Tuberculosis – टी.बी. क्या है
टी.बी. माइकोबेक्टीरियम ट्यूबरक्यूलोसिस नामक रोगाण से होती है। यह रोगाण टी.बी. Tuberculosis रोगी के खाँसने, छींकने और थूकने से वातावरण में फैल जाते है। जब स्वस्थ व्यक्ति उस वातावरण में साँस लेता है तो उसके शरीर में साँस के द्वारा प्रविष्ट हो कर उसे संक्रमित कर सकते हैं।
सामान्यतया 80-85 प्रतिशत टी.बी. रोगी फेफड़ों की टी.बी. के होते है। शेष रोगियों में टी.बी. के रोगाणु शरीर के किसी भी भाग को प्रभावित कर सकता हैं। यदि टी.बी. रोगी पूरा उपचार लेता है तो वह पूरी तरह से ठीक हो सकता है।
- विश्व मे लगभग 95 लाख लोग हर साल टी०बी० की चपेट मे आते हैं।
- 95 प्रतिशत विकासशील देशो मे हैं।
- भारत उन 22 देशो में सबसे ऊपर हैं। जिनमे टी०बी० की समस्या सबसे ज्यादा हैं टी०बी० किसी भी व्यक्ति को हो सकती है। यह आयु, लिंग, अमीर-गरीब, जाति धर्म नहीं देखती।भारत की 40 प्रतिशत जनसंख्या टी०बी० के बैक्टीरिया से प्रभावित है।
- प्रतिदिन 2 लाख जनसंख्या टी०बी० बैक्टीरिया से प्रभावित होती है।
प्रतिदिन लगभग 5 हजार लोगो को टी०बी० की बीमारी होती है। हर साल लगभग 8 लाख लोगो को पॉजिटिव (Sputum.) टीबी होती है।
Symptoms of tuberculosis – टी.बी. के लक्षण
- दो हफ्ते या उससे अधिक समय की खाँसी के साथ बलगम आना।
- बुखार, खासतौर पर शाम को बढ़ना।
- खाँसी के साथ बलगम मे खून आना
- छाती में दर्द।
- भूख कम लगना।
- वजन का घटना।
Spread of TB – टी.बी. कैसे फैलती है?
केवल फेफड़ो की टी.बी. के रोगी ही टी.बी. फैला सकते है। ऐसे रोगी के खाँसने या छींकने से टी.बी. के कीटाणु हवा में फैल जाते है और सांस द्वारा स्वस्थ व्यक्ति के फेफड़ों में पहुँच कर रोग उत्पन्न कर सकते है।
टी.बी. से प्रभावित अंग
टी.बी. मुख्यतः (80 प्रतिशत) फेफड़ो में होती है। फेफड़ों के अतिरिक्त यह रोग शरीर के किसी भी अंग को प्रभावित कर सकता है
जैसे गाँठे, हड्डियाँ, मस्तिष्क, गुर्दे, आंते इत्यादि। इन अंगों की टी.बी. का रोगी अन्य किसी को बीमारी नही फैला सकता।
Pulmonary tuberculosis – फेफड़ों की टी. बी./पल्मोनरी ट्यूबरकुलोसिस
जैसा कि पहले ही बताया जा चूका है कि शरीर का कोई भी अंग प्रभावित हो सकता है परन्तु क्षय के जीवाणुओं का मुख्य निशाना फेफड़े (Lungs) ही होते हैं। परन्तु इन पर सीधा आक्रमण बहुत कम होता है, ये जीवाणु पहले लिम्फ ग्रन्थियों को संक्रमित करते हैं। आगे चलकर रोग फेफड़ों तक पहुँच जाते हैं। क्षय के किसी-किसी रोगी में अन्य कोई भी लक्षण नहीं होता है, अचानक एक दिन मुंह से रक्त की उल्टी होने से ही रोग का सन्देह हो जाता है।
चिकित्सा विधि –
उपचार/सहायक चिकित्सा एक्यट स्टेज में जैसे-ज्वर, भयंकर खाँसी, रोगी की दैनिक आवश्यकताओं की अपेक्षा खाँसी के साथ खुन आना-ऐसी दशा में तो मरीज को टीबी अस्पताल में भर्ती कराना चाहिए अधिक पोषण वाला आहार देना चाहिये।
Tuberculosis of bone – अस्थियों की टी. बी.
