{"id":12142,"date":"2022-11-30T15:51:59","date_gmt":"2022-11-30T08:51:59","guid":{"rendered":"http:\/\/12point.net\/?p=12142"},"modified":"2022-11-30T15:51:59","modified_gmt":"2022-11-30T08:51:59","slug":"vai-tro-cua-vitamin-va-cac-khoang-chat-trong-quan-ly-dau","status":"publish","type":"post","link":"https:\/\/12point.net\/vai-tro-cua-vitamin-va-cac-khoang-chat-trong-quan-ly-dau\/","title":{"rendered":"VAI TR\u00d2 C\u1ee6A VITAMIN V\u00c0 C\u00c1C KHO\u00c1NG CH\u1ea4T TRONG QU\u1ea2N L\u00dd \u0110AU"},"content":{"rendered":"

DS V\u00f5 Ng\u1ecdc Minh Th\u01b0 – Khoa D\u01b0\u1ee3c<\/em><\/span><\/p>\n

T\u1ea1i Hoa K\u1ef3, \u0111au m\u1ea1n t\u00ednh l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u khi\u1ebfn ng\u01b0\u1eddi d\u00e2n t\u00ecm \u0111\u1ebfn c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb, t\u00ecnh tr\u1ea1ng n\u00e0y g\u00e2y \u1ea3nh h\u01b0\u1edfng b\u1ea5t l\u1ee3i \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 tinh th\u1ea7n c\u1ee7a b\u1ec7nh nh\u00e2n, c\u00f3 th\u1ec3 khi\u1ebfn ng\u01b0\u1eddi b\u1ec7nh suy nh\u01b0\u1ee3c. D\u1ef1a tr\u00ean Kh\u1ea3o s\u00e1t ph\u1ecfng v\u1ea5n s\u1ee9c kh\u1ecfe Qu\u1ed1c gia n\u0103m 2019, kho\u1ea3ng 1\/5 s\u1ed1 ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh \u1edf Hoa K\u1ef3 g\u1eb7p c\u00e1c c\u01a1n \u0111au v\u00e0o h\u1ea7u h\u1ebft c\u00e1c ng\u00e0y ho\u1eb7c h\u00e0ng ng\u00e0y. Vi\u1ec7c qu\u1ea3n l\u00fd \u0111au m\u1ed9t c\u00e1ch h\u1ee3p l\u00fd \u0111ang ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c quan t\u00e2m do h\u1eadu qu\u1ea3 v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 c\u1ee7a vi\u1ec7c l\u1ea1m d\u1ee5ng v\u00e0 qu\u00e1 li\u1ec1u opioid. Khi c\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n kh\u00f4ng l\u00e0m gi\u1ea3m c\u01a1n \u0111au ho\u1eb7c kh\u00f4ng d\u1ec5 d\u00e0ng ti\u1ebfp c\u1eadn \u0111\u01b0\u1ee3c, ng\u01b0\u1eddi b\u1ec7nh s\u1ebd t\u00ecm ki\u1ebfm c\u00e1c li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb thay th\u1ebf. N\u0103m 2011, \u0111au m\u1ea1n t\u00ednh \u0111\u01b0\u1ee3c ghi nh\u1eadn g\u00e2y hao t\u1ed5n kinh ph\u00ed t\u1eeb 560 t\u1ef7 \u0111\u1ebfn 635 t\u1ef7 \u0111\u00f4 la m\u1ed7i n\u0103m, trong \u0111\u00f3 chi ph\u00ed li\u00ean quan tr\u1ef1c ti\u1ebfp \u0111\u1ebfn ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe b\u1ec7nh nh\u00e2n ch\u1ec9 chi\u1ebfm t\u1eeb 261 t\u1ef7 \u0111\u1ebfn 300 t\u1ef7 \u0111\u00f4 la.<\/span><\/p>\n

Hi\u1ec7p h\u1ed9i nghi\u00ean c\u1ee9u \u0111au qu\u1ed1c t\u1ebf (IASP) \u0111\u1ecbnh ngh\u0129a\u00a0\u0111au<\/em>\u00a0l\u00e0 \u201cM\u1ed9t c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu, c\u00f3 t\u00ednh ch\u1ea5t c\u1ea3m t\u00ednh, \u0111i k\u00e8m ho\u1eb7c t\u01b0\u01a1ng t\u1ef1 v\u1edbi nh\u1eefng t\u1ed5n th\u01b0\u01a1ng th\u1ef1c th\u1ec3 ho\u1eb7c ti\u1ec1m t\u00e0ng c\u1ee7a c\u00e1c m\u00f4\u201d. Theo \u0111\u1ecbnh ngh\u0129a, t\u00ecnh tr\u1ea1ng \u0111au c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u t\u01b0\u01a1ng \u1ee9ng t\u00f9y thu\u1ed9c v\u00e0o c\u00e1ch ph\u00e2n lo\u1ea1i \u0111au. C\u00f3 b\u1ed1n c\u00e1ch ph\u00e2n lo\u1ea1i \u0111au ph\u1ed5 bi\u1ebfn d\u1ef1a tr\u00ean c\u01a1 ch\u1ebf sinh l\u00fd b\u1ec7nh (\u0111au c\u1ea3m th\u1ee5 ho\u1eb7c \u0111au th\u1ea7n kinh), th\u1eddi gian (c\u1ea5p t\u00ednh ho\u1eb7c m\u1ea1n t\u00ednh), c\u0103n nguy\u00ean (\u00e1c t\u00ednh ho\u1eb7c kh\u00f4ng \u00e1c t\u00ednh) ho\u1eb7c v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu.\u00a0<\/sup>M\u1ee5c ti\u00eau c\u1ee7a vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ea5t k\u1ef3 lo\u1ea1i \u0111au n\u00e0o l\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng, ch\u1ee9c n\u0103ng ho\u1ea1t \u0111\u1ed9ng v\u00e0 s\u1ef1 tho\u1ea3i m\u00e1i c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

