SERVIKOGEN BOSH OG‘RIG‘IDA MIOFASSIAL TRIGGER NUQTALARNING KLINIK AHAMIYATI: FENOTIPLASHDAN MAQSADLI BOTULIN TOKSINI-A TERAPIYASIGACHA
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servikogen bosh og‘rig‘i, miofassial trigger nuqta, A tip botulin toksini, botulinoterapiya, bosim og‘riq bo‘sag‘asi, cervical range of motion, Neck Disability Index, Headache Impact Test-6, personalizatsiyalangan davolash##article.abstract##
Servikogen bosh og‘rig‘i (SBO) bo‘yin umurtqa pog‘onasi, yuqori servikal bo‘g‘imlar va yumshoq to‘qimalardan kelib chiqadigan ikkilamchi bosh og‘rig‘i bo‘lib, klinik fenotipi ko‘pincha migren va zo‘riqish tipidagi bosh og‘rig‘i bilan qisman ustma-ust tushadi. Ayniqsa, faol miofassial trigger nuqtalar tipik bosh og‘rig‘ini qayta chaqirishi, mahalliy bosimga sezuvchanlikni oshirishi va bo‘yin harakatlari bilan bog‘liq simptomlarni kuchaytirishi mumkin. Shu sababli SBOni faqat anatomik tashxis sifatida emas, balki mushak-skelet, miofassial va nositseptiv komponentlari turli darajada ifodalangan geterogen klinik sindrom sifatida baholash muhimdir. Ushbu maqolada SBOda miofassial trigger nuqtalarning diagnostik va patofiziologik ahamiyati, bosim og‘riq bo‘sag‘asi, cervical range of motion, Cervical Flexion-Rotation Test, Neck Disability Index va Headache Impact Test-6 kabi ko‘rsatkichlarning klinik qiymati tahlil qilindi. Shuningdek, A tip botulin toksinining mushak relaksatsiyasi bilan bir qatorda periferik nositseptiv mediatorlar ajralishini kamaytirishi mumkin bo‘lgan mexanizmlari va SBOda uni qo‘llashga oid mavjud klinik dalillar tanqidiy ko‘rib chiqildi. Hozirgi dalillar BoNT-A samaradorligi bo‘yicha bir xil xulosaga kelish imkonini bermaydi; bu holat bemorlarni tanlash mezonlari, doza, preparat, inʼeksiya nuqtalari va natijalarni baholash usullarining geterogenligi bilan izohlanadi. Maqolada faol trigger nuqtalar soni va lokalizatsiyasi, tipik og‘riqni palpatsiya bilan qayta chaqirish, bosim og‘riq bo‘sag‘asi, bo‘yin harakatchanligi, NDI, HIT-6 va bosh og‘rig‘i kundaligi kabi parametrlarni birlashtiruvchi klinik fenotiplash yondashuvi taklif etiladi. Bu yondashuv BoNT-Aga ehtimoliy javob beruvchi bemorlarni kelgusida prospektiv ravishda aniqlash uchun ilmiy asos yaratishi mumkin.
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