If the patient has symptoms such as fever, redness, fever, pain and dyskinesia, he should go to the rheumatology immunology department of a regular hospital for systematic examination and diagnosis in time. Regular diagnosis and treatment! After the diagnosis, it is necessary to return to the clinic and adjust the medication and treatment plan in time. The treatment after recurrence should be followed up in time.
Common clinical symptoms of rheumatic joint swelling and pain;
Fever: there are high fever onset and long-term low fever.
Pain: swelling and pain of joints and muscles, pain of limbs, neck and shoulders, back and heel.
Skin symptoms: rash, photosensitivity, oral and vulvar ulcers, eye symptoms, cyanosis reticulata, skin ulcers, etc.
Morning stiffness: refers to the stiffness and tightness of the joints after the patient wakes up in the morning, which can be improved after the activity.
Raynaud's syndrome: When the fingers (toes) are cold or emotional, they will turn white, then purple and red, or accompanied by numbness and pain at the fingers (toes). In severe cases, skin ulceration may occur.
Muscle weakness.
So: when you have the above symptoms, please go to the rheumatology department of a regular hospital in time. Early treatment is helpful to control the disease as soon as possible and the prognosis is good.
Misunderstandings in the treatment of rheumatoid arthritis;
Myth 1: Positive rheumatoid factor is rheumatoid arthritis.
Many patients and even doctors think that joint pain plus rheumatoid factor positive is rheumatoid arthritis, which is a misunderstanding. Rheumatoid factor itself is an autoantibody against denatured immunoglobulin G produced by human body, and it is called rheumatoid factor because it was first found in the serum of patients with rheumatoid arthritis. 5% ~ 10% normal serum can also be positive for rheumatoid factor, but the titer is low, and the diagnosis can only be made if the titer is above 1∶64. Similarly, rheumatoid factor negative can not rule out rheumatoid arthritis, and there are always a few patients with rheumatoid factor negative in clinic.
Myth 2: Anti-rheumatic treatment is anti-inflammatory and analgesic.
Many patients, including primary doctors, also believe that anti-rheumatism is to use anti-inflammatory and analgesic drugs. With some anti-inflammatory and analgesic drugs, the joints will be fine. In fact, the key to the treatment of rheumatoid arthritis is to prevent joint injury and deformity. At present, besides analgesic and anti-inflammatory drugs, there are glucocorticoids, immunosuppressants and biological agents for the treatment of rheumatoid diseases.
Myth 3: Self-help "pure Chinese medicine secret recipe, ancestral secret recipe"
In particular, patients should be reminded of these so-called "pure Chinese medicine secret recipes, ancestral secret recipes" and so on. And medication must be regular. Do not take drugs without drug batch number, contraindications, manufacturer's address, etc. However, it is necessary to use drugs with quasi-trade names of traditional Chinese medicines to avoid taking hormones by mistake. Cases of femoral neck necrosis caused by long-term use of Chinese patent medicine containing a lot of hormones are common in China. Generally, it is used in acute phase or low dose when immunosuppressive drugs are ineffective. Once there are side effects such as osteoporosis and hypertension, it is necessary to reduce or stop taking drugs under the guidance of a doctor. After the immunosuppressive drugs take effect, gradually reduce the dosage of hormones or stop using hormones, that is, "kick down the ladder" therapy. I can't believe that some Chinese medicinal liquor, even traditional Chinese medicine, has toxic and side effects, and even leads to serious poisoning reactions and life-threatening. Traditional Chinese medicine has unique advantages and disadvantages in treating rheumatoid arthritis, and it should be treated under the guidance of doctor's advice.
Myth 4: You don't want to move if you have joint pain, and you stay in bed if you don't want to move.
Rheumatoid patients should insist on proper exercise, which can maintain their physique and restore joint function. Otherwise, the body will gradually weaken, the limbs and even the whole body muscles will be useless, and the joints will be stiff and deformed, becoming a lifelong disability. The patient needs rest in the acute stage of joint swelling. After the acute phase, you can do hip, knee and ankle flexion and extension exercises in bed or physical therapy. Gradually increase the exercise of life ability such as dressing, eating and bathing to prevent joint deformation. It is worth advocating that exercising in warm water can not only relieve joint pain and promote muscle relaxation, but also improve joint mobility, muscle strength and endurance.
Myth 5: After the symptoms are relieved, stop taking the medicine by yourself.
Rheumatoid arthritis is a chronic disease. There is no complete cure at present. Most patients can achieve clinical remission under standardized, systematic and orderly treatment, so that patients can live a normal life. Therefore, patients with rheumatoid arthritis must adhere to medication and not forget the pain. The consequence of this is that the condition will become more and more serious.
Myth 6: Do not monitor drug side effects after taking medicine.
Patients with rheumatoid arthritis, especially those with a long medical history, think that their understanding of the disease is better than that of specialists during the long-term medication, and they don't pay attention to blood routine, urine routine, liver and kidney function, and think that their symptoms are very good, so they don't need to do those tests, which wastes money. In fact, this is extremely wrong. Any patient's understanding of his own disease is one-sided, starting with his own disease, lacking disease-related knowledge. Therefore, while standardizing the application of drugs, we should monitor the side effects of drugs.
Diet regulation of rheumatism: diet is a concern of a considerable number of patients, and there are many so-called dietary taboos, all of which are relative.
The following are the principles of diet:
Nutrient-rich: Don't deliberately avoid eating certain foods, but have a balanced nutrition.
Choose foods low in saturated fat and cholesterol: avoid fried foods and eat low-fat and skim milk.
Eat more vegetables and fruits.
Don't eat salty food: taking hormones together can lead to water and sodium retention.
Drink water in moderation.
Different diseases:
Wind-heat type and damp-heat type: the main symptoms of wind-heat type are joint wandering pain, fever, sore throat, constipation, red urine and obvious increase of erythrocyte sedimentation rate; The main symptoms of damp-heat type can be low fever, chest tightness, anorexia, joint swelling and pain with effusion. Patients with these symptoms should choose a cold diet, such as barley porridge, mung beans, raw pears, bean rolls, chrysanthemums, reed roots and so on. It is helpful to clear the fire, but it is not suitable to eat warm food, such as pepper, mustard, ginger, cinnamon, wine and so on. Because eating these will aggravate the symptoms.
Cold-dampness type: clinical manifestations are joint swelling and pain or water accumulation, loss of appetite, irregular stool, long urine, chills and chills, and accelerated erythrocyte sedimentation rate; This type of patients should choose some warm foods, such as pig, cow and sheep bone soup, ginger, cinnamon, papaya, medicated wine and so on.
Deficiency of both liver and kidney: the clinical manifestations are mostly long course of disease, joint pain and deformity, muscle atrophy, tendon contracture, chills, emaciation, dull complexion, no increase in erythrocyte sedimentation rate or close to normal. This type of patients can eat more nourishing foods, such as soft-shelled turtle, chicken, duck and goose, pork, beef, sheep bone marrow (not used by gout patients), walnuts, longan and sesame seeds.
Common problems in the treatment of rheumatism;
Question 1: pessimistic thinking, thinking that you have an incurable disease.
In fact, there is a clear connection between mental stress and illness. More than forty years ago, someone studied 50 patients with rheumatoid arthritis. They drew a chart of everyone's life and illness, and found that there was a close time relationship between the stimulation of life and the aggravation of illness in two-thirds of patients. Don't worry, fear, pessimism, disappointment, unhappiness and unhappiness about the disease. We should learn to be self-disciplined, self-regulated, broad-minded, open-minded, establish the belief of overcoming diseases, and have perseverance and courage.
Question 2: Believe in advertisements and rumors, and believe in "magic medicine"
Rheumatism is a long-term chronic disease, many of which cannot be completely cured, so we must have the ideological understanding of fighting the disease for a long time. Don't trust the secret recipe and magic medicine mentioned in the advertisement, so as not to be deceived and delay the illness. In addition, health care products cannot replace drug therapy, and the composition and dosage of health care products and drugs are two different concepts.
Question 3: abuse of hormones or talk about hormone discoloration.
Glucocorticoid is the strongest anti-inflammatory drug, which can be described as a "double-edged sword" in the treatment of rheumatism. How to treat rheumatism with glucocorticoid is an art, we should not only see its curative effect, but also realize its adverse reactions. Some quacks add a lot of hormones to the so-called "ancestral secret recipe" without telling patients. Patients are heavily dependent after taking it for a long time. Once the drug is stopped, the condition will deteriorate rapidly and serious complications such as femoral head necrosis will occur.
It is safe to take hormones under the guidance of a doctor! ! !
Question 4: Western medicine can only "treat the symptoms", but Chinese medicine can "cure the disease"?
New understanding: Western medicine and Chinese medicine have their own advantages in treating rheumatism. In recent years, the combination of traditional Chinese and western medicine has made encouraging achievements in treating rheumatism. For example, the most important pathological change of wind-like disease is bone and joint erosion. A large number of clinical studies have found that some western medicines can control the progress of the disease and prevent the occurrence of bone and joint erosion.