Trong su\u1ed1t 3 th\u1eadp k\u1ef7 qua, c\u00e1ch ti\u1ebfp c\u1eadn v\u00e0 qu\u1ea3n l\u00fd \u0111au \u0111\u00e3 tr\u1edf th\u00e0nh m\u1ed9t l\u0129nh v\u1ef1c tr\u1ecdng t\u00e2m ch\u00ednh. V\u00e0o nh\u1eefng n\u0103m 1990, vi\u1ec7c \u0111\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111au kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng y t\u1ebf kh\u1ea9n c\u1ea5p v\u00e0 xem nh\u01b0 \u201cd\u1ea5u hi\u1ec7u quan tr\u1ecdng th\u1ee9 5\u201d (ngo\u00e0i 4 d\u1ea5u hi\u1ec7u sinh t\u1ed3n ch\u00ednh: nhi\u1ec7t \u0111\u1ed9, m\u1ea1ch, h\u00f4 h\u1ea5p v\u00e0 huy\u1ebft \u00e1p). V\u1edbi n\u1ed7 l\u1ef1c trong vi\u1ec7c qu\u1ea3n l\u00fd \u0111au v\u00e0 s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u00e1c s\u1ea3n ph\u1ea9m thu\u1ed1c m\u1edbi, vi\u1ec7c k\u00ea \u0111\u01a1n opioid r\u1ed9ng r\u00e3i \u0111\u00e3 d\u1eabn \u0111\u1ebfn m\u1ed9t cu\u1ed9c \u201ckh\u1ee7ng ho\u1ea3ng opioid\u201d to\u00e0n c\u1ea7u. \u0110\u1ec3 gi\u1ea3i quy\u1ebft t\u00ecnh tr\u1ea1ng n\u00e0y, c\u00e1c nghi\u00ean c\u1ee9u v\u00e0 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb \u0111\u00e3 x\u00e1c \u0111\u1ecbnh c\u00e1c ph\u01b0\u01a1ng th\u1ee9c qu\u1ea3n l\u00fd \u0111au thay th\u1ebf. H\u1ea7u h\u1ebft c\u00e1c h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb g\u1ea7n \u0111\u00e2y v\u00e0 c\u00e1c b\u00e1o c\u00e1o th\u1ef1c h\u00e0nh ca l\u00e2m s\u00e0ng t\u1ed1t \u0111\u00e3 khuy\u1ebfn c\u00e1o qu\u1ea3n l\u00fd \u0111au theo h\u01b0\u1edbng c\u00e1 th\u1ec3 h\u00f3a, \u0111a m\u00f4 th\u1ee9c v\u00e0 to\u00e0n di\u1ec7n bao g\u1ed3m thu\u1ed1c, li\u1ec7u ph\u00e1p ph\u1ee5c h\u1ed3i, th\u1ee7 thu\u1eadt can thi\u1ec7p, ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn h\u00e0nh vi – s\u1ee9c kh\u1ecfe c\u0169ng nh\u01b0 tr\u1ecb li\u1ec7u h\u1ed7 tr\u1ee3 v\u00e0 t\u00edch h\u1ee3p. Tuy nhi\u00ean, h\u1ea1n ch\u1ebf c\u1ee7a c\u00e1c t\u00e0i li\u1ec7u n\u00e0y l\u00e0 thi\u1ebfu b\u00e0n lu\u1eadn v\u1ec1 vai tr\u00f2 c\u1ee7a vitamin v\u00e0 kho\u00e1ng ch\u1ea5t trong vi\u1ec7c qu\u1ea3n l\u00fd \u0111au. Theo m\u1ed9t cu\u1ed9c kh\u1ea3o s\u00e1t \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00e0o n\u0103m 2002, h\u01a1n m\u1ed9t ph\u1ea7n ba s\u1ed1 ng\u01b0\u1eddi M\u1ef9 s\u1eed d\u1ee5ng tr\u1ecb li\u1ec7u h\u1ed7 tr\u1ee3 v\u00e0 thay th\u1ebf. B\u1edfi c\u00e1c d\u01b0\u1ee3c s\u0129 th\u01b0\u1eddng l\u00e0 nh\u1eefng nh\u00e2n vi\u00ean y t\u1ebf c\u00f3 th\u1ec3 \u0111\u01b0a ra nh\u1eefng t\u01b0 v\u1ea5n ban \u0111\u1ea7u v\u1ec1 thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n khi ng\u01b0\u1eddi b\u1ec7nh t\u00ecm \u0111\u1ebfn c\u00e1c gi\u1ea3i ph\u00e1p \u0111i\u1ec1u tr\u1ecb y t\u1ebf nh\u1eb1m gi\u1ea3i quy\u1ebft t\u00ecnh tr\u1ea1ng \u0111au. Do \u0111\u00f3, nh\u1eadn th\u1ee9c v\u1ec1 vai tr\u00f2 c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a c\u00e1c t\u00e1c nh\u00e2n n\u00e0y trong vi\u1ec7c qu\u1ea3n l\u00fd \u0111au \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng.<\/span><\/p>\n

\u0110AU TH\u1ea6N KINH<\/strong><\/span><\/p>\n

T\u1ed5 ch\u1ee9c IASP \u0111\u1ecbnh ngh\u0129a\u00a0\u0111au th\u1ea7n kinh<\/em>\u00a0l\u00e0 “\u0111au do t\u1ed5n th\u01b0\u01a1ng ho\u1eb7c b\u1ec7nh c\u1ee7a h\u1ec7 th\u1ea7n kinh giao c\u1ea3m”. T\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 do m\u1ed9t s\u1ed1 c\u0103n nguy\u00ean bao g\u1ed3m \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, ung th\u01b0, nghi\u1ec7n r\u01b0\u1ee3u m\u1ea1n t\u00ednh, nhi\u1ec5m vi r\u00fat herpes zoster, t\u1ed5n th\u01b0\u01a1ng d\u00e2y th\u1ea7n kinh, nhi\u1ec5m \u0111\u1ed9c thu\u1ed1c v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng nh\u01b0 tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, ch\u1ea5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng v\u00e0 b\u1ec7nh l\u00fd \u0111a x\u01a1 c\u1ee9ng.\u00a0<\/sup>C\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u tay b\u1eb1ng thu\u1ed1c hi\u1ec7n nay bao g\u1ed3m thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin-noradrenalin (venlafaxin v\u00e0 duloxetin), thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng, thu\u1ed1c ch\u1ed1ng co gi\u1eadt (gabapentin v\u00e0 pregabalin). V\u1edbi b\u1ea3n ch\u1ea5t ph\u1ee9c t\u1ea1p c\u1ee7a \u0111au th\u1ea7n kinh v\u00e0 s\u1ef1 \u0111a d\u1ea1ng c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng, t\u1ef7 l\u1ec7 \u0111au th\u1ea7n kinh c\u00f3 th\u1ec3 l\u00ean t\u1edbi 10% d\u00e2n s\u1ed1, do \u0111\u00f3 nhu c\u1ea7u v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi ng\u00e0y c\u00e0ng t\u0103ng k\u00e9o theo s\u1ef1 ch\u00fa \u00fd nghi\u00ean c\u1ee9u v\u1ec1 b\u1ed5 sung vitamin.<\/span><\/p>\n

Vitamin B12\u00a0<\/strong><\/span><\/p>\n

\"\"<\/p>\n

C\u00e1c m\u00f4 h\u00ecnh th\u1ef1c nghi\u1ec7m tr\u00ean \u0111\u1ed9ng v\u1eadt \u0111\u00e3 ch\u1ec9 ra m\u1ed9t s\u1ed1 c\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a vitamin B12 gi\u00fap gi\u1ea3m \u0111au th\u1ea7n kinh \u1edf ng\u01b0\u1eddi (B\u1ea2NG 1<\/strong>). M\u1ed9t t\u1ed5ng quan h\u1ec7 th\u1ed1ng g\u1ea7n \u0111\u00e2y g\u1ed3m 325 b\u00e0i b\u00e1o cho th\u1ea5y c\u00e1c nghi\u00ean c\u1ee9u ch\u1ec9 ra s\u1eed d\u1ee5ng vitamin B12 c\u00f3 hi\u1ec7u qu\u1ea3 nh\u1ea5t trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean l\u00e0 \u0111au th\u1ea7n kinh sau zona (PHN), b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean li\u00ean quan \u0111\u1ebfn r\u01b0\u1ee3u. T\u1ed5ng quan kh\u00f4ng ghi nh\u1eadn nghi\u00ean c\u1ee9u b\u00e1c b\u1ecf c\u00f4ng d\u1ee5ng c\u1ee7a vitamin B12 \u0111\u1ed1i v\u1edbi ch\u1ee9ng \u0111au th\u1ea7n kinh.<\/span><\/p>\n\n\n\n\n
\n

B\u1ea3ng 1. M\u1ed9t s\u1ed1 c\u01a1 ch\u1ebf \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t d\u1ef1a tr\u00ean m\u00f4 h\u00ecnh th\u1ef1c nghi\u1ec7m tr\u00ean \u0111\u1ed9ng v\u1eadt c\u1ee7a vitamin B12 v\u1edbi t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au th\u1ea7n kinh\u00a0<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vitamin B12 c\u00f3 t\u00e1c \u0111\u1ed9ng t\u00edch c\u1ef1c \u0111\u1ebfn vi\u1ec7c t\u00e1i t\u1ea1o c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh th\u00f4ng qua ph\u00e1t tri\u1ec3n c\u00e1c s\u1ee3i tr\u1ee5c, t\u1ed1c \u0111\u1ed9 d\u1eabn truy\u1ec1n th\u1ea7n kinh v\u00e0 s\u1ef1 bi\u1ec7t h\u00f3a t\u1ebf b\u00e0o Schwann.<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vitamin B12 c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p enzym COX (cyclooxygenase) v\u00e0 prostaglandin.<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vitamin B12 l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 homocystein trong m\u00e1u, qua \u0111\u00f3 th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p c\u00e1c ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh (noradrenalin v\u00e0 5-hydroxytryptamin) c\u00f3 th\u1ec3 c\u00f3 vai tr\u00f2 gi\u1ea3m \u0111au<\/span><\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vitamin B12 c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf c\u1ea3m gi\u00e1c \u0111au th\u00f4ng qua TRPV1 (k\u00eanh cation kh\u00f4ng ch\u1ecdn l\u1ecdc c\u00f3 ch\u1ee7 y\u1ebfu \u1edf c\u00e1c neuron c\u1ea3m th\u1ee5 \u0111au), ho\u1ea1t t\u00ednh c\u1ee7a TRPV1 gi\u1ea3m khi ti\u1ebfp x\u00fac v\u1edbi v\u1edbi nhi\u1ec7t, acid v\u00e0 capsaicin.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

B\u1ec7nh th\u1ea7n kinh\u00a0ngo\u1ea1i bi\u00ean\u00a0do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng:<\/em><\/strong>\u00a0T\u0103ng \u0111\u01b0\u1eddng huy\u1ebft (v\u00e0 t\u0103ng lipid m\u00e1u) l\u00e0m t\u0103ng s\u1ea3n xu\u1ea5t c\u00e1c g\u1ed1c oxy h\u00f3a ho\u1ea1t \u0111\u1ed9ng (ROS), c\u00e1c s\u1ea3n ph\u1ea9m glycat h\u00f3a b\u1ec1n v\u1eefng (AGEs) v\u00e0 c\u00e1c lo\u1ea1i \u0111\u01b0\u1eddng kh\u00f4ng h\u00f2a tan nh\u01b0 sorbitol. C\u00e1c s\u1ea3n ph\u1ea9m n\u00e0y g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o v\u00e0 t\u1ea1o m\u00f4i tr\u01b0\u1eddng ti\u1ec1n vi\u00eam, \u0111\u1eb7c bi\u1ec7t \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh ngo\u1ea1i vi. M\u1eb7c d\u00f9 vi\u1ec7c s\u1eed d\u1ee5ng vitamin B12 cho b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 xu h\u01b0\u1edbng t\u0103ng, nh\u01b0ng b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 l\u00e0 kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 v\u00ec h\u1ea7u h\u1ebft c\u00e1c th\u1eed nghi\u1ec7m nghi\u00ean c\u1ee9u thi\u1ebfu th\u1eddi gian theo d\u00f5i ho\u1eb7c c\u1ee1 m\u1eabu ch\u01b0a \u0111\u1ee7 l\u1edbn v\u00e0 kh\u00f4ng c\u00f3 nh\u00f3m gi\u1ea3 d\u01b0\u1ee3c (placebo) \u0111\u1ec3 so s\u00e1nh. Ngo\u00e0i ra, nhi\u1ec1u nghi\u00ean c\u1ee9u trong s\u1ed1 n\u00e0y t\u1eadp trung v\u00e0o vi\u1ec7c s\u1eed d\u1ee5ng b\u1ed5 sung vitamin B12 c\u00f3 ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c gabapentinoid (gabapentin, pregabalin) v\u00e0 c\u00e1c vitamin nh\u00f3m B kh\u00e1c, do \u0111\u00f3 g\u00e2y h\u1ea1n ch\u1ebf cho vi\u1ec7c \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111\u01a1n l\u1ebb c\u1ee7a vitamin B12.<\/span><\/p>\n

\u0110au th\u1ea7n kinh sau zona (PHN):<\/em><\/strong>\u00a0PHN l\u00e0 c\u01a1n \u0111au dai d\u1eb3ng k\u00e9o d\u00e0i tr\u00ean 4 th\u00e1ng sau ph\u00e1t ban c\u1ee7a b\u1ec7nh zona do vi r\u00fat\u00a0Herpes zoster<\/em>\u00a0g\u00e2y ra. T\u00ecnh tr\u1ea1ng vi\u00eam g\u00e2y ra b\u1edfi vi r\u00fat l\u00e0m x\u01a1 h\u00f3a c\u00e1c s\u1ee3i tr\u1ee5c th\u1ea7n kinh khi\u1ebfn ch\u00fang ho\u1ea1t \u0111\u1ed9ng ph\u00f3ng \u0111i\u1ec7n m\u1ed9t c\u00e1ch t\u1ef1 ph\u00e1t, ng\u1eabu nhi\u00ean v\u00e0 bi\u1ec3u hi\u1ec7n ph\u1ea3n \u1ee9ng kh\u00f4ng t\u01b0\u01a1ng x\u1ee9ng v\u1edbi c\u00e1c k\u00edch th\u00edch, d\u1eabn \u0111\u1ebfn t\u0103ng nh\u1ea1y c\u1ea3m \u1edf c\u00e1c c\u01a1 quan ngo\u1ea1i vi v\u00e0 c\u00f3 c\u1ea3m gi\u00e1c \u0111au c\u1ea3 khi kh\u00f4ng c\u00f3 k\u00edch th\u00edch g\u00e2y \u0111au (ch\u1ee9ng lo\u1ea1n c\u1ea3m gi\u00e1c), c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y \u0111au k\u00e9o d\u00e0i k\u1ec3 c\u1ea3 khi kh\u00f4ng c\u00f2n t\u1ed5n th\u01b0\u01a1ng m\u00f4. N\u0103m th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o t\u1ed5ng quan h\u1ec7 th\u1ed1ng cho th\u1ea5y vitamin B12 r\u1ea5t h\u1eefu \u00edch (d\u00f9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u01a1n tr\u1ecb li\u1ec7u hay \u0111\u00f3ng vai tr\u00f2 l\u00e0 li\u1ec7u ph\u00e1p b\u1ed5 tr\u1ee3) \u0111\u1ed1i v\u1edbi PHN kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed bi\u1ec3u hi\u1ec7n c\u01a1n \u0111au.<\/span><\/p>\n

B\u1ec7nh th\u1ea7n kinh\u00a0ngo\u1ea1i bi\u00ean\u00a0li\u00ean quan \u0111\u1ebfn r\u01b0\u1ee3u:<\/em><\/strong>\u00a0S\u1ef1 thi\u1ebfu h\u1ee5t vitamin do nghi\u1ec7n r\u01b0\u1ee3u m\u1ea1n t\u00ednh d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng h\u1ee7y myelin c\u1ee7a c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh ngo\u1ea1i vi v\u00e0 l\u00e0m ch\u1eadm d\u1eabn truy\u1ec1n th\u1ea7n kinh do nhi\u1ec5m \u0111\u1ed9c th\u1ea7n kinh g\u00e2y ra b\u1edfi r\u01b0\u1ee3u. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng \u0111\u1ed1i x\u1ee9ng v\u00e0 xa, bao g\u1ed3m d\u1ecb c\u1ea3m, chu\u1ed9t r\u00fat, y\u1ebfu v\u00e0 \u0111au. B\u1ed5 sung vitamin trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y s\u1ebd gi\u00fap gi\u1ea3m c\u00e1c bi\u1ebfn ch\u1ee9ng \u0111\u00f3. Vi\u1ec7c b\u1ed5 sung vitamin B12 c\u00f3 th\u1ec3 mang l\u1ea1i l\u1ee3i \u00edch trong vi\u1ec7c c\u1ea3i thi\u1ec7n c\u01a1n \u0111au.<\/span><\/p>\n

K\u1ebdm<\/strong><\/span><\/p>\n

\"\"<\/p>\n

C\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a b\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean do h\u00f3a tr\u1ecb li\u1ec7u (CIPN) ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh r\u00f5 r\u00e0ng, gi\u1ea3 thuy\u1ebft c\u01a1 ch\u1ebf c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn s\u1ef1 tho\u00e1i h\u00f3a s\u1ee3i tr\u1ee5c do ti\u1ebfp x\u00fac l\u00e2u d\u00e0i v\u1edbi c\u00e1c t\u00e1c nh\u00e2n h\u00f3a tr\u1ecb li\u1ec7u. M\u1ed9t nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 l\u00e0 do s\u1ef1 gia t\u0103ng c\u00e1c g\u1ed1c oxy h\u00f3a t\u1ef1 do (ROS) t\u1eeb c\u00e1c thu\u1ed1c h\u00f3a tr\u1ecb li\u1ec7u, v\u00ec v\u1eady vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t ch\u1ed1ng oxy h\u00f3a \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ng\u0103n ng\u1eeba CIPN \u0111ang \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c nghi\u00ean c\u1ee9u. B\u1ea3ng c\u00e2u h\u1ecfi d\u1ef1a tr\u00ean Nghi\u00ean c\u1ee9u v\u1ec1 Ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng, T\u1eadp luy\u1ec7n, L\u1ed1i s\u1ed1ng v\u00e0 Ti\u00ean l\u01b0\u1ee3ng Ung th\u01b0 (DELCaP) \u0111\u00e3 cho th\u1ea5y m\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa vi\u1ec7c s\u1eed d\u1ee5ng vitamin t\u1ed5ng h\u1ee3p v\u1edbi gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc CIPN \u1edf b\u1ec7nh nh\u00e2n ung th\u01b0 v\u00fa giai \u0111o\u1ea1n I-III c\u00f3 s\u1eed d\u1ee5ng doxorubicin, cyclophosphamid v\u00e0 paclitaxel. Tuy nhi\u00ean nguy c\u01a1 gi\u1ea3m \u0111\u00e1ng k\u1ec3 t\u1ef7 l\u1ec7 m\u1eafc CIPN kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea \u1edf nh\u00f3m ch\u1ec9 b\u1ed5 sung m\u1ed9t lo\u1ea1i vitamin. M\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean m\u00f4 h\u00ecnh chu\u1ed9t v\u1edbi CIPN g\u00e2y ra b\u1edfi paclitaxel \u0111\u00e3 ghi nh\u1eadn c\u00f3 s\u1ef1 gi\u1ea3m nh\u1ea1y c\u1ea3m \u0111au t\u1ea1i ch\u1ed7 ph\u1ee5 thu\u1ed9c v\u00e0o li\u1ec1u l\u01b0\u1ee3ng sau khi d\u00f9ng k\u1ebdm trong t\u1ed1i \u0111a 4 ng\u00e0y. Nghi\u00ean c\u1ee9u n\u00e0y cho th\u1ea5y s\u1ef1 b\u1ed5 sung k\u1ebdm ngo\u1ea1i sinh c\u00f3 t\u00e1c d\u1ee5ng \u1ee9c ch\u1ebf TRPV1 (m\u1ed9t protein v\u1eadn chuy\u1ec3n cation kh\u00f4ng ch\u1ecdn l\u1ecdc), do \u0111\u00f3 ng\u0103n ch\u1eb7n s\u1ef1 nh\u1ea1y c\u1ea3m do paclitaxel g\u00e2y ra \u0111\u1ed1i v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 ngo\u1ea1i vi. Nghi\u00ean c\u1ee9u Pathways cho th\u1ea5y ph\u1ee5 n\u1eef b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng k\u1ebdm v\u00e0 c\u00e1c ch\u1ea5t ch\u1ed1ng oxy h\u00f3a kh\u00e1c sau khi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n c\u00f3 nguy c\u01a1 m\u1eafc CIPN cao h\u01a1n ng\u01b0\u1eddi kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u1eeb 2 \u0111\u1ebfn 3 l\u1ea7n trong 6 th\u00e1ng theo d\u00f5i. Nh\u01b0 v\u1eady, c\u1ea7n c\u00f3 c\u00e1c nghi\u00ean c\u1ee9u s\u00e2u h\u01a1n v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng k\u1ebdm \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb CIPN tr\u01b0\u1edbc khi c\u00f3 b\u1ea5t k\u1ef3 thay \u0111\u1ed5i n\u00e0o \u0111\u1ed1i v\u1edbi c\u00e1c khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb.<\/span><\/p>\n

Vitamin E<\/strong><\/span><\/p>\n

\"\"<\/p>\n

Vitamin E, l\u00e0 m\u1ed9t ch\u1ea5t ch\u1ed1ng oxy h\u00f3a tan trong d\u1ea7u quan tr\u1ecdng. M\u1ed1i li\u00ean quan gi\u1eefa vitamin E v\u00e0 vai tr\u00f2 c\u1ee7a c\u00e1c g\u1ed1c oxy h\u00f3a t\u1ef1 do (ROS) trong \u0111au th\u1ea7n kinh v\u1eabn \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. N\u0103m 2006, m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean m\u00f4 h\u00ecnh chu\u1ed9t \u0111\u00e3 k\u1ebft lu\u1eadn r\u1eb1ng s\u1eed d\u1ee5ng vitamin E – ti\u00eam m\u1ed9t l\u1ea7n duy nh\u1ea5t, li\u1ec1u cao (0,1, 1 ho\u1eb7c 5 g\/kg, kh\u00f4ng c\u00f3 li\u1ec1u t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u1edf ng\u01b0\u1eddi do s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 chuy\u1ec3n h\u00f3a gi\u1eefa c\u00e1c lo\u00e0i) ho\u1eb7c li\u1ec1u th\u1ea5p l\u1eb7p l\u1ea1i h\u00e0ng ng\u00e0y (50 ho\u1eb7c 100 mg\/kg, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi 3g \u1edf ng\u01b0\u1eddi n\u1eb7ng 60kg) \u00a0l\u00e0m gi\u1ea3m c\u00e1c bi\u1ec3u hi\u1ec7n li\u00ean quan \u0111\u1ebfn lo\u1ea1n c\u1ea3m \u0111au c\u01a1 h\u1ecdc. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 k\u1ebft qu\u1ea3 c\u1ee7a nghi\u00ean c\u1ee9u DELCaP, m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng giai \u0111o\u1ea1n III tr\u00ean b\u1ec7nh nh\u00e2n ung th\u01b0 \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng h\u00f3a ch\u1ea5t (g\u00e2y \u0111\u1ed9c th\u1ea7n kinh) cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 m\u1eafc CIPN b\u1ea5t k\u1ec3 c\u00f3 s\u1eed d\u1ee5ng vitamin E hay kh\u00f4ng. C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u nh\u1eadn th\u1ea5y c\u00f3 s\u1ef1 gi\u1ea3m nh\u1eb9 th\u1eddi gian \u0111au th\u1ea7n kinh \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n d\u00f9ng 400 mg vitamin E hai l\u1ea7n m\u1ed7i ng\u00e0y; tuy nhi\u00ean, h\u1ecd c\u0169ng l\u01b0u \u00fd r\u1eb1ng li\u1ec1u l\u01b0\u1ee3ng nh\u01b0 v\u1eady c\u00f3 th\u1ec3 qu\u00e1 th\u1ea5p \u0111\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c l\u1ee3i \u00edch \u0111\u00e1ng k\u1ec3. M\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng so s\u00e1nh vi\u1ec7c b\u1ed5 sung vitamin E v\u1edbi gi\u1ea3 d\u01b0\u1ee3c (placebo) nh\u01b0 l\u00e0 li\u1ec7u ph\u00e1p b\u1ed5 tr\u1ee3 cho ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u0111au chu\u1ea9n \u1edf b\u1ec7nh th\u1ea7n kinh do \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0a ra k\u1ebft lu\u1eadn vitamin E c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c gi\u1ea3m m\u1ed9t s\u1ed1 c\u01a1n \u0111au, nh\u01b0ng kh\u00f4ng ghi nh\u1eadn s\u1ef1 c\u1ea3i thi\u1ec7n v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng.<\/span><\/p>\n

\u0110AU M\u1ea0N T\u00cdNH<\/strong><\/span><\/p>\n

Theo IASP,\u00a0\u0111au m\u1ea1n t\u00ednh<\/em>\u00a0l\u00e0 “c\u01a1n \u0111au dai d\u1eb3ng ho\u1eb7c t\u00e1i ph\u00e1t trong h\u01a1n 3 th\u00e1ng.” C\u00e1c nguy\u00ean t\u1eafc v\u1ec1 vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111au th\u1ea7n kinh v\u00e0 \u0111au m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 t\u01b0\u01a1ng t\u1ef1 nhau, v\u00ec m\u1ed9t s\u1ed1 d\u1ea1ng \u0111au th\u1ea7n kinh c\u00f3 th\u1ec3 tr\u1edf th\u00e0nh \u0111au m\u1ea1n t\u00ednh. C\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u l\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c (ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng, t\u1eadp th\u1ec3 d\u1ee5c, thay \u0111\u1ed5i h\u00e0nh vi, l\u1ed1i s\u1ed1ng) v\u00e0 k\u00ea \u0111\u01a1n thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng opioid. Tuy nhi\u00ean, do t\u00ednh ch\u1ea5t c\u1ee7a \u0111au m\u1ea1n t\u00ednh, nhi\u1ec1u b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n opioid. \u0110au m\u1ea1n t\u00ednh l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y m\u1ea5t kh\u1ea3 n\u0103ng ho\u1ea1t \u0111\u1ed9ng \u1edf ng\u01b0\u1eddi M\u1ef9 tr\u01b0\u1edfng th\u00e0nh, do \u0111\u00f3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thay th\u1ebf c\u0169ng \u0111\u01b0\u1ee3c th\u00fac \u0111\u1ea9y \u0111\u00e1ng k\u1ec3, bao g\u1ed3m vi\u1ec7c nghi\u00ean c\u1ee9u v\u1ec1 vitamin v\u00e0 kho\u00e1ng ch\u1ea5t.<\/span><\/p>\n

Vitamin C<\/strong><\/span><\/p>\n

\"\"<\/p>\n

S\u1ef1 thi\u1ebfu h\u1ee5t vitamin C (n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng <11 \u00b5mol\/L) bi\u1ec3u hi\u1ec7n c\u1ee7a ch\u1ee9ng \u0111au c\u01a1 li\u00ean quan \u0111\u1ebfn b\u1ec7nh Scorbut v\u00e0 \u0111au kh\u1edbp \u1edf \u0111\u1ea7u g\u1ed1i, c\u1ed5 tay v\u00e0 m\u1eaft c\u00e1 ch\u00e2n do ch\u1ea3y m\u00e1u t\u1eeb l\u00f2ng m\u1ea1ch v\u00e0o c\u00e1c m\u00f4 c\u01a1 x\u01b0\u01a1ng. S\u1ef1 thi\u1ebfu h\u1ee5t vitamin n\u00e0y r\u1ea5t hi\u1ebfm x\u1ea3y ra \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n (<6% \u1edf M\u1ef9), \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ecb \u1ea3nh h\u01b0\u1edfng ch\u1ee7 y\u1ebfu l\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n ng\u01b0\u1eddi cao tu\u1ed5i, b\u1ec7nh nh\u00e2n ung th\u01b0 v\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n n\u1eb7ng. Vi\u1ec7c s\u1eed d\u1ee5ng vitamin C \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 nh\u1ea5t \u0111\u1ecbnh trong vi\u1ec7c qu\u1ea3n l\u00fd \u0111au.<\/span><\/p>\n

H\u1ed9i ch\u1ee9ng \u0111au c\u1ee5c b\u1ed9 ph\u1ee9c h\u1ee3p (CRPS):<\/strong><\/em>\u00a0Nhi\u1ec1u th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng vi\u1ec7c b\u1ed5 sung vitamin C l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc CRPS \u1edf b\u1ec7nh nh\u00e2n ph\u1eabu thu\u1eadt c\u1ed5 tay v\u00e0 m\u1eaft c\u00e1 ch\u00e2n, v\u1edbi li\u1ec1u l\u01b0\u1ee3ng hi\u1ec7u qu\u1ea3 nh\u1ea5t l\u00e0 0,5 g tr\u1edf l\u00ean m\u1ed7i ng\u00e0y. M\u1ee9c li\u1ec1u n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c d\u00f9ng d\u1ef1 ph\u00f2ng vi\u00eam x\u01b0\u01a1ng kh\u1edbp \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ph\u1eabu thu\u1eadt thay th\u1ebf kh\u1edbp, nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y sau \u0111\u00f3 \u0111\u1ec1u kh\u00f4ng m\u1eafc CRPS.<\/span><\/p>\n

B\u1ec7nh vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p v\u00e0 vi\u00eam x\u01b0\u01a1ng kh\u1edbp:<\/strong><\/em>\u00a0Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 l\u01b0\u1ee3ng vitamin C trung b\u00ecnh th\u1ea5p h\u01a1n kho\u1ea3ng m\u1ed9t n\u1eeda so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. M\u1ed9t nghi\u00ean c\u1ee9u ghi nh\u1eadn t\u1ed5ng s\u1ed1 c\u01a1n \u0111au \u1edf m\u1ed9t b\u1ec7nh nh\u00e2n vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p gi\u1ea3m sau khi truy\u1ec1n vitamin C li\u1ec1u cao hai l\u1ea7n m\u1ed7i tu\u1ea7n. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c tr\u00ean b\u1ec7nh nh\u00e2n vi\u00eam x\u01b0\u01a1ng kh\u1edbp s\u1eed d\u1ee5ng canxi ascorbat 1g \u0111\u01b0\u1eddng u\u1ed1ng m\u1ed7i ng\u00e0y cho th\u1ea5y m\u1ee9c \u0111\u1ed9 gi\u1ea3m \u0111au ch\u1ec9 b\u1eb1ng 50% so v\u1edbi khi d\u00f9ng thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid (NSAIDs). \u0110i\u1ec1u \u0111\u00f3 cho th\u1ea5y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh x\u01b0\u01a1ng kh\u1edbp, vi\u1ec7c d\u00f9ng vitamin C \u0111\u01b0\u1eddng ti\u00eam mang l\u1ea1i hi\u1ec7u qu\u1ea3 h\u01a1n so v\u1edbi \u0111\u01b0\u1eddng u\u1ed1ng.<\/span><\/p>\n

\u0110au do ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh:<\/strong><\/em>\u00a0Vitamin C c\u00f3 t\u00e1c d\u1ee5ng \u0111i\u1ec1u ti\u1ebft \u0111\u1ebfn s\u1ef1 h\u00ecnh th\u00e0nh x\u01b0\u01a1ng v\u00e0 collagen. M\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean 16 b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh Paget x\u01b0\u01a1ng cho th\u1ea5y c\u00f3 t\u00ecnh tr\u1ea1ng \u0111au c\u00f3 c\u1ea3i thi\u1ec7n sau khi u\u1ed1ng vitamin C 3g\/ng\u00e0y trong 2 tu\u1ea7n. Tuy nhi\u00ean, so v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng calcitonin, hi\u1ec7u qu\u1ea3 gi\u1ea3m \u0111au c\u1ee7a vitamin C tr\u00ean b\u1ec7nh l\u00fd n\u00e0y th\u1ea5p h\u01a1n.<\/span><\/p>\n

\u0110au th\u1ea7n kinh sau zona (PHN):<\/strong><\/em>\u00a0N\u1ed3ng \u0111\u1ed9 vitamin C trong huy\u1ebft thanh \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh Zona th\u1ea5p h\u01a1n nhi\u1ec1u so v\u1edbi ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh v\u00e0 \u0111i\u1ec1u n\u00e0y l\u00e0m t\u0103ng nguy c\u01a1 b\u1ecb \u0111au sau Zona (PHN). C\u00e1c th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng cho th\u1ea5y s\u1eed d\u1ee5ng vitamin C \u0111\u01b0\u1eddng ti\u00eam l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 m\u1eafc PHN v\u00e0 gi\u1ea3m \u0111au k\u00e9o d\u00e0i.<\/span><\/p>\n

\u0110au do ung th\u01b0:<\/strong><\/em>\u00a0B\u1ec7nh nh\u00e2n ung th\u01b0 th\u01b0\u1eddng c\u00f3 nhu c\u1ea7u vitamin C cao v\u00e0 l\u01b0u l\u01b0\u1ee3ng tu\u1ea7n ho\u00e0n th\u1ea5p h\u01a1n nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. C\u00e1c nghi\u00ean c\u1ee9u d\u1ef1a tr\u00ean b\u1ea3ng c\u00e2u h\u1ecfi ki\u1ec3m tra ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng cho th\u1ea5y t\u00ecnh tr\u1ea1ng \u0111au \u0111\u00e3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 (> 30%) sau khi d\u00f9ng vitamin C theo \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c \u0111\u01b0\u1eddng ti\u00eam.<\/span><\/p>\n

Gi\u1ea3m nhu c\u1ea7u v\u1ec1 opioid:<\/strong><\/em>\u00a0B\u1ec7nh nh\u00e2n s\u1eed d\u1ee5ng opioid gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng cai nghi\u1ec7n khi d\u00f9ng k\u00e8m vitamin C. M\u1ed9t v\u00e0i nghi\u00ean c\u1ee9u c\u0169ng cho th\u1ea5y nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u1ea7n d\u00f9ng opioid (t\u00ednh t\u01b0\u01a1ng \u0111\u01b0\u01a1ng theo morphin) \u00edt h\u01a1n so v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng s\u1eed d\u1ee5ng c\u00f9ng vitamin C.<\/span><\/p>\n

Vitamin D<\/strong><\/span><\/p>\n

\"\"<\/p>\n

S\u1ef1 thi\u1ebfu h\u1ee5t vitamin D c\u00f3 li\u00ean quan \u0111\u1ebfn m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n g\u00e2y \u0111au m\u1ea1n t\u00ednh, bao g\u1ed3m b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng t\u00edp 1, t\u0103ng huy\u1ebft \u00e1p, h\u1ed9i ch\u1ee9ng chuy\u1ec3n h\u00f3a, thi\u1ebfu m\u00e1u c\u01a1 tim c\u1ee5c b\u1ed9, ng\u00e3, g\u00e3y x\u01b0\u01a1ng, tr\u1ea7m c\u1ea3m v\u00e0 ung th\u01b0. C\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y c\u0169ng cho th\u1ea5y m\u1ed1i li\u00ean quan gi\u1eefa s\u1ef1 thi\u1ebfu h\u1ee5t vitamin D v\u1edbi b\u1ec7nh h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m, \u0111au kh\u1edbp do \u1ee9c ch\u1ebf men aromatase, \u0111au \u0111\u1ea7u, PHN, \u0111au \u1edf b\u1ec7nh nh\u00e2n d\u00f9ng opioid li\u1ec1u cao, v\u00e0 c\u00e1c lo\u1ea1i \u0111au c\u01a1 x\u01b0\u01a1ng kh\u1edbp v\u00e0 \u0111au do ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh. Trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, m\u1ee9c \u0111\u1ed9 \u0111au v\u00e0 s\u1eed d\u1ee5ng opioid \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o gia t\u0103ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 s\u1ef1 thi\u1ebfu h\u1ee5t n\u1ed3ng \u0111\u1ed9 vitamin D trong m\u00e1u. Ngo\u00e0i t\u00e1c d\u1ee5ng \u0111\u1ed1i v\u1edbi x\u01b0\u01a1ng v\u00e0 n\u1ed9i ti\u1ebft t\u1ed1, vitamin D c\u00f2n \u0111i\u1ec1u h\u00f2a c\u00e1c ph\u1ea3n \u1ee9ng vi\u00eam qua trung gian h\u1ec7 mi\u1ec5n d\u1ecbch m\u1eafc ph\u1ea3i. T\u01b0\u01a1ng t\u1ef1 nh\u01b0 vi\u1ec7c b\u1ed5 sung vitamin C, vi\u1ec7c s\u1eed d\u1ee5ng vitamin D trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y ng\u0103n ng\u1eeba c\u01a1n \u0111au li\u00ean quan \u0111\u1ebfn s\u1ef1 thi\u1ebfu h\u1ee5t vitamin (<30 nmol\/L) v\u00e0 \u00edt c\u00f3 t\u00e1c d\u1ee5ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 \u0111\u1ee7 l\u01b0\u1ee3ng vitamin D c\u1ea7n thi\u1ebft. Hi\u1ec7n t\u1ea1i ch\u01b0a c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng \u0111\u1ec3 thay \u0111\u1ed5i c\u00e1c khuy\u1ebfn ngh\u1ecb li\u00ean quan \u0111\u1ebfn vi\u1ec7c b\u1ed5 sung vitamin D, do \u0111\u00f3 c\u1ea7n ti\u1ebfn h\u00e0nh nhi\u1ec1u nghi\u00ean c\u1ee9u s\u00e2u h\u01a1n v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y.<\/span><\/p>\n

Magie<\/strong><\/span><\/p>\n

\"\"<\/p>\n

Magie l\u00e0 m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 t\u1ea1o \u0111i\u1ec7n th\u1ebf\u00a0N<\/em>-methyl-D-aspartate. Khi g\u1eafn v\u00e0o c\u00e1c th\u1ee5 th\u1ec3 n\u00e0y, magie c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m k\u00edch th\u00edch \u0111au b\u1eb1ng c\u00e1ch ng\u0103n ng\u1eeba v\u00e0 l\u00e0m gi\u1ea3m t\u00ecnh tr\u1ea1ng qu\u00e1 m\u1eabn c\u1ea3m v\u1edbi c\u01a1n \u0111au. Magie l\u00e0m gi\u1ea3m s\u1ef1 h\u01b0ng ph\u1ea5n th\u1ea7n kinh c\u01a1 do c\u00f3 t\u00e1c d\u1ee5ng \u0111\u1ed1i kh\u00e1ng v\u1edbi canxi trong gi\u1ea3i ph\u00f3ng acetylcholin. \u0110\u1ec3 xem x\u00e9t \u0111i\u1ec1u ch\u1ec9nh thay \u0111\u1ed5i c\u00e1c khuy\u1ebfn ngh\u1ecb \u0111\u1ed1i v\u1edbi vi\u1ec7c gi\u1ea3m \u0111au, c\u1ea7n ti\u1ebfn h\u00e0nh c\u00e1c nghi\u00ean c\u1ee9u b\u00e0n lu\u1eadn k\u1ef9 h\u01a1n v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y tr\u01b0\u1edbc khi \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh. Tuy nhi\u00ean s\u1eed d\u1ee5ng magie cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn v\u00e0 h\u1ee9a h\u1eb9n nhi\u1ec1u ti\u1ec1m n\u0103ng t\u00edch c\u1ef1c<\/span><\/p>\n

\u0110au\u00a0li\u00ean quan \u0111\u1ebfn\u00a0ph\u1eabu thu\u1eadt\u00a0(Perioperative):<\/strong><\/em>\u00a0M\u1ed9t t\u1ed5ng quan h\u1ec7 th\u1ed1ng ph\u00e2n t\u00edch d\u1eef li\u1ec7u t\u1eeb 27 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean, c\u00f3 \u0111\u1ed1i ch\u1ee9ng, cho th\u1ea5y vi\u1ec7c s\u1eed d\u1ee5ng magie t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n (ti\u00eam\/truy\u1ec1n t\u0129nh m\u1ea1ch) trong su\u1ed1t qu\u00e1 tr\u00ecnh g\u00e2y m\u00ea c\u1ee7a b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111au sau ph\u1eabu thu\u1eadt m\u00e0 kh\u00f4ng l\u00e0m t\u0103ng nguy c\u01a1 g\u1eb7p bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i.\u00a0<\/sup>Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng v\u1edbi li\u1ec1u n\u1ea1p t\u1eeb 30 mg\/kg \u0111\u1ebfn 50 mg\/kg sau \u0111\u00f3 l\u00e0 li\u1ec1u duy tr\u00ec t\u1eeb 6 mg\/kg \u0111\u1ebfn 20 mg\/kg m\u1ed7i gi\u1edd. Magie c\u0169ng c\u00f3 li\u00ean quan \u0111\u1ebfn l\u00e0m t\u0103ng \u1ed5n \u0111\u1ecbnh huy\u1ebft \u0111\u1ed9ng trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt c\u0169ng nh\u01b0 gi\u00fap h\u1ea1n ch\u1ebf l\u01b0\u1ee3ng thu\u1ed1c g\u00e2y m\u00ea v\u00e0 opioid c\u1ea7n s\u1eed d\u1ee5ng. Thu\u1ed1c kh\u00f4ng c\u00f3 hi\u1ec7u qu\u1ea3 trong vi\u1ec7c gi\u1ea3m \u0111au li\u00ean quan \u0111\u1ebfn ph\u1eabu thu\u1eadt l\u1ea5y thai, ph\u1eabu thu\u1eadt c\u1eaft t\u1eed cung, ph\u1eabu thu\u1eadt tho\u00e1t v\u1ecb b\u1eb9n, v\u00e0 ph\u1eabu thu\u1eadt suy gi\u00e3n t\u0129nh m\u1ea1ch. Tuy nhi\u00ean, \u0111\u00e1ng ch\u00fa \u00fd l\u00e0 c\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0a ra k\u1ebft qu\u1ea3 n\u00e0y ch\u1ec9 s\u1eed d\u1ee5ng magie m\u1ed9t li\u1ec1u duy nh\u1ea5t thay v\u00ec s\u1eed d\u1ee5ng li\u1ec1u n\u1ea1p k\u1ebft h\u1ee3p v\u1edbi truy\u1ec1n li\u00ean t\u1ee5c.<\/span><\/p>\n

Ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u:<\/strong><\/em>\u00a0S\u1ef1 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 magie huy\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u, tuy nhi\u00ean c\u0103n nguy\u00ean c\u1ee7a t\u00ecnh tr\u1ea1ng n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch \u0111\u1ea7y \u0111\u1ee7. K\u1ebft qu\u1ea3 b\u1ed5 sung magie kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t trong vi\u1ec7c ng\u0103n ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb ch\u1ee9ng \u0111au n\u1eeda \u0111\u1ea7u gi\u1eefa c\u00e1c b\u1ec7nh nh\u00e2n. Nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 do s\u1ef1 kh\u00e1c bi\u1ec7t trong d\u1ea1ng b\u00e0o ch\u1ebf, li\u1ec1u l\u01b0\u1ee3ng v\u00e0 c\u00e1ch d\u00f9ng magie c\u0169ng nh\u01b0 ph\u00e2n lo\u1ea1i \u0111au n\u1eeda \u0111\u1ea7u.<\/span><\/p>\n

\u0110au c\u01a1 x\u01a1 h\u00f3a:<\/strong><\/em>\u00a0B\u1ec7nh nh\u00e2n b\u1ecb \u0111au c\u01a1 x\u01a1 h\u00f3a c\u00f3 n\u1ed3ng \u0111\u1ed9 magie huy\u1ebft th\u1ea5p v\u00e0 l\u01b0\u1ee3ng magie h\u1ea5p thu c\u0169ng th\u1ea5p. B\u1ed5 sung magie \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 l\u1ee3i v\u00ec vitamin n\u00e0y l\u00e0m gi\u1ea3m n\u1ed3ng \u0111\u1ed9 ch\u1ea5t P, c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c gi\u1ea3m \u0111au do \u0111au c\u01a1 x\u01a1 h\u00f3a.<\/span><\/p>\n

PHN:<\/strong><\/em>\u00a0Magie sulfat ti\u00eam t\u0129nh m\u1ea1ch v\u1edbi li\u1ec1u 30 mg\/kg trong 30 ph\u00fat \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 l\u00e0m gi\u1ea3m ho\u1eb7c h\u1ebft ho\u00e0n to\u00e0n c\u01a1n \u0111au \u1edf b\u1ec7nh nh\u00e2n sau zona (PHN). C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng magie c\u00f3 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ketamin trong vi\u1ec7c gi\u1ea3m \u0111au li\u00ean quan \u0111\u1ebfn \u0111au sau zona (PHN), tuy nhi\u00ean c\u1ea7n ti\u1ebfn h\u00e0nh nhi\u1ec1u nghi\u00ean c\u1ee9u h\u01a1n tr\u01b0\u1edbc khi \u0111\u01b0a ra khuy\u1ebfn ngh\u1ecb magie sulfat l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn trong \u0111i\u1ec1u tr\u1ecb.<\/span><\/p>\n

CIPN:<\/strong><\/em>\u00a0M\u1ed9t nghi\u00ean c\u1ee9u n\u0103m 2004 ghi nh\u1eadn vi\u1ec7c truy\u1ec1n canxi v\u00e0 magie (Ca2+\/Mg2+) tr\u01b0\u1edbc v\u00e0 sau khi d\u00f9ng oxaliplatin c\u00f3 th\u1ec3 ng\u0103n ng\u1eeba s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a CIPN. C\u00e1c ph\u00e2n t\u00edch g\u1ed9p v\u00e0 t\u1ed5ng quan h\u1ec7 th\u1ed1ng \u0111\u01b0a ra c\u00e1c k\u1ebft qu\u1ea3 kh\u00f4ng nh\u1ea5t qu\u00e1n. M\u1eb7c d\u00f9 hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c vitamin n\u00e0y ch\u01b0a \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh r\u00f5 r\u00e0ng, nh\u01b0ng vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c d\u1ecbch truy\u1ec1n n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng.<\/span><\/p>\n

\u00a0<\/strong>K\u1ebeT LU\u1eacN<\/strong><\/span><\/h1>\n

\u0110au l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe ph\u1ee9c t\u1ea1p, c\u00f3 t\u00e1c \u0111\u1ed9ng kh\u00e1c nhau tr\u00ean c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n kh\u00e1c nhau. M\u1eb7c d\u00f9 m\u1ed9t s\u1ed1 li\u1ec7u ph\u00e1p d\u01b0\u1ee3c l\u00fd, thu\u1ed1c nh\u1eb1m qu\u1ea3n l\u00fd \u0111au t\u01b0\u01a1ng \u0111\u1ed1i s\u1eb5n c\u00f3, tuy nhi\u00ean kh\u00f4ng c\u00f3 m\u1ed9t ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb chung n\u00e0o ph\u00f9 h\u1ee3p cho t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n. Vitamin v\u00e0 kho\u00e1ng ch\u1ea5t c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn thay th\u1ebf gi\u00fap gi\u1ea3m \u0111au, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi ch\u1ee9ng \u0111au th\u1ea7n kinh v\u00e0 \u0111au m\u1ea1n t\u00ednh. M\u1eb7c d\u00f9 b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 vi\u1ec7c s\u1eed d\u1ee5ng vitamin v\u00e0 kho\u00e1ng ch\u1ea5t c\u00f2n h\u1ea1n ch\u1ebf, c\u00e1c d\u01b0\u1ee3c s\u0129 v\u1eabn c\u1ea7n ph\u00e1t huy vai tr\u00f2 t\u01b0 v\u1ea5n gi\u00fap b\u1ec7nh nh\u00e2n \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh c\u00f3 c\u01a1 s\u1edf v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t n\u00e0y.<\/span><\/p>\n

\u00a0<\/strong><\/span><\/p>\n

Theo: canhgiacduoc.org.vn\/ <\/em><\/span><\/p>\n

Ngu\u1ed3n:\u00a0https:\/\/www.uspharmacist.com\/article\/vitamins-and-minerals-for-pain-management\u00a0<\/em><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

DS V\u00f5 Ng\u1ecdc Minh Th\u01b0 – Khoa D\u01b0\u1ee3c T\u1ea1i Hoa K\u1ef3, \u0111au m\u1ea1n t\u00ednh l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n<\/p>\n","protected":false},"author":1,"featured_media":12149,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[17],"tags":[],"jetpack_featured_media_url":"https:\/\/12point.net\/wp-content\/uploads\/2022\/11\/845Vit.jpg","jetpack-related-posts":[{"id":11687,"url":"https:\/\/12point.net\/benh-dau-mua-khi-hoi-va-dap\/","url_meta":{"origin":12142,"position":0},"title":"B\u1ec7nh \u0111\u1eadu m\u00f9a kh\u1ec9 – H\u1ecfi v\u00e0 \u0111\u00e1p","date":"02\/08\/2022 15:07","format":false,"excerpt":"B\u1ec7nh \u0111\u1eadu m\u00f9a kh\u1ec9 - H\u1ecfi v\u00e0 \u0111\u00e1p Ng\u00e0y 20 th\u00e1ng 5 n\u0103m 2022 \u0110\u01b0\u1ee3c d\u1ecbch t\u1eeb: https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/monkeypox B\u1ec7nh \u0111\u1eadu m\u00f9a kh\u1ec9 l\u00e0 g\u00ec? \u0110\u1eadu m\u00f9a kh\u1ec9 l\u00e0 m\u1ed9t b\u1ec7nh do vi r\u00fat \u0111\u1eadu m\u00f9a kh\u1ec9 g\u00e2y ra. \u0110\u00e2y l\u00e0 b\u1ec7nh l\u00e2y nhi\u1ec5m t\u1eeb \u0111\u1ed9ng v\u1eadt do vi r\u00fat g\u00e2y\u2026","rel":"","context":"In "Tin y t\u1ebf"","img":{"alt_text":"","src":"https:\/\/i0.wp.com\/12point.net\/wp-content\/uploads\/2022\/08\/845hoidap.jpg?resize=350%2C200&ssl=1","width":350,"height":200},"classes":[]},{"id":1810,"url":"https:\/\/12point.net\/ban-tin-covid-19-18-gio-ngay-04-12-2020\/","url_meta":{"origin":12142,"position":1},"title":"B\u1ea2N TIN COVID-19 – 18 GI\u1edc NG\u00c0Y 04\/12\/2020","date":"07\/12\/2020 07:33","format":false,"excerpt":"Chi\u1ec1u 4\/12, tr\u00f2n 24h Vi\u1ec7t Nam kh\u00f4ng c\u00f3 ca m\u1eafc m\u1edbi COVID-19 (Th\u1ee9 s\u00e1u, 04\/12\/2020 18:03) Chi\u1ec1u ng\u00e0y 4\/12, B\u1ea3n tin c\u1ee7a Ban Ch\u1ec9 \u0111\u1ea1o Qu\u1ed1c gia ph\u00f2ng ch\u1ed1ng COVID-19 cho bi\u1ebft, kh\u00f4ng ghi nh\u1eadn ca m\u1eafc m\u1edbi COVID-19. 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