ng v\u00e0 h\u1ebft khi n\u1eb1m).
\nC\u1eed \u0111\u1ed9ng t\u1ef1 \u00fd c\u1ee7a ch\u00e2n\u2026
\n\u2013 C\u00e1c b\u1ec7nh l\u00fd kh\u00f4ng th\u00fac \u0111\u1ea9y v\u1eadn \u0111\u1ed9ng
\nChu\u1ed9t r\u00fat ch\u00e2n
\nKh\u00f4ng tho\u1ea3i m\u00e1i do t\u01b0 th\u1ebf, \u0111au kh\u1edbp\u2026
\n\u2013 B\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u v\u00e0 b\u1ec7nh kh\u00e1c
\nSuy t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi, vi\u00eam \u0111\u1ed9ng m\u1ea1ch
\nB\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi\u2026<\/p>\n

2. \u0110i\u1ec1u tr\u1ecb<\/strong><\/h2>\n

\u0110\u1ec3 quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb c\u1ea7n \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 \u1ea3nh h\u01b0\u1edfng c\u1ee7a b\u1ec7nh \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1ec9 xem x\u00e9t khi \u1edf b\u1ec7nh nh\u00e2n c\u00f3 m\u1ee9c \u0111\u1ed9 v\u1eeba tr\u1edf l\u00ean v\u00e0 sau khi \u0111i\u1ec1u ch\u1ec9nh c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y n\u1eb7ng ho\u1eb7c k\u00edch ho\u1ea1t nh\u01b0: s\u1eed d\u1ee5ng thu\u1ed1c an th\u1ea7n kinh, ch\u1ed1ng tr\u1ea7m c\u1ea3m (nh\u1ea5t l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu ch\u1ecdn l\u1ecdc serotonin), thu\u1ed1c ch\u1ed1ng n\u00f4n, thu\u1ed1c kh\u00e1ng histamin\u2026
\nC\u00f3 m\u1ed9t s\u1ed1 thang \u0111i\u1ec3m \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh nh\u01b0ng ph\u1ed5 bi\u1ebfn nh\u1ea5t cho \u0111\u1ebfn nay v\u1eabn l\u00e0 thang \u0111i\u1ec3m \u0111\u00e1nh gi\u00e1 \u0111\u1ed9 n\u1eb7ng c\u1ee7a nh\u00f3m qu\u1ed1c t\u1ebf v\u1ec1 h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean (The International Restless Legs Syndrome Study Group rating scale for the severity of restless legs syndrome). Trong \u0111\u00f3 c\u00f3 b\u1ed9 10 c\u00e2u h\u1ecfi \u0111\u01b0\u1ee3c cho \u0111i\u1ec3m t\u1eeb 0 \u0111\u1ebfn 4 (r\u1ea5t n\u1eb7ng), t\u1ed5ng \u0111i\u1ec3m l\u00e0 40. R\u1ea5t n\u1eb7ng l\u00e0 t\u1eeb 31-40 \u0111i\u1ec3m, n\u1eb7ng 21-30 \u0111i\u1ec3m, trung b\u00ecnh 11-20 \u0111i\u1ec3m, nh\u1eb9 t\u1eeb 1-10 \u0111i\u1ec3m.<\/p>\n

2.1. \u0110i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c<\/strong><\/h3>\n