बहुत से लोगों को अस्थियों में ‘क्षय हो जाता है। विशेषकर रीढ की हड्डी (Spine) का क्षय। इस प्रकार की टी.बी. भी बहुत देखने को मिलती है। यदि लंबे समय तक उसकी उचित चिकित्सा न की गई तो शरीर धड़ से निचले / ऊपर भाग को लकवा मार जाता है जो फालिज (Paralysis) कहलाता है।
नोट-यदि रोगी में पूर्व वर्णित क्षय के सामान्य लक्षणों के अतिरिक्त मेरुदंड काका कशेरुक (वरटीब्रा) या अन्य किसी अस्थि में पीड़ा रहती हो अथवा उस अंग को दबाने पर पीड़ा होती हो तो उस अंग का एक्स-रे करके निश्चित करना चाहिए कि उसे अस्थि काया नहीं है। अस्थि क्षय की चिकित्सा एक्स-रे द्वारा पुष्टि के बिना नहीं करनी चाहिए।और इलाज Docter की देख रेख में करना चाहिए
Meningeal tuberculosis – मस्तिष्कावरण का क्षय

मस्तिष्कावरण का क्षय
माइकोबैक्टीरियम कुलोसिस द्वारा उत्पन्न तीव्र मस्तिष्कावरण जिसमें तीव्र लक्षणों के उत्पन्न हान। शाम को ज्वर हो जाता है, बेचैनी हो जाती है तथा चिडचिडापन हो जाता है।
साथ ही क्षय के सामान्य लक्षणों के साथ-साथ रोगी के सिर में हर समय दद है। कुछ रोगियों में वमन (Vomiting) भी हो जाता है। ऐसी दशा में मस्तिष्कावरण का क्षय होने की सम्भावना अधिक होती है
Tuberculosis abdomen- उदर की ग्रन्थियों का क्षय रोग
उदर की गन्थियों में क्षय रोग होने प्रकार के विकार उत्पन्न हो सकते हैं, कुछ रोगियों में भूख की कमी, हर समय दर्द बना रहता, वजन का घटना संध्याकालीन ज्वर आदि सामान्य लक्षणों के साथ-साथ हर समय पेट में पीड़ा रहना क्षय का संकेत देता है। इसके साथ ही कुछ रोगियों में अतिसार (Diarrhoea) भी हो सकता है। पेट में बार-बार दर्द हो अधिकतर पेट के दाहिने निचले भाग में होता है इसके साथ ज्वर भी हो जाता है। पेट का निरीक्षण करने पर दर्द के आस-पास पेट मे पिंड (उभार) प्रतीत होता है, जो इधर-उधर हिलता है तथा ग्रंथियों के कारण होता है।
इन रोगियों में फेफड़े की टी. बी. नहीं होती बल्कि ऐसे रोगी की गर्दन तथा बगल (Axilla) में पुरानी अथवा नई ग्रन्थियों के उभार प्रतीत होते हैं। रक्त का ई. एस. आर. (E.S.R.) बढ़ा हुआ होता है। पेट का साधारण एक्स-रे लेने पर ग्रन्थियाँ कैल्शियम युक्त दिखाई दे सकती हैं। इस प्रकार की टी.बी. की चिकित्सा टी.बी. के अन्य रोगों की भाँति औषधि द्वारा ही की जाती है केवल कुछ शंका वाले रोगियों में उदरपिंड (Lump in abdomen) के लिए ऑपरेशन की आवश्यकता हो सकती है।
सावधान- इस प्रकार का पिंड कैंसर रोग में भी बनता है किन्तु वहाँ क्षय रोग के अन्य लक्षण नहीं पाए जाते हैं।
Tuberculosis of intestine – छोटी आंत की टी. बी.
इस प्रकार की टी. बी. में छोटी आंत में घाव हो जाते हैं। साथ ही अधिकतर रोगियों में फेफड़े की टी. बी. हो सकती है। ऐसे रोगियों में क्षय के अन्य लक्षण यथा-खाँसी, सायंकालीन जीर्ण ज्वर, भूख की कमी तथा शरीर भार में कमी के साथ-साथ पुराना अजीर्ण एवं अतिसार (Chronic diarrhoea) मिलते हैं। बार-बार पेट दर्द हो जाता है। • अतिसारों में साधारण चिकित्सा से लाभ नहीं।
- निरीक्षण करने पर पूरे पेट में दुखन, जो नाभि के आस-पास कुछ अधिक ही होती है। .
