Problem description:
My boyfriend often has gout and recently caught a cold. Eating is usually excusable. Although there seems to be nothing serious, he is still worried about his physical condition.
Analysis:
Rheumatism:
Rheumatism is divided into broad sense and narrow sense. Rheumatism in a broad sense refers to a group of diseases that affect bone joints and their surrounding soft tissues, such as tendons, synovial bursas and fascia. According to the classification system of rheumatism 1983 revised by the committee of nomenclature and classification of American Rheumatology Association, rheumatism is classified into 10, including 100 kinds of diseases. It has been widely accepted and adopted by medical circles in various countries. It can be seen that rheumatism is a clinical branch including many diseases.
The word rheumatism first appeared in Huangdi Neijing, which is called arthralgia, so it is commonly known as rheumatoid arthritis in traditional Chinese medicine. Rheumatism is called rheumatic disease, which includes all kinds of comprehensive connective tissue diseases, such as joints, muscles, tendons and bursa of fabricius, which erode the musculoskeletal iliac system and involve the whole body. The main manifestations are pain and swelling, which is called "immortal cancer". Arthritis and rheumatic diseases are roughly divided into rheumatoid arthritis, rheumatoid arthritis, ankylosing spondylitis, proliferative arthritis and gouty arthritis by the Rheumatology Society.
Because rheumatism involves joints, it causes pain, soreness, numbness, swelling, and even redness and deformation. In severe cases, it will cause the destruction of joint bones, leading to joint deformation and inability to take care of themselves. Most of them are chronic, recurrent and long-term diseases. The joints of rheumatoid arthritis involving synovium are characterized by redness, swelling, heat pain and dysfunction. Among them, the distal interphalangeal joint is the most easily involved, followed by shoulder, ankle and elbow joint. Morning stiffness is very common. At the initial stage, wrist back swelling, PIP spindle swelling, tenderness, numbness of fingers, weakness in clenched fists, and heavy load. In the later stage, patients may have typical hand signs, including hand muscle atrophy (MCP) and lateral subluxation to form "ulnar deviation", PIP overstretching surface and DIP overstretching to form "Gooseneck deformity". Carpal tunnel syndrome may occur when tenosynovitis of flexor carpi depresses median nerve. Shoulder and knee joint diseases often make patients lose their self-care ability. RA mainly invades the small joints of hands and feet, and other organs or tissues such as heart and lung will also be damaged. The main pathological changes are synovitis, tissue infiltration, synovial pannus formation, erosion of cartilage and bone tissue, and recurrent synovitis, which leads to the destruction, deformity and functional loss of joint structure, and finally leads to the loss of labor force.
Sun god
Rheumatoid arthritis is an inflammatory, progressive, symmetrical and destructive joint disease. Symptoms are joint pain, swelling, difficulty in moving and stiffness, and long-lasting late symptoms are joint deformity and stiffness, leading to lifelong disability. Rheumatism is recognized as a difficult disease in the world, and the World Health Organization has designated 10+02 as "World Arthritis Day" every year. The level of prevention and treatment of rheumatism in our province is unbalanced, especially the knowledge of diagnosis, treatment and prevention of rheumatism among grassroots doctors is obviously insufficient, and misdiagnosis, mistreatment and abuse occur from time to time.
Pathogenesis and course of rheumatoid diseases
Rheumatism mostly occurs in the rainy season in spring in eastern China, and humidity and cold are important inducing factors. It has been recognized that group A hemolytic streptococcus infection is related to the onset of rheumatism. Some scholars once thought that the occurrence of the disease must meet the following four conditions: group A hemolytic streptococcus infection. Streptococcus in human body produces antibody reaction. Group a hemolytic streptococcus persists. The infection site is in the respiratory tract.
When hemolytic streptococcus is infected, patients often have upper respiratory tract infections such as pharyngitis and tonsillitis first, and rheumatic fever occurs after 2-3 weeks; Repeated attacks involving joints, forming rheumatism. Traditional Chinese medicine believes that rheumatism belongs to the category of arthralgia syndrome, which is mainly caused by stagnation of qi and blood, instability of defending yang and invasion of pathogenic wind, cold and dampness, resulting in stagnation of qi and blood and obstruction of meridians. The occurrence of the disease is related to the individual's nutritional status, immune function, living conditions, climate environment and the toxicity of epidemic strains. Current research shows that cellular immunity caused by T lymphocytes plays a key role in the pathological process of RA.
The purpose of rheumatism treatment is to relieve the symptoms of joint pain, slow down the progress of the disease, reduce the occurrence of disability, restore joint function as much as possible and improve the quality of life of patients.
Matters needing attention in the treatment of rheumatism
Rheumatism is mainly joint disease. Inflammation occurs in the synovium of the joint, and fleshy tooth tissue grows on the edge of the synovium. The pannus produced destroys articular cartilage and blood vessels slowly expand. In severe cases, all articular cartilage can be "eaten". At present, drugs can't cure this disease, but only control its development.
Use drugs scientifically under the guidance of a doctor and don't abuse hormones. Western medicine can treat rheumatism with the following drugs: non-steroidal anti-inflammatory painkillers, such as fenbid and voltarin, can relieve symptoms but cannot cure them radically; Drugs that alleviate the disease, such as immunosuppressants, can alleviate the disease; Hormones can quickly eliminate symptoms, but the side effects of hormones are great, so they must be used with caution, and the dosage and time of taking must be strictly controlled. Be wary of those pills that are mail-ordered, have no formal labels, have unknown ingredients, and have a "magical" initial effect. Nine times out of ten these pills contain hormones.
Rheumatoid patients should be examined early and treated early. Under the condition that internal medicine can't control the disease well, it is not only cheap and painless to remove the synovium as soon as possible, but also can avoid the risk that plastic or fusion surgery may fail after missing the operation period of synoviectomy. In the future, the advantages far outweigh the disadvantages. Patients who take traditional Chinese medicine for a long time should regularly check their kidneys and liver function. Some traditional Chinese medicines contain heavy metals. Therefore, rheumatoid patients who take traditional Chinese medicine for a long time should go to the hospital regularly to check their liver and kidney functions.
Influence of living conditions on treatment (prevention) of rheumatism
The quality of living conditions is closely related to the onset of rheumatoid arthritis. Traditional Chinese medicine believes that dampness is yin evil, sticky, and easy to combine with cold, wind and other evil spirits to form diseases. If you live in a wetland for a long time, pathogenic wind, cold and dampness will easily cause joint stagnation, leading to poor circulation of qi and blood and unfavorable joint flexion and extension. Modern medical research shows that the air humidity and the degree of living congestion are positively related to the incidence of rheumatoid arthritis. Humid air and crowded people are conducive to the growth, reproduction and spread of streptococcus, and poor ventilation and lighting conditions in the residence will increase the incidence of rheumatoid arthritis in people with poor health. For the health of you and your family, you can try to choose a house with fresh air, many green plants around, dry climate and good lighting conditions.
If it is acute rheumatism, first of all, we should emphasize rest, especially those with joint redness, fever, pain or palpitation and shortness of breath, so we must stay in bed. After remission, you can get up properly. At the same time, strengthen nutrition, and give rheumatism a diet with high calorie, high vitamins, high protein and easy absorption, such as milk, chicken, duck, fish, fruit and fresh vegetables.
Drug treatment should first control streptococcal infection, but intramuscular injection of penicillin. Those who are allergic to penicillin can switch to erythromycin or sulfonamides. Hormone application can quickly control the acute symptoms of rheumatism, but it should be carried out under the guidance of a doctor. In order to prevent rheumatism, those who often have tonsillitis, angina and otitis media should be treated in time. Pay attention to keep warm at ordinary times, wear a mask when going out in winter, don't be greedy for cold in summer, don't sit in the wetland and don't sleep in the wind. Wipe your skin immediately after wading and swimming, change clothes immediately after getting wet, or drink a bowl of brown sugar and ginger tea immediately. At ordinary times, we should take proper physical exercise, such as Qigong, Tai Ji Chuan and aerobics. To strengthen our physique and improve our immune function.
Rheumatism is a chronic disease with a long and lingering course, which often leads to negative disappointment and even loss of confidence in the disease. However, depression, excessive sadness and excessive mental stress will affect the immune function of the body, leading to the disorder of qi and blood in the limbs, and the decline of resistance, which will lead to the aggravation of the disease. Practice has proved that a positive and optimistic attitude towards life and correct disease treatment can improve the symptoms of 60% patients with rheumatism. On the contrary, some patients who get better after various treatments often get worse or relapse because of psychological factors. This shows that psychological (mental) factors play a very positive role in the process of rehabilitation. Therefore, we should maintain a normal mental state, be optimistic and cheerful, establish confidence in overcoming the disease, and actively cooperate with the treatment.
More active treatment improves the treatment of rheumatism. People who have recently been diagnosed with rheumatoid arthritis may suffer from a milder disease than those who were diagnosed with the disease 25 years ago. New research shows that since the 1960s, the overall symptoms of rheumatoid arthritis, which many doctors have guessed, have become less serious.
Researchers say that this improvement trend is partly due to the more active treatment strategies introduced in recent years and the natural process of this disease activity. Rheumatoid arthritis is a chronic inflammatory disease, which can lead to cartilage corrosion and joint pain. However, the process and symptoms of rheumatic diseases vary from person to person, and vary with time, ranging from mild to severe injuries.
Is rheumatoid arthritis getting lighter and lighter? In a study published in the Journal of Arthritis and Rheumatism this month, researchers analyzed the severity of symptoms and disability of all patients diagnosed with rheumatoid arthritis in a Dutch hospital from 1985 to 2005. The results showed that among those who were recently diagnosed with this disease, the overall symptom severity was low during the first five years; Paco M. J. Welsing, a researcher, is a Master of Science from Nijmegen Medical Center of Radboud University. In a press release, he said that in recent years, patients with early rheumatoid arthritis have less disease activity, and patients with earlier disease courses are more stable.
The researchers said that the reason behind this improvement remains to be discovered, but it is indeed consistent with the more active treatment strategies and new drugs currently used to treat rheumatoid arthritis. For example, the researchers found that these symptoms are often shorter at the time of diagnosis, and they also found that the time between the diagnosis of rheumatoid arthritis and the start of anti-inflammatory drugs to treat prednisone (an adrenal corticosteroid) has become shorter; In addition, faster treatment methods, such as methotrexate, can actually slow down the progress of the disease, which seems to be some factors contributing to this improvement.
However, this study shows that among people who have been recently diagnosed with this disease, the physical disability rate has not decreased at the time of diagnosis and after a period of time; In fact, with the passage of time, the physical disability rate shows signs of deterioration. But the researchers said that the findings of this study may not necessarily be related to the actual severity of the disease; The result of this contradiction may be related to patients' feelings about their own diseases. The researchers pointed out that even though the clinical measurement of rheumatoid patients has improved over time, the patients' own feelings about their diseases have not improved; According to the researchers, this may affect the rate of physical disability.