C\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c cho \u0111\u1ebfn hi\u1ec7n t\u1ea1i v\u1eabn ch\u01b0a c\u00f3 nghi\u00ean c\u1ee9u \u0111\u1ea7y \u0111\u1ee7 kh\u1eb3ng \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb, tuy nhi\u00ean m\u1ed9t s\u1ed1 bi\u1ec7n ph\u00e1p \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng:
\n\u2013 Li\u1ec7u ph\u00e1p nh\u1eadn th\u1ee9c h\u00e0nh vi
\n+ Gi\u1ea3m r\u01b0\u1ee3u, cafein.
\n+ Th\u1ec3 d\u1ee5c th\u01b0\u1eddng xuy\u00ean.
\n+ \u0110i b\u1ed9, ng\u00e2m ch\u00e2n, \u00e1p l\u1ef1c kh\u00ed, \u0111\u1ec7m rung\u2026
\n+ Xoa b\u00f3p ch\u00e2n.
\n\u2013 Tr\u00e1nh c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng n\u1eb7ng
\n+ V\u1ea5n \u0111\u1ec1 gi\u1ea5c ng\u1ee7: m\u1ea5t ng\u1ee7\u2026
\n+ Thu\u1ed1c: tr\u00e1nh s\u1eed d\u1ee5ng c\u00e1c nh\u00f3m thu\u1ed1c c\u00f3 th\u1ec3 t\u0103ng n\u1eb7ng nh\u01b0 ch\u1ed1ng tr\u1ea7m c\u1ea3m, an th\u1ea7n kinh, ch\u1ed1ng n\u00f4n, kh\u00e1ng histamin\u2026
\n\u2013 Yoga, ch\u00e2m c\u1ee9u \u0111\u01b0\u1ee3c m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 cho l\u00e0 c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng nh\u01b0ng ch\u01b0a \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng \u0111\u00e1nh gi\u00e1.
\n\u2013 B\u1ed5 sung s\u1eaft:
\nC\u00f9ng v\u1edbi s\u1ef1 ph\u00e1t hi\u1ec7n v\u1ec1 thi\u1ebfu h\u1ee5t s\u1eaft trong h\u1ec7 th\u1ed1ng th\u1ea7n kinh trung \u01b0\u01a1ng \u1edf b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean, khuy\u1ebfn c\u00e1o v\u1ec1 vai tr\u00f2 c\u1ee7a vi\u1ec7c t\u1ea7m so\u00e1t thi\u1ebfu h\u1ee5t s\u1eaft b\u1eb1ng c\u00e1c x\u00e9t nghi\u1ec7m ferritin, s\u1eaft, \u0111\u1ed9 b\u00e3o h\u00f2a transferin, t\u1ed5ng l\u01b0\u1ee3ng s\u1eaft g\u1eafn k\u1ebft (Total Iron Binding Capacity) v\u00e0 b\u1ed5 xung cho c\u00e1c b\u1ec7nh nh\u00e2n thu\u1ed9c nh\u00f3m n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh.
\nB\u1ed5 sung s\u1eaft \u0111\u01b0\u1eddng u\u1ed1ng n\u00ean \u00e1p d\u1ee5ng v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 ferritin d\u01b0\u1edbi 75ng\/ml v\u00e0 \u0111\u1ed9 b\u00e3o h\u00f2a transferin d\u01b0\u1edbi 45%. Li\u1ec1u l\u01b0\u1ee3ng: 65mg s\u1eaft nguy\u00ean ch\u1ea5t\/ng\u00e0y ho\u1eb7c m\u1ed7i 2 ng\u00e0y, n\u00ean ph\u1ed1i h\u1ee3p v\u1edbi vitamin C 100-200mg v\u00e0 u\u1ed1ng v\u00e0o bu\u1ed5i t\u1ed1i, khi d\u1ea1 d\u00e0y r\u1ed7ng \u0111\u1ec3 t\u0103ng kh\u1ea3 n\u0103ng h\u1ea5p thu v\u00e0 kh\u1ea3 n\u0103ng \u0111i v\u00e0o n\u00e3o c\u1ee7a s\u1eaft. Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 b\u1ed5 sung calci.
\nB\u1ed5 sung s\u1eaft b\u1eb1ng truy\u1ec1n t\u0129nh m\u1ea1ch: C\u00e2n nh\u1eafc truy\u1ec1n t\u0129nh m\u1ea1ch s\u1eaft n\u1ebfu \u0111\u1ed9 b\u00e3o h\u00f2a transferrin <45% v\u00e0 n\u1ed3ng \u0111\u1ed9 ferritin huy\u1ebft thanh <100 ng \/mL v\u00e0 v\u1edbi b\u1ec7nh nh\u00e2n h\u1ea1n ch\u1ebf kh\u1ea3 n\u0103ng h\u1ea5p thu ho\u1eb7c kh\u00f4ng dung n\u1ea1p theo \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111\u01b0\u1eddng u\u1ed1ng sau 3 th\u00e1ng.
\nTheo d\u00f5i v\u00e0 x\u00e9t nghi\u1ec7m l\u1ea1i sau m\u1ed7i 3 th\u00e1ng l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 tr\u00e1nh qu\u00e1 t\u1ea3i s\u1eaft. C\u00f3 th\u1ec3 d\u1eebng \u0111i\u1ec1u tr\u1ecb n\u1ebfu ferritin tr\u00ean 100ng\/ml v\u00e0 nguy\u00ean nh\u00e2n g\u00e2y thi\u1ebfu h\u1ee5t s\u1eaft \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft (n\u1ebfu c\u00f3) ho\u1eb7c kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb.
\nHi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb \u0111\u1ed1i v\u1edbi b\u1ed5 sung s\u1eaft \u0111\u01b0\u1eddng u\u1ed1ng c\u00f3 th\u1ec3 c\u1ea7n t\u1edbi v\u00e0i tu\u1ea7n, b\u1ed5 sung s\u1eaft \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 th\u1ea5y sau v\u00e0i ng\u00e0y \u0111i\u1ec1u tr\u1ecb.<\/p>\n

2.2. \u0110i\u1ec1u tr\u1ecb d\u00f9ng thu\u1ed1c<\/strong><\/h3>\n

C\u00e1c thu\u1ed1c thu\u1ed9c nh\u00f3m dopaminergic
\n\u2013 Levodopa l\u00e0 m\u1ed9t trong nh\u1eefng thu\u1ed1c \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean v\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ed1t, n\u00ean d\u00f9ng tr\u01b0\u1edbc khi \u0111i ng\u1ee7 n\u1ebfu b\u1ec7nh nh\u00e2n ch\u1ec9 c\u00f3 tri\u1ec7u ch\u1ee9ng v\u1ec1 \u0111\u00eam.
\nM\u1ed9t s\u1ed1 l\u01b0u \u00fd: khi d\u00f9ng levodopa k\u00e9o d\u00e0i c\u00f3 m\u1ed9t s\u1ed1 nguy c\u01a1: hi\u1ec7n t\u01b0\u1ee3ng augmentation, \u0111\u00e2y l\u00e0 bi\u1ec3u hi\u1ec7n t\u0103ng to\u00e0n di\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng sau m\u1ed9t th\u1eddi gian d\u00f9ng levodopa. C\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee7a augmentation bao g\u1ed3m c\u00e1c tri\u1ec7u ch\u1ee9ng xu\u1ea5t hi\u1ec7n s\u1edbm h\u01a1n, n\u1eb7ng h\u01a1n, th\u1eddi gian t\u1eeb l\u00fac ngh\u1ec9 \u0111\u1ebfn l\u00fac xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng ng\u1eafn h\u01a1n v\u00e0 c\u00f3 th\u1ec3 lan t\u1edbi v\u00f9ng kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3 (lan t\u1edbi tay). B\u1ec7nh nh\u00e2n \u0111\u00f4i khi c\u1ea7n d\u00f9ng t\u0103ng li\u1ec1u \u0111\u1ec3 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng. Kho\u1ea3ng 60-70% b\u1ec7nh nh\u00e2n c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y n\u1ebfu d\u00f9ng li\u1ec1u tr\u00ean 300mg\/ng\u00e0y tr\u00ean 2 th\u00e1ng. Gi\u1ea3m t\u00e1c d\u1ee5ng khi d\u00f9ng k\u00e9o d\u00e0i; t\u00e1c d\u1ee5ng d\u1ed9i ng\u01b0\u1ee3c cu\u1ed1i li\u1ec1u (tri\u1ec7u ch\u1ee9ng t\u0103ng n\u1eb7ng v\u00e0o bu\u1ed5i s\u00e1ng s\u1edbm). V\u00ec v\u1eady, khuy\u1ebfn c\u00e1o hi\u1ec7n t\u1ea1i ch\u1ec9 n\u00ean d\u00f9ng levodopa li\u1ec1u th\u1ea5p cho nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean ng\u1eaft qu\u00e3ng ho\u1eb7c d\u00f9ng ng\u1eafn ng\u00e0y cho ph\u1ee5 n\u1eef mang thai \u1edf nh\u1eefng th\u00e1ng cu\u1ed1i thai k\u1ef3.
\n\u2013 C\u00e1c thu\u1ed1c \u0111\u1ed3ng v\u1eadn dopaminergic: Pramipexole, Rotigotine, Ropinirole l\u00e0 nh\u1eefng thu\u1ed1c c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ed1t \u0111\u01b0\u1ee3c FDA ch\u1ea5p thu\u1eadn cho \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean, nguy c\u01a1 hi\u1ec7n t\u01b0\u1ee3ng augmentation th\u1ea5p h\u01a1n so v\u1edbi levodopa, t\u1ef7 l\u1ec7 m\u1eafc kho\u1ea3ng 3-9% khi d\u00f9ng 1 n\u0103m. V\u00ec v\u1eady c\u00f3 th\u1ec3 l\u00e0 l\u1ef1a ch\u1ecdn ban \u0111\u1ea7u n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi thu\u1ed1c t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn ph\u1ed1i t\u1eed c\u1ee7a k\u00eanh calci alpha 2 delta, ho\u1eb7c c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p v\u1edbi thu\u1ed1c thu\u1ed9c nh\u00f3m n\u00e0y v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00e1ng tr\u1ecb.