As a treasure of our country, traditional Chinese medicine has played an important role in the treatment of rheumatism since ancient times and is still widely used at present. The combination of Chinese and western medicine can reduce toxicity and increase efficiency.
Question 5: Why do you need long-term medication after symptom control?
Up to now, most rheumatic immune diseases are incurable and need long-term or even lifelong medication. The remission of symptoms only shows that the disease has been controlled and not completely cured. The disease in the body may not really stop, and it will still recur after stopping the drug or being stimulated by the outside world. Only long-term application of disease control drugs (slow-acting drugs) can slow down or prevent the progress of the above process.
Why do you have to check regularly?
(1) Evaluate the curative effect and adjust the treatment plan.
(2) Monitoring the toxic and side effects of drugs.
(3) To achieve the goal of minimal side effects and the best curative effect.
Prevention of rheumatoid arthritis: 1 primary prevention;
(1) Actively avoid the invasion of pathogenic wind, cold and dampness, and protect against cold, rain and moisture. Keep your joints warm and don't wear wet clothes, shoes, socks, etc. Pay attention to the combination of work and rest, eat properly and live regularly. The combination of work and rest is the main measure of health care and an important guarantee to avoid rheumatoid arthritis. (2). Enhance physical fitness, improve their disease resistance. Strengthen exercise at ordinary times to enhance physical fitness. Regular physical exercise, such as health gymnastics, Tai Ji Chuan, radio gymnastics, walking and so on, is of great benefit to the prevention of rheumatoid arthritis. (3) Maintaining a normal mental state is also helpful for the prevention of rheumatoid arthritis. According to clinical investigation, we can all find that some patients are induced by mental stimulation, excessive sadness and depression. After suffering from this disease, mood swings often aggravate the condition. All these suggest that mental (or psychological) factors have certain influence on this disease. Therefore, we should maintain a positive and peaceful attitude in life and actively prevent the invasion of this disease.
(4) Pathogen infection produces immune response to cause diseases or induce the onset of this disease, such as tonsillitis, pharyngolaryngitis, sinusitis, chronic cholecystitis, dental caries, enteritis and other infectious diseases, so timely and effective prevention and control of infection is an important means to prevent rheumatoid arthritis.
(5) Strengthen nutrition, live a regular life and improve immunity.
Secondary prevention: after the onset of rheumatic joint, comprehensive intervention measures are taken to limit the development of the disease, protect joint function, prevent and reduce the occurrence of disability, relieve symptoms and improve the quality of life. Early treatment is mostly treatable and even reversible. Treatment includes:
(1) Drug treatment: The drug treatment of rheumatic joints is individualized, and different treatment schemes are implemented according to different conditions, functional status and prognosis of different patients, emphasizing early practical chronic anti-rheumatic drugs and traditional Chinese medicines.
(2) Exercise therapy.
(3) physical therapy.
(4) Occupational therapy: For people with mild hand dysfunction, practice daily life and manual activities, train the meticulous movements of hands and fingers, and improve their functions. (5) Chinese medicine therapy: Du moxibustion; Traditional Chinese medicine fumigation and cupping based on syndrome differentiation: pot-walking therapy; Acupuncture and cupping; Auricular points, Chinese medicine hot compress, intermediate frequency pulse therapy, infrared therapy, ion osmosis, package therapy, etc. The first choice is Du Moxibustion, Chinese medicine hot compress, intermediate frequency pulse therapy, infrared therapy, iontophoresis and package therapy.
What are the main treatment principles of rheumatoid arthritis?
The main therapeutic principle of wind therapy for rheumatoid arthritis is comprehensive treatment. Comprehensive treatment measures: refers to the principle of combining traditional Chinese and western medicine-western medicine mainly treats rheumatoid arthritis, combined with traditional Chinese medicine: first, improve the curative effect of western medicine to play a synergistic role, second, reduce the toxic and side effects of western medicine, and third, reduce the dosage of western medicine. * * * Control inflammation, relieve symptoms, control disease development, prevent irreversible bone changes, protect joint and muscle functions as much as possible, reduce joint deformities, avoid disability and return to normal life.
Four points in the treatment of rheumatoid arthritis: early-find early symptoms and check them in time. Combination medication-several drugs are taken at the same time. Standard-regular hospital, regular physical examination, taking medicine on time. Long-term-chronic diseases with long treatment cycle.
Following the above four principles can control the disease early, improve the quality of life and prevent joint deformity.