- ऐसे रोगी के रक्त में ई. एस. आर. (E.S.R.) की वृद्धि मिलती है।
- रोग के अधिक होने पर सावधानीपूर्वक एक्स-रे करने पर रोग दृष्टिगत होता है।
- औषधि चिकित्सा करने पर शीघ्र लाभ का प्रमाण मिलता है।
यदि आँतों में घाव के ठीक हो जाने के कारण स्ट्रिक्चर उत्पन्न होने से कोई रुकावट हो गई हो तो ऑपरेशन की आवश्यकता हो सकती है।
Tuberculosis of intestine joint – छोटी और बड़ी आँत के जोड़ की टी. बी:-
यदि कोई रोगी क्षय के अन्य लक्षणों के साथ दाहिनी ओर पेट के निचले भाग (Right illiac fossa) में बहुत समय से चले आ रहे दर्द की शिकायत करता है। उसे कब्ज या अतिसार हो सकते हैं। पेट का परीक्षण करने पर दर्द के स्थान पर दुखन व गाँठ का आभास होता है, तो यह समझना चाहिए कि उसे आत की टी.बी. है। याद रहे- इस रोग को पेट के ठीक उसी स्थान में होने वाले दो अन्य रोगों यथा ‘एपेंडीसाइटिस तथा बढ़े रोगियों में कैंसर से भिन्न करके पहचानना अति आवश्यक होता है।
Abdominal TB – पेट सम्बन्धी अन्य प्रकार की टी. बी

पेट सम्बन्धी अन्य प्रकार की टी. बी
इस प्रकार की टी. बी. में पेट के भीतरी अंगों का आवरण क्षयग्रस्त हो जाता है। ऐसा रोगी में सुई चुभने जैसा दर्द बताता है। सायंकाल में जीर्ण ज्वर, भोजन की इच्छा का कम होना, भार में कमी तथा अतिसार आदि लक्षण हो सकते हैं। ऐसे रोगी को फुफ्फुस क्षय भी हो सकता है। किन्तु मुख्य लक्षण पुराना पेट दर्द ही है। ऐसे रोगी का पेट दर्द थोड़ा कठोर तथा नगाड़े की भाँति तना हुआ होता है, जो हाथ से छने पर दुखन का आभास देता है। रक्त का ई. एस. आर. बढ़ा हुआ होता है। इस प्रकार के क्षय रोग की चिकित्सा केवल औषधियों द्वारा ही की जाती है।
जलन्दरयुक्त पेट की जटिल टी.बी इस प्रकार की टी.बी. में रोगी के पेट में तरल इकट्ठा होकर पेट फूलकर जलन्दर (Ascites) का रूप धारण कर लेता है। इसके अन्य लक्षण तथा चिन्ह उपरोक्त पाँचवें प्रकार के क्षय रोग की भाँति होते हैं तथा इसमें छाती का एक्स-रे सामान्य दिखाई देता है
Tuberculosis kidney – वक्कों का क्षय रोग

वक्कों का क्षय रोग
यदि कोई रोगी क्षय के अन्य लक्षणों के साथ रात-दिन बार-बार मत्र आना कभी-कभी मत्र के साथ कम या अधिक आना तथा मूत्र परीक्षण में निरंतर ची|Albument रावं PITदर्शाता हो जो मूत्र तत्रक इफक्शन का चिकित्सा करने से भी लाभ न हो तो यह सिद्ध करता है कि वह क्षय रोग के कारण है।
Tuberculosis of genitals in women – स्त्रियों में गुप्तांग की टी.बी.

स्त्रियों में गुप्तांग की टी.बी.
स्त्रियों में किसी भी प्रकार की टी.बी. के कारण मासिक धर्म में पूर्णतया रुकावट आ सकती है। यदि कोई महिला क्षय के अन्य लक्षणों के साथ मासिक धर्म बन्द होने की शिकायत करती है तो उसे गुप्तांग का क्षय रोग हो सकता है।
Treatments of tuberculosis – टी.बी. का इलाज
टी.बी. होने पर टी.बी. को छिपायें नहीं जल्द व पूरा इलाज करायें। टी.बी. के सफल इलाज के लिए सही दवाईयां निश्चित मात्रा में निश्चित समय और पूरी अवधि (6 महीने) तक लेनी जरूरी
इलाज को बीच में छोड़ने से टी.बी. की दवाईयों का असर जाता रहता है और रोग एमडीआर टीबी बन जाता है ऐसा रोगी दूसरे व्यक्तियों को भी इसी प्रकार की एमडीआर टीबी टी.बी. का शिकार बना सकता है। जो नार्मल टीबी से काफी गंभीर इजाज होता है
Prevention of tuberculosis – टी.बी. की रोकथाम
- रोगी की शीघ्र जाँच व सही इलाज।
- रोगी खाँसते तथा छींकते समय मुँह पर कपड़ा रखें।
- बलगम इधर उधर न थूकें इससे बीमारी फैलने का खतरा रहता है।
- बलगम हमेशा ढ़क्कनदार डिब्बे में थूकें।
- इकट्ठा हुए बलगम को 15 मिनट उबालकर बहते पानी में बहा दें।
- बलगम पाजटिव मरीज के घर में नवजात शिशु के जन्म के तुरन्त बाद बी.सी.जी. का टीका जरूर लगवायें।
Tuberculosis diet – एक व्यक्ति के लिए दिन की प्रतिदर्श आहारिका
Morning Diet, Breakfast – सुबह का नास्ता
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