\nTrong c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y th\u1ea5y thu\u1ed1c gi\u00fap gi\u1ea3m 6-7 \u0111i\u1ec3m theo thang \u0111i\u1ec3m IRLS (International Restless Legs Syndrome Study Group rating scale for the severity of restless legs syndrome). C\u1ea7n l\u01b0u \u00fd t\u00e1c d\u1ee5ng g\u00e2y nguy c\u01a1 r\u1ed1i lo\u1ea1n ki\u1ec3m so\u00e1t xung \u0111\u1ed9ng (impulse control disorders).
\n\u2013 M\u1ed9t s\u1ed1 thu\u1ed1c kh\u00e1c nh\u01b0 cabergoline, pergolide c\u00f3 hi\u1ec7u qu\u1ea3 ki\u1ec3m so\u00e1t tri\u1ec7u ch\u1ee9ng t\u1ed1t nh\u01b0ng c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 \u0111\u1eb7c bi\u1ec7t l\u00e0 nguy c\u01a1 g\u00e2y b\u1ec7nh l\u00fd van tim v\u00e0 g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh l\u00e0 c\u00f3 h\u1ea1i nhi\u1ec1u h\u01a1n n\u00ean kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh.
\nC\u00e1c thu\u1ed1c t\u00e1c d\u1ee5ng tr\u00ean ph\u1ed1i t\u1eed c\u1ee7a k\u00eanh calci alpha 2 delta (gabapentine, pregabaline)
\n\u2013 C\u00e1c thu\u1ed1c n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 t\u1ed1t v\u00e0 c\u00f3 kh\u00f4ng g\u00e2y hi\u1ec7n t\u01b0\u1ee3ng augmentation v\u00ec th\u1ebf c\u00e1c c\u1eadp nh\u1eadt khuy\u00ean c\u00e1o hi\u1ec7n t\u1ea1i n\u00ean l\u00e0 l\u1ef1a ch\u1ecdn ban \u0111\u1ea7u cho c\u00e1c b\u1ec7nh nh\u00e2n th\u1ec3 m\u00e3n t\u00ednh, dai d\u1eb3ng (Chronic persistent restless legs syndrome) tr\u1eeb khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ho\u1eb7c c\u1ea3nh b\u00e1o th\u1eadn tr\u1ecdng. Thu\u1ed1c c\u00f3 \u01b0u th\u1ebf v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 \u0111au m\u00e3n t\u00ednh, c\u00f3 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi, m\u1ea5t ng\u1ee7.
\n\u2013 Th\u1eadn tr\u1ecdng do l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t hi\u1ec7n \u00fd t\u01b0\u1edfng v\u00e0 h\u00e0nh vi t\u1ef1 s\u00e1t, r\u1ed1i lo\u1ea1n th\u0103ng b\u1eb1ng, t\u0103ng c\u00e2n, tr\u1ea7m c\u1ea3m n\u1eb7ng, b\u1ec7nh l\u00fd c\u00f3 th\u1ec3 d\u1eabn t\u1edbi suy h\u00f4 h\u1ea5p (COPD), nghi\u1ec7n ch\u1ea5t. C\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n t\u0103ng theo li\u1ec1u s\u1eed d\u1ee5ng.
\nC\u00e1c thu\u1ed1c kh\u00e1c
\n\u2013 C\u00e1c opioid: c\u00e1c thu\u1ed1c thu\u1ed9c nh\u00f3m n\u00e0y nh\u01b0 (tramadol, codeine, oxycodone, methadone) c\u00f3 hi\u1ec7u qu\u1ea3 nh\u01b0ng c\u00f3 nguy c\u01a1 l\u1ea1m d\u1ee5ng thu\u1ed1c n\u00ean ch\u1ec9 \u00e1p d\u1ee5ng v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n kh\u00e1ng tr\u1ecb v\u1edbi li\u1ec1u th\u1ea5p, ho\u1eb7c v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb th\u1ec3 ng\u1eaft qu\u00e3ng. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn v\u1ec1 hi\u1ec7u qu\u1ea3 c\u0169ng nh\u01b0 nguy c\u01a1 l\u1ea1m d\u1ee5ng thu\u1ed1c.
\n\u2013 C\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nh\u01b0 carbamazepine, clonidine, amantadine, benzodiazepine, b\u1ed5 sung magie\u2026 c\u00f3 th\u1ec3 c\u00f3 hi\u1ec7u qu\u1ea3 trong h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean nh\u01b0ng ch\u1ec9 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong m\u1ed9t s\u1ed1 \u00edt c\u00e1c nghi\u00ean c\u1ee9u v\u00e0 ch\u01b0a c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng.<\/p>\n

B\u1ea3ng 2. M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c th\u00f4ng d\u1ee5ng<\/p>\n\n\n\n\n\n\n\n\n\n\n
Lo\u1ea1i thu\u1ed1c<\/strong><\/td>\nLi\u1ec1u d\u00f9ng (mg\/ng\u00e0y)<\/strong><\/td>\nT\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n<\/strong><\/td>\n<\/tr>\n
Pramipexole<\/td>\n0,125-0,75<\/td>\nN\u00f4n, bu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n ki\u1ec3m so\u00e1t xung \u0111\u1ed9ng<\/td>\n<\/tr>\n
Ropinirole<\/td>\n0,24-4,0<\/td>\nN\u00f4n, bu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n ki\u1ec3m so\u00e1t xung \u0111\u1ed9ng<\/td>\n<\/tr>\n
Rotigotine (mi\u1ebfng d\u00e1n)<\/td>\n1-3<\/td>\nN\u00f4n, bu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n ki\u1ec3m so\u00e1t xung \u0111\u1ed9ng, k\u00edch \u1ee9ng da.<\/td>\n<\/tr>\n
Levodopa<\/td>\n50-200<\/td>\nN\u00f4n, augmentation, m\u1ea5t t\u00e1c d\u1ee5ng<\/td>\n<\/tr>\n
Gabapentin enacarbil<\/td>\n600-1800<\/td>\nBu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n th\u0103ng b\u1eb1ng, \u0111au \u0111\u1ea7u, n\u00f4n<\/td>\n<\/tr>\n
Gabapentin<\/td>\n100-2400<\/td>\nBu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n th\u0103ng b\u1eb1ng, \u0111au \u0111\u1ea7u, n\u00f4n<\/td>\n<\/tr>\n
Pregabalin<\/td>\n50-450<\/td>\nBu\u1ed3n ng\u1ee7, r\u1ed1i lo\u1ea1n th\u0103ng b\u1eb1ng, \u0111au \u0111\u1ea7u, n\u00f4n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

3. K\u1ebft lu\u1eadn<\/strong><\/h2>\n

H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean l\u00e0 b\u1ec7nh l\u00fd c\u00f3 xu h\u01b0\u1edbng m\u00e3n t\u00ednh dai d\u1eb3ng nh\u1ea5t l\u00e0 \u1edf c\u00e1c b\u1ec7nh nh\u00e2n cao tu\u1ed5i, c\u00f3 \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c. M\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb nh\u1eb1m gi\u1ea3m b\u1edbt ho\u1eb7c lo\u1ea1i b\u1ecf tri\u1ec7u ch\u1ee9ng gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.
\nTr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c s\u00e0ng l\u1ecdc thi\u1ebfu h\u1ee5t s\u1eaft v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 t\u0103ng n\u1eb7ng ho\u1eb7c k\u00edch ho\u1ea1t tri\u1ec7u ch\u1ee9ng \u0111\u1ec3 c\u00f3 \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p. \u01afu ti\u00ean s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c.
\n<\/em><\/strong><\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h2>\n

1. Allen RP, Picchietti DL, Auerbach M, et al. Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome\/Willis-Ekbom disease in adults and children: an IRLSSG task force report. Sleep Med 2018; 41:27.
\n2. Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults\u2013an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep 2012; 35:1039.
\n3. Daniel L. Picchietti, Oliviero Bruni, et al. Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group. Sleep Medicine 14 (2013) 1253\u20131259.
\n4. Daniel L. Picchietti, Jennifer G. Hensley, Jacquelyn L. Bainbridge, et al. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome\/Willis-Ekbom disease during pregnancy and lactation. Sleep Medicine Reviews 22 (2015) 64e77.
\n5. Garcia-Borreguero D, Kohnen R, Silber MH, et al. The long-term treatment of restless legs syndrome\/Willis-Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group. Sleep Med 2013; 14:675.
\n6. Garcia-Borreguero D, Silber MH, Winkelman JW, et al. Guidelines for the first-line treatment of restless legs syndrome\/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Med 2016; 21:1.
\n7. Karl Jr. Ekbom. The History of Restless Legs Syndrome: Some Early Clinical Observations. J Neurol Disord Stroke 5(1) (2017): 1117.
\n8. Michael H. Silber, et al. The Appropriate Use of Opioids in the Treatment of Refractory Restless Legs Syndrome. Mayo Clin Proc. 2018;93(1):59-67.
\n9. Shiyi Guo, Jinsha Huang, et al. Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management. Front, Aging Neurosci, 02 June 2017.
\n10. Silber MH, Buchfuhrer MJ, Earley CJ, et al. The Management of Restless Legs Syndrome: An Updated Algorithm. Mayo Clin Proc 2021; 96:1921.
\n11. Winkelman JW, Armstrong MJ, Allen RP, et al. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2016; 87:2585.<\/p>\n","protected":false},"excerpt":{"rendered":"

H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean (Restless Leg Syndrome) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd th\u1ea7n kinh, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu trong ch\u00e2n v\u00e0 s\u1ef1 khao kh\u00e1t ph\u1ea3i di chuy\u1ec3n ch\u00e2n \u0111\u1ec3 gi\u1ea3m b\u1edbt c\u1ea3m gi\u00e1c n\u00e0y. B\u1ec7nh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u00e0o ban \u0111\u00eam, g\u00e2y ra kh\u00f3 ng\u1ee7 v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng […]<\/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":"\nC\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n \u2013 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu trong ch\u00e2n v\u00e0 khao kh\u00e1t di chuy\u1ec3n ch\u00e2n \u0111\u1ec3 gi\u1ea3m b\u1edbt c\u1ea3m gi\u00e1c n\u00e0y.\" \/>\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=\"C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n \u2013 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ch\u00e2n kh\u00f4ng y\u00ean - 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