How does it feel to have rheumatoid arthritis?
Rheumatoid arthritis is the most common disease in the rheumatology department. For example, Dr. Xie treats more than 1,000 people with rheumatoid arthritis every year. Let's answer this question today:
What are the symptoms of rheumatoid arthritis and how to treat it?
The core symptoms of early rheumatoid arthritis are swelling and pain in the joints. However, the swelling and pain of rheumatoid arthritis often have their own characteristics:
1. Symmetry: It does not mean that if the left index finger is swollen, the right index finger must also be swollen; but if the left finger is swollen and painful, the right finger is generally swollen and painful. Both left and right, involving many joints, this is called "symmetry", which is a major feature of rheumatoid arthritis
2. Extensiveness: Many joints in the body are swollen and painful, not just one joint. In this case, rheumatoid arthritis should be highly suspected (or first ruled out). The swelling and pain of a single joint sometimes need to be checked for other reasons first.
3. Hand joints: The joints most commonly affected by rheumatoid arthritis are finger joints, and swelling of many other joints such as elbows and knees can also occur. But generally, the hand joints have the most problems and are the most common.
4. Proximal finger joints are involved, but distal finger joints are not involved: As shown in the figure below, the middle row of fingers are swollen and painful, while the row of joints near the nails have no symptoms. This is an important feature of rheumatoid arthritis.
Over time, if not treated in time, joint deformities will occur. The textbooks describe three major characteristics: swan neck deformity, button flower deformity, and ulnar deviation - the typical one is like the figure below:
To diagnose and evaluate rheumatoid arthritis, symptoms alone are far from enough. Laboratory tests are also needed, mainly including the following two categories:
1. Positive rheumatoid characteristic antibodies: including anti-cyclic citrullinated antibodies (anti-CCP), rheumatoid factors (RF), anti-keratin antibodies (AKA), and anti-mutated citrullinated vimentin antibodies (MCV). Patients with positive rheumatoid characteristic antibodies account for the vast majority of rheumatoid arthritis.
2. Increased inflammatory indicators: including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Most early rheumatoid arthritis patients have both of the above, and a very small number of patients only have increased inflammatory indicators without positive rheumatoid characteristic antibodies (such patients must have characteristics that are highly consistent with rheumatoid arthritis to be diagnosed).
When the patient has many of the above typical clinical + typical laboratory tests, and other diseases are excluded, the rheumatologist will diagnose you as "rheumatoid arthritis"
Once you have rheumatoid arthritis, you need to start treatment as soon as possible! The earlier the treatment, the less joint damage, the better the treatment effect, and the greater the certainty of maintaining the existing joint function! It can be said that: Time is joints! The treatment of rheumatoid arthritis is a process of racing against time to save joints!
Generally speaking, after the diagnosis of rheumatoid arthritis, we need to give drugs to control the disease as soon as possible to prevent joint damage and maintain joint function. These drugs include:
Sinomenine is now known to be effective in neuralgia and rheumatic diseases. That is a unique plant alkaloid, as it potently releases histamine in association with degranulation of mast cells in connective tissue. The released histamine is responsible for the pharmacological actions of sinomenine, such as vasodilation, increased vascular permeability, acceleration of the thoracic and peripheral lymph flow, contraction of smooth muscles, increased peristalsis of the intestines, and stimulation of gastric acid secretion.
Sinomenine hydrochloride has anti-inflammatory, analgesic, antihypertensive and antiarrhythmic pharmacological effects. At present, a variety of preparations have been applied to the clinic for the rheumatism and rheumatoid arthritis.
Sinomenine hydrochloride has inhibitory effect on lymphocyte proliferationcan.It be used as an antihypertensive and anti-inflammatory. Sinomenine hydrochloride has anti-inflammatory effect, sinomenine has strong effect on histamine release.