Ankylosing spondylitis (ankylosing spondylitis
Spondylitis (AS) is a chronic inflammatory disease, which mainly invades sacroiliac joints, osteophytes of the spine, soft tissues near the spine and peripheral joints, and may be accompanied by extra-articular manifestations. In severe cases, spinal deformity and rigidity may occur. The prevalence rate in China is about 0.3%, the onset age is 13 ~ 3 1 year, the peak age is 20 ~ 30 years old, and the ratio of male to female is about 2 ~ 3: 1. Women have a slow onset and a mild illness.
The etiology is unknown, which may be related to genetic and environmental factors. It has been confirmed that the incidence of as is closely related to human leukocyte antigen (HLA)-B27, and there is an obvious trend of family aggregation.
1
Morning stiffness: the waist stiffness that appears immediately after getting up in the morning or sitting for a long time will be relieved after the activity.
Peripheral joints: Hip, knee, ankle and shoulder joint are mostly involved, and elbow and hand-foot facet joints are occasionally seen. Nonright
Symmetry, few joints or single joints, lower
Arthritis in the main joints of limbs is characterized by its persistence and destructiveness.
2. Extraarticular manifestations
1
Fever, fatigue, emaciation and fatigue
2
Eyes: uveitis, conjunctivitis, pain, congestion, photophobia, tears, blurred vision.
three
Lung: fibrosis of upper lobe of lung
4 heart: ascending aortic root and aortic valve lesions, cardiac conduction system disorders.
five
Kidney: IgA nephropathy, amyloidosis
six
Nervous system: limb paresthesia, cauda equina syndrome
seven
Myophilia
Imaging examination is of great significance to the diagnosis of this disease. The earliest changes of AS occurred in sacroiliac joint, X-ray, CT and MRI of sacroiliac joint.
Principles of treatment:
Early, combined and individualized treatment
General treatment: physical therapy, topical drugs, etc.
medicine
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Biological agents: such as etanercept, infliximab, adalimumab, etc.
Glucocorticoid.
Anti-rheumatic drugs (DMARDs) to change the condition: including sulfasalazine, methotrexate, leflunomide, cyclophosphamide, thalidomide, etc.
Plant medicine: such as tripterygium wilfordii, total glucosides of paeony, etc.
Surgical therapy
To correct the deformity and improve the quality of life, AS, which is incurable, still needs drug treatment. Hip involvement is the main cause of disability, artificial umbrella hip placement
Changing surgery is the best choice.
Health education of ankylosing spondylitis
Take care of yourself
Keep an optimistic attitude.
Avoid cold and humid environment, excessive fatigue, mental stimulation, irregular life, etc.
Take medicine on time and follow up regularly.
Dietary principle
Eat more protein-rich and nutritious foods such as meat and fish, eat more fruits and vegetables to supplement vitamins, and drink more milk to supplement calcium.
Avoid overweight and reduce joint burden.
Quit smoking and drinking during medication.
Principles of rehabilitation training
Avoid forgetting to maintain a normal posture because of the influence of illness.
Do what you can, or it will backfire.
Acute rest, recovery functional exercise, dynamic and static combination, dynamic and lasting.
Do not exercise within 2 hours after eating.
Rehabilitation training of ankylosing spondylitis
The first section: chest expansion exercise, with two feet together or one foot taking a step forward, the forearms are bent inward, and the left and right chest are flat (twice), and then the forearms are abduction (twice).
The second section: the body rotates, the feet are shoulder width apart, the forearm is bent on the chest, and the body rotates to the left and right respectively.
Section 3: Lateral body movement: Raise the left arm and stick it to the left ear, and stick the right hand to the right waist and stick it to the right body. Repeat the above actions in the opposite direction.
The fourth quarter: kick back, arms up, and kick left and right legs separately.
Section 5: Thoracolumbar Exercise: Lie on the bed, put your hands flat on your sides, support the bed with your feet, and lift the thoracolumbar spine (the head must not leave the bed surface).
Section 6: tilt your head, lie prone on the bed, with your hands akimbo and your head and feet tilted.
Section 7: Little Yin Fei, support his hands and knees on the bed, lift his left hand (right hand) forward, and kick his right leg (left leg) backward to the maximum.
Section 8: Tumbler, sitting on the bed, with his hands crossed forward in front of his knees and rolling back and forth (with his hips as the fulcrum).
Section 9: Head up, prone position, hands crossed behind your head, head up (feet on the bed).
Section 10: The waves rise, the hands support the bed railing, the feet touch the ground, and the body moves in waves from bottom to top.