The "golden period" of rheumatoid arthritis treatment: within half a year after the onset of rheumatoid arthritis, it is often the time when the disease progresses fastest. Studies have shown that 50% of joint injuries in patients with rheumatism occur six months after onset. If you don't make timely diagnosis and treatment in the past six months and let the injury develop, it will greatly affect the future treatment effect. If the joint is irreversibly deformed, drug treatment will often fail, and there is only one way, that is, surgical replacement of the joint.
Advantages of traditional Chinese medicine in treating rheumatism;
The biggest advantage of traditional Chinese medicine in treating rheumatism is syndrome differentiation and comprehensive treatment of systemic conditioning;
(1). The diagnosis of rheumatism is a complicated and difficult process. Some diseases take a long time to be diagnosed. Before the diagnosis is made, the help of western medicine is often not available. Rheumatologists in China can give corresponding treatment based on syndrome differentiation, which often achieves good results.
(2) Rheumatism patients will have more adverse reactions after long-term high-dose application of hormones and immunosuppressants, which will make their condition repeat in the process of drug reduction. Traditional Chinese medicine can obviously reduce adverse drug reactions, reduce the dosage of western medicine and minimize the toxic and side effects of western medicine through systematic conditioning.
(3) For some rheumatism patients who are allergic to western medicine and cannot use western medicine, Chinese medicine treatment is more important.
Daily protection of rheumatoid arthritis: daily protection;
(1) Use large and powerful joints: When joints are inflamed, they will become unstable and more vulnerable. Small joints such as finger joints are more prone to deformation when exerting force. Therefore, in daily life, patients should try to use large and powerful joints, and when carrying heavy objects, try to use arms and elbows instead of fingers; Don't support with your fingers, support with your palms. (2), to avoid the joint to keep an action for a long time: don't stand for a long time, sit down and rest at the right time. When sitting down, you should always change your sitting posture, change the position of your feet, stretch the bones and muscles of your lower limbs, or get up and walk. Avoid finger flexion for a long time, such as writing, knitting, typing, repairing, etc., and stop to rest and stretch your fingers from time to time.
(3) Pay attention to joint pain. If you feel joint pain during the activity, you should stop the activity immediately and check whether the activity method is improper.
(4) Pay attention to the balance of work and rest, and make adjustments according to the condition. If you have arthritis, you should increase your rest time.
How to exercise rheumatoid arthritis?
Objective: To prevent joint stiffness and contracture, prevent muscle atrophy, promote blood circulation, restore joint function, cheer up the spirit, enhance physical fitness and increase confidence in rehabilitation through appropriate and reasonable exercise. Precautions:
Start slowly
The pain in the motor joint is severe and needs to be suspended.
Always change your posture to exercise.
Hold on, don't give up.
Exercise method:
Morning exercise and walking can not only enhance the physique of patients with rheumatoid arthritis and promote their rehabilitation, but also increase appropriate joint activities, thus reducing joint stiffness and deformity and reducing the formation of disability. The main methods are:
1) Go fast and walk backwards. This is an effective fitness method that ordinary people can easily master and stick to. The so-called fast walking means 120 steps per minute, from short to long. The so-called walking backwards means walking backwards, on a flat road or square, every time 100-200 steps, which can be alternately carried out with fast walking.
2) Tai Ji Chuan, Taijijian, Wuqinxi and other China traditional martial arts.
3) Cycling, disco dancing for the elderly, traditional dancing, aerobics, etc.
Here is a simple set of finger exercises:
Action 1: put your arms flat on the table with your palms down.
Step 1: Take the wrist joint as the fulcrum, raise your hand upward, and the posture is similar to greeting others, and swing as much as possible.
Step 2: Take the wrist joint as the fulcrum, gradually lower the hand, lower than the plane of the wrist joint, and the forearm has the feeling of pulling forward.
Step 3: Relax for 6 seconds.
Action 2: the elbow joint is supported on the desktop, and the back of the hand is facing yourself.
Step 1: Take the wrist joint as the fulcrum and tilt your hand in the direction of the little finger.
Step 2: Turn your hand in the direction of your thumb with your wrist as the fulcrum, as if you were shaking your hand.
Action 3:
Step 1: Touch your thumb with your index finger.
Step 2: Touch your thumb with your middle finger.
Step 3: Touch your thumb with your middle finger.
Step 4: Touch your thumb with your little finger.
Action 4:
Step 1: bend your fingers and hold them in a fist shape.
Step 2: Let go of your five fingers and straighten them as far as possible.