Rheumatoid Arthritis
Rheumatoid arthritis is a chronic systemic autoimmune disease that focuses on the joints. All tissues that make up the joints can be affected. The prominent clinical manifestation is symmetrical polyarthritis, especially in the small joints of the hands, feet, fingers, toes, and ankles. In the early or acute phase of the disease, the joints are red, swollen, hot, and painful, and there are movement disorders. In the late phase, the joints are ankylosed or deformed, and there is atrophy of the bones and skeletal muscles. Throughout the course of the disease, the patient may have fever, weakness, anemia, subcutaneous nodules, pericarditis, pleurisy, vasculitis and other lesions, rheumatoid arthritis is in the Chinese medicine ''paralysis evidence'' domain.
Etiology
Western medicine etiology
Immunologic factors--There are a large number of lymphocytes and plasma cells lubricating the synovial tissue, and there are immune complexes composed of denatured IgG and rheumatoid factor in the fluid. As the immune complexes deposited on the synovial membrane activate the body's complement system, a large number of neutrophils infiltrate into the synovial membrane and joint cavity causing inflammation, which promotes phagocytosis by neutrophils and macrophages (at the same time, as a result of phagocytosis of the immune complexes bound to the complement, rheumatoid cells are formed). In the process of eliminating the complexes, the lysosomes of the rheumatoid cells release large amounts of youtuber causing damage to the joint tissues.
Genetic factors--Research reports published by relevant scholars suggest a higher incidence of disease in close relatives, suggesting a correlation with genetics.
Infectious factors - Streptococcus, diphtheria-like bacteria, mycoplasma, viruses, etc. are pathogens of rheumatoid arthritis.
Chinese medicine etiology and pathogenesis
Insufficient innate talent, deficiency of vital energy, wind, cold, dampness, heat, paralysis in the muscles, joints and meridians, so that the blood and qi do not run smoothly, resulting in paralysis. Due to the different responses of individuals to external evils, they can be categorized as follows
A body with yang deficiency feels wind, cold and dampness, which attacks the skin externally and the joints internally, causing the meridians to be blocked and the joints to be swollen, hot and painful when they are heated up.
In a body with Yang deficiency, wind, cold and dampness are felt, or the dampness is removed from the skin when wading in the rain, causing the Yang energy not to develop and the blood and qi to stagnate, and the joints are unfavorable. When the body with Yang deficiency is exposed to wind-cold-dampness, it will become cold, resulting in swollen joints and cold pain, and it prefers warmth and fear of cold.
When paralysis lasts for a long time, it depletes the qi and injures the blood, and damages the internal organs, resulting in a positive deficiency and coldness of the body, and then it occurs repeatedly. When the disease is prolonged and the evil is deep and the internal organs are deficient, the positive is not able to overcome the evil, so the fluid is stagnant, and the phlegm is blocked in the veins, tendons, and bones, resulting in deformity and swelling of the bones and joints, and loss of flexibility in the limb movement.
Clinical Diagnosis
Disease Recognition
a. Symptoms and signs
Generalized symptoms; fatigue, weakness, low fever. Weight loss with muscle pain and numbness of limbs. Cold fingers, anemia and other symptoms.
Joint manifestations: stiffness in the morning, symmetrical pain and swelling, activity is affected, and in the advanced stage of the disease, the joints are hard and deformed.
Other manifestations: subcutaneous nodules around the joints, the tips of the upper limbs, the ankles of the lower limbs, mitral valvular lesions, pleurisy, and panic attacks on the heart and lungs.
b. Laboratory and Other Tests
Mild anemia, increased ESR (sedimentation rate).
X-ray examination: Early stage, there is no obvious change in the skeletal system, but with the change of the disease, the X-ray suggests osteoporosis in the joints, reduction of space and erosion of bone, disappearance of cartilage, and even subluxation.
Serologic tests: decreased albumin, increased globulin, and 80% positive rheumatoid factor.
Diagnosis
Damp-heat impediment: acute, red, swollen and hot pain in the joints, body heat and sweat without relieving the pain, joint flexion and extension, stiffness in the morning, irritability, short and red urine, yellow tongue coating, and number of pulses.
Cold-dampness paralysis Severe pain in the joints, unable to flex or extend, or even stiffness and constriction, sometimes mild, sometimes severe, aggravated by cold, relieved by heat, with thin white tongue coating and tight or slow pulse.
Toxic-heat impediment Red and swollen joints, throbbing pain with heat, inability to touch, red spots under the skin, fever and chills, vexation, thirst, yellow ulcer, dry stools, yellow coating, and slippery pulse.
Liver and kidney deficiency paralysis; the disease affects the liver and kidney; the bones are withered and the tendons are withered; the joints are straight and deformed; the body is weak; ulcer is small; stool is dry; the coating is small; the tongue is thin; and the pulse is small and countless.
Treatment
Western Medicine
General Treatment As the disease is long and prone to recurrent attacks, it is necessary to pay close attention to daily life during recuperation, avoiding or removing triggers, such as cold, humidity, fatigue, mental stimulation, trauma and infections.
Medications: A. Non-aspirin anti-inflammatory drugs, aspirin, etc. B. Anti-rheumatic drugs; C. Adrenocorticotropic hormone.
Surgical treatment.
Chinese medicine
Damp-heat ticks should be treated by clearing heat and removing dampness, activating blood circulation and promoting ticks. The formula is Xuanpao Tang combined with Ermiao San, plus or minus.
Cold-dampness ticks Warming the meridians, dispersing cold, removing dampness, and clearing the ticks are treated by combining Wu Tou Tang with Job's Tears Tang, plus or minus.
Toxin-heat paralysis To clear heat and detoxify the blood, activate blood circulation, cool the blood and promote paralysis, add or subtract Si Miao Yong An Tang to the formula.
Liver-kidney Dampness Tick To nourish the liver and kidney, strengthen the tendons and bones, smooth out blood and Qi, and soothe the joints, the formula is Yuuji Pill plus or minus.
Acupuncture and Moxibustion
Acupuncture and moxