Ndi oyenera jekeseni wa intrathecal ndi njira zina zochizira (monga systemic analgesics, adjuvant therapy kapena sheath) Ziconotide ndi yamphamvu, yosankha komanso yosinthika ya N-mtundu wa voltage-sensitive calcium channel blocker, yomwe imakhala yothandiza kupweteka kwa refractory, ndipo sikubala. kukana mankhwala pambuyo poyang'anira nthawi yayitali, ndipo sizimayambitsa kudalira kwakuthupi ndi m'maganizo, komanso sizimayambitsa kupsinjika kwa kupuma komwe kumawopseza moyo chifukwa cha kumwa mopitirira muyeso.Mlingo wovomerezeka watsiku ndi tsiku ndi wochepa, wokhala ndi zotsatira zabwino zochizira, chitetezo chambiri, zotsatira zochepa, palibe kukana mankhwala komanso kuledzera.Mankhwalawa ali ndi chiyembekezo chachikulu cha msika ngati mankhwala opweteka.
Malinga ndi ziwerengero zosakwanira, chiwerengero cha ululu padziko lapansi ndi pafupifupi 35% ~ 45% pakalipano, ndipo chiwerengero cha ululu kwa okalamba ndi okwera kwambiri, pafupifupi 75% ~ 90%.Kafukufuku wina wa ku America amasonyeza kuti chiwerengero cha migraine chinawonjezeka kuchokera ku 23.6 miliyoni mu 1989 kufika pa 28 miliyoni mu 2001. Pofufuza za ululu wosatha m'mizinda isanu ndi umodzi ku China, apeza kuti chiwerengero cha ululu wosatha kwa akuluakulu ndi 40%, ndipo mlingo wa chithandizo chamankhwala ndi 35%;Chiwopsezo cha kupweteka kosatha kwa okalamba ndi 65% ~ 80%, ndipo kuchuluka kwakuwonana ndi dokotala ndi 85%.M’zaka zaposachedwapa, ndalama zogulira chithandizo chamankhwala zochotsera ululu zikuwonjezereka chaka ndi chaka.
Kuchokera ku 2013 mpaka July 2015, Pain Research Center ku United States ndi mabungwe angapo azachipatala adachita kafukufuku wanthawi yayitali, wapakati komanso wowonera pa jakisoni wa intrathecal wa ziconotide mu 93 odwala akulu achikazi oyera omwe ali ndi ululu wopweteka kwambiri.Kupweteka kwa digito ndi chiwerengero cha odwala omwe ali ndi jekeseni wa intrathecal wa ziconotide komanso popanda jekeseni wa ziconotide anafaniziridwa Pakati pawo, odwala 51 anagwiritsa ntchito jekeseni wa intrathecal wa ziconotide, pamene odwala 42 sanatero.Zotsatira zowawa zoyambira zinali 7.4 ndi 7.9, motsatira.Mlingo wovomerezeka wa jakisoni wa intrathecal wa ziconotide unali 0.5-2.4 mcg/tsiku, womwe unasinthidwa malinga ndi momwe wodwalayo akuyankhira ululu ndi zotsatira zake.Avereji mlingo woyambirira anali 1.6 mcg/tsiku, 3.0 mcg/tsiku pa miyezi 6 ndi 2.5 pa miyezi 9.Pa miyezi ya 12, inali 1.9 mcg / tsiku, ndipo pambuyo pa miyezi 6, chiwerengero chochepa chinali 29.4%, kusiyana kowonjezereka kunali 6.4%, ndi kusintha kwa chiwerengero cha 69.2% ndi 35.7% motsatira.Pambuyo pa miyezi ya 12, chiwerengero chochepa chinali 34.4% ndi 3.4% motsatira, ndipo kuwonjezeka kwa chiwerengero chazomverera kunali 85.7% ndi 71.4% motsatira.Zotsatira zapamwamba kwambiri zinali nseru (19.6% ndi 7.1%), kuyerekezera zinthu m'maganizo (9.8% ndi 11.9%) ndi chizungulire (13.7% ndi 7.1%).Zotsatira za phunziroli zinatsimikiziranso mphamvu ndi chitetezo cha ziconotide zomwe zimalimbikitsidwa ngati jekeseni woyamba wa intrathecal.
Kuphunzira koyambirira kwa ziconotide kungayambike m'zaka za m'ma 1980, pamene njira yochiritsira yogwiritsira ntchito ma peptides olimba ndi mapuloteni mu conus venom adafufuzidwa kwa nthawi yoyamba.Ma conotoxins awa ndi ma peptides ang'onoang'ono olemera mu ma disulfide bond, nthawi zambiri zotsalira za 10-40 kutalika, kulunjika njira zosiyanasiyana za ion, GPCR ndi mapuloteni onyamula bwino komanso mosankha.Ziconotide ndi 25-peptide yochokera ku Conus magus, yomwe ili ndi zomangira zitatu za disulfide, ndipo β-fold yake yaifupi imakonzedwa mwapang'onopang'ono kukhala mawonekedwe apadera atatu, omwe amalola kuti azitha kuletsa njira za CaV2.2.
