1, symptoms of rheumatoid arthritis
1, pain
Joint pain is the most common symptom of rheumatism. Pain may occur in all joints of the whole body, but pain in limbs and trunk may cause pathological changes in internal organs and nervous system.
2, muscle pain
Muscle can also have pain symptoms, muscle weakness, increased muscle enzymes and myogenic injuries, such as systemic lupus erythematosus, mixed connective tissue disease and dermatomyositis.
3. Irregular fever
Before rheumatism appears, there will be irregular fever, no chills, ineffective antibiotic treatment and accelerated erythrocyte sedimentation rate, such as systemic lupus erythematosus, acute neutrophilic febrile dermatosis, adult Stier's disease and panniculitis. A fever may be the first symptom.
4, skin and mucous membrane symptoms
Dermatomyositis, Sjogren's syndrome, Behcet's disease, panniculitis and so on. May cause rash, oral ulcer, skin ulcer, cyanosis reticulata, eye symptoms, etc.
5. Reynolds sign
Fingertips turn white, then purple and finally red when they are cold or emotional changes, accompanied by numbness, pain and severe skin ulcers, which can be seen in rheumatoid arthritis, systemic lupus erythematosus and mixed connective tissue disease.
6. Abnormal blood indexes of autoantibodies
Anti-ENA antibody, anti-ds-DNA antibody, anti-platelet antibody, antinuclear antibody, anticardiolipin antibody, rheumatoid factor, etc.
2. How to treat rheumatism effectively?
1. Syndrome Differentiation According to patients' clinical manifestations and symptoms, laboratory test results and tongue pulse, patients are divided into stages and classified according to TCM syndrome differentiation. Disease differentiation can be divided into early, middle and late stages according to the development process of the disease, and can be divided into the following types according to the angle of TCM syndrome differentiation: wind-cold-dampness resistance type, phlegm-blood stasis type, rheumatic fever type and liver-kidney yin deficiency type.
Second, the nursing methods
1 wind-cold-dampness resistance type is more common in the early stage of rheumatoid arthritis, with swelling and pain in joints of limbs, severe pain in cold, mild pain in heat, reddish skin and light touch. This kind of patients often see red tongue, thin white fur and thin pulse. The dialectical nursing should pay attention to cold and warmth, and arrange the patients in the south of the ward where they can bask in the sun. This kind of patients mainly stretch joints to promote qi and blood circulation. Local fumigation with traditional Chinese medicine to dispel wind and cold. In western medicine nursing, early reduction of activities, bed rest and muscle relaxation have mild analgesic effects. Strengthen the knowledge education of patients and emphasize early active cooperation with the treatment and nursing of rheumatoid arthritis to promote early recovery. Spicy and loose food should be eaten in diet, and onion, ginger and pepper can be used as seasoning. After a meal, the quilt is slightly sweaty, so that cold and dampness can relieve sweating.
Phlegm and blood stasis syndrome is more common in the early and middle stages of rheumatoid arthritis, with joint swelling, fixed pain, limited flexion and extension, and some patients have the law of light day and heavy night. This kind of patients are more common in dark tongue, white greasy fur and thin pulse. Dialectical nursing: the ward should be dry, and the notebook room should be moisture-proof and warm. Acupuncture, moxibustion and local irradiation with TDP lamp, especially after acupuncture, can obviously improve joint function. Nurses should help bedridden patients to perform joint flexion and extension activities within the maximum tolerance range of 1-2 times a day to maintain joint movement function. Traditional Chinese medicine decoction can promote blood circulation, remove blood stasis, dredge meridians, increase local blood circulation, resolve phlegm and dissipate stagnation, and warm meridians.
Rheumatic damp-heat stasis type is more common in joint swelling and pain, very painful, thirsty and fever. Tongue pulse is mostly red, yellow, greasy fur and pulse condition. This kind of rheumatism is mostly active and its condition changes rapidly. It is necessary to closely observe the changes of the condition, keep the air in the ward fresh, let the patient rest in bed, and pay attention to the body position and posture. We can use short-term automatic methods to rest the joints to reduce inflammation. Traditional Chinese medicine decoction adopts the methods of clearing heat, eliminating dampness and dredging collaterals, and adopts anti-inflammatory, antipyretic and analgesic methods to make patients sweat and reduce fever. Change sweaty clothes in time, and it is not advisable to use alcohol to cool down to prevent sweat gland occlusion; Eat coix seed, wax gourd and red bean porridge, and avoid fried and spicy food.
The clinical manifestations of liver and kidney yin deficiency type are joint swelling, dizziness, soreness of waist and knees, less red tongue coating and thready pulse. Most of these patients are in the middle and late stage, with long illness time, blocked activities, need to be taken care of by others in life, heavy mental burden and pessimistic mood. In nursing, it is necessary to discover the psychological changes of patients in time, give careful care in life, and use hot compress, physical therapy and massage locally. Improve local and systemic blood circulation, maintain the functional position of the affected limb when lying flat, and avoid deformity after long-term bed rest. According to the principle of dynamic and static combination, patients should exercise properly in bed, such as stretching quadriceps femoris and lifting legs to gradually increase fatigue. Traditional Chinese medicine decoction should be taken warm, and the ward should be warm, avoiding cold and humidity. Cold and indigestible food should be avoided in diet, and wolfberry porridge can be taken regularly.
Thirdly, discuss rheumatoid arthritis, a common and difficult disease in clinic, which can cause joint injury, joint deformity and dysfunction. Our department adopts the nursing method of combining traditional Chinese and western medicine, based on disease differentiation, carries out specific syndrome differentiation and patient care, and pays attention to the combination of local nursing and holistic nursing. On the basis of disease nursing in western medicine and syndrome differentiation in traditional Chinese medicine, different nursing methods are given, such as wind resistance, cold resistance and moisture resistance. Phlegm and blood stasis type, because patients are often accompanied by joint motor dysfunction, nursing should encourage patients to exercise more and maintain joint motor function, so as to achieve the purpose of dredging qi and blood, resolving phlegm and removing blood stasis. Rheumatic fever and depression should be closely observed, paying attention to the changes and prognosis of the disease. In order to improve patients' physique, it is necessary to strengthen psychological care, take care of them in life and adjust their diet. Rheumatoid arthritis should be mainly combined with functional exercise, integrating psychology, diet, medication and nursing, so as to control the inflammation of joints and other tissues, relieve symptoms, maintain and restore the activity function of joints and improve the self-care ability of patients. The nursing method of integrated traditional Chinese and western medicine plays an important role in improving curative effect and promoting disease rehabilitation.
The treatment of rheumatism, the above small series introduces the related treatment methods of rheumatism and the nursing methods of some common phenomena, as well as the different treatment effects of various diseases, hoping to bring help to everyone and wish you health.