What is rheumatoid?

/kloc-before the 0/9th century, human beings did not have the concept of "rheumatoid disease", but understood low back pain, leg pain and joint pain, that is, what they thought was "rheumatism". With the development of medicine, the understanding of rheumatoid arthritis (also known as "rheumatoid") in the medical field is gradually clear, but the public, especially the elderly, is still unclear about "rheumatism" and "rheumatoid". We often ask, "Doctor, do I have rheumatism?" But after a detailed chat, you will find that the so-called "rheumatism" we are worried about is actually "rheumatoid arthritis".

Today we will popularize this "rheumatoid arthritis", which is rheumatoid arthritis (RA).

What is "rheumatoid"?

Rheumatoidarthritis (RA) is a chronic systemic disease with unknown etiology, mainly inflammatory synovitis. It is characterized by multi-joint, symmetrical and aggressive joint inflammation of hand and foot facet joints, often accompanied by involvement of extra-articular organs, and positive serum rheumatoid factor. Because advanced severe diseases can lead to joint deformity, functional loss and disability, the majority of patients are very afraid and nervous about the disease. Women are prone to the disease, the incidence rate is 2-3 times that of men, and it can occur at any age, and the high incidence age is 40-60 years old.

What are the symptoms of rheumatoid arthritis?

First of all, it is morning stiffness. In other words, when you get up in the morning, you will feel tight joints and inflexible activities. With proper joint activities, the morning stiffness will gradually ease to disappear.

Second, the performance of arthritis. It is characterized by multi-joint involvement and symmetry. Joints that are easily affected include hands, feet, wrists, ankles and temporomandibular joints, and others may include elbows, shoulders, cervical vertebrae, hips and knees. If the disease continues to progress, it may also cause deformity of the corresponding joints of hands and feet, and even cause joint function loss and disability.

Third, the performance of all systems outside the joint. The general manifestations are fever, rheumatoid nodule formation and lymph node enlargement. It involves respiratory system, pleurisy, pleural effusion, interstitial lung disease, nodular lung disease and so on. Are very common; Involving the heart, common pericarditis, pericardial effusion, myocarditis and so on. ; Involving the kidney, the common ones are primary glomerulus and tubulointerstitial nephritis, renal amyloidosis and so on. In addition, there may be mild and moderate anemia.

What do ordinary people call "rheumatism"?

In fact, people often say that "rheumatism" is mostly osteoarthritis (OA), which is a degenerative disease caused by many factors, such as old age, obesity, strain, trauma, joint congenital abnormality, joint deformity, etc., such as degenerative injury of articular cartilage, reactive hyperplasia of articular margin and subchondral bone, also known as osteoarthropathy, degenerative arthritis, senile arthritis, osteoarthritis, etc. The clinical manifestations are slow-developing joint pain, tenderness, stiffness, joint swelling, limited movement and joint deformity. To put it bluntly, this disease means that your bones and joints are aging like machine parts.

Because both osteoarthritis and rheumatoid arthritis belong to joint diseases, they all have joint pain, swelling, limited activity and so on, and their symptoms are aggravated in cold and humid environment, so it is normal for Chinese people to often confuse these two diseases.

What tests do you need to do to suspect rheumatoid arthritis?

General laboratory tests often include blood routine, urine routine, liver and kidney function, C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, immunoglobulin, serum protein electrophoresis, complement, rheumatoid antibody series, anti-CCP antibody and so on.

Physical examination items include X-ray film, magnetic resonance imaging (MRI), joint color Doppler ultrasound, heart color Doppler ultrasound, lung CT and so on.

How do doctors diagnose rheumatoid arthritis?

At present, there are two commonly used diagnostic criteria. This is a little high. It doesn't matter if you don't understand. Just take a look and get to know it. Don't make your own diagnosis.

20 10 ACR/EULAR RA new classification standard

fellowship

score

(0-5 points)

Serology (at least 1)

score

(0-3 points)

1 big joint

Radio frequency and ACPA are negative.

2 ~ 10 joint

1

Low titers of RF and/or ACPA are positive.

2

1 ~ 3 small joints (with or without large joints involved)

2

High titers of RF and/or ACPA (more than 3 times the normal value) are positive.

three

4 ~ 10 facet joint (with or without major joint participation)

three

& gt 10 joint (involving at least one surface)

five

Acute phase reactant (at least 1)

score

(0- 1)

Symptom duration

score

(0- 1)

CRP and ESR are normal.

Elevated CRP or ESR

1

≥6 weeks

1

A total score of more than 6 points can diagnose RA.

Diagnostic criteria of early rheumatoid arthritis (ERA) 20 12

1) morning stiffness ≥30 minutes;

2) Arthritis in more than 3 joint areas; (14 joint area includes: bilateral elbow joint, wrist joint, metacarpophalangeal joint, proximal interphalangeal joint, knee joint, ankle joint and metatarsophalangeal joint);

3) hand arthritis;

4) rheumatoid factor (RF) positive;

5) Anti-CCP antibody was positive.

≥3 diagnosable RA

How to treat rheumatoid arthritis?

For patients, early treatment, cooperation, standardization, combined medication and functional exercise are very important. Don't try so-called "traditional Chinese medicine" that is "miraculous" obtained through informal channels easily, so as to avoid organ damage such as liver and kidney caused by unknown drugs.

Patients with joint swelling and pain should pay attention to rest and perform necessary joint immobilization, which can be combined with Chinese medicine acupuncture, cupping, Chinese medicine fumigation, Chinese medicine hot bag external application and other physical therapy methods to promote the disappearance of swelling and pain symptoms. When the joint pain is relieved and disappeared, proper functional exercise should be carried out to promote the recovery of joint function and prevent the loss of function.

Commonly used drugs mainly include non-steroidal anti-inflammatory drugs, such as diclofenac, loxoprofen and celecoxib. It has anti-inflammatory and analgesic effects, and promotes the relief of joint swelling and pain; Slow-acting anti-rheumatic drugs, such as hydroxychloroquine, leflunomide, cyclosporine, total glucosides of paeony, sulfasalazine, etc. Glucocorticoids, such as prednisone. However, glucocorticoid is the first choice to treat rheumatoid arthritis; Biological agents, such as infliximab, etanercept and tuzumab. It is characterized by rapid onset and good curative effect, but the price is relatively expensive.

The standardized treatment of rheumatoid arthritis must be carried out under the guidance of a professional doctor, and you must not use drugs yourself!

How does TCM identify rheumatoid arthritis?

The record of rheumatoid arthritis in traditional Chinese medicine first appeared in Neijing, which is called "Bi". There are many descriptions of "Bi" in TCM literature, among which "stubborn Bi" and "Li Feng" are more similar to rheumatoid arthritis. Wang Dao's "The Secret of Outer Taiwan" thinks that this disease is mostly caused by wind-cold, summer-heat and dampness, and it is caused by deficiency. In a word, Chinese medicine believes that the disease is caused by internal factors of liver and kidney deficiency, plus wind cold and summer dampness. Generally, it can be divided into wind-cold-dampness arthralgia syndrome, wind-damp-heat arthralgia syndrome, phlegm-blood stasis arthralgia syndrome and qi deficiency arthralgia syndrome for a long time.

How to prevent it?

Avoid the invasion of cold and dampness. Be cold-proof, rain-proof, moisture-proof, keep your joints warm, and don't wear wet clothes, shoes and socks. Summer is hot, don't be greedy for cold dew, drink cold drinks, etc. The climate in autumn is dry, but the autumn wind is cool and the weather turns cold, so we should prevent it from catching cold. It's freezing in winter, so keeping warm is the most important thing.

Pay attention to combining work and rest. The combination of work and rest is the main measure to strengthen health care. Clinically, although the condition of some patients with rheumatoid arthritis is basically controlled, they are in the recovery period of the disease, often aggravated or relapsed due to fatigue, so we should pay attention to the combination of work and rest.

Strengthen exercise and enhance physical fitness. It is of great benefit to take part in physical exercise regularly, such as practicing Qigong, Tai Ji Chuan and taking a walk. Anyone who insists on exercising, with strong body and strong disease resistance, is not easy to get sick. As the saying goes, "Righteousness exists within, and evil cannot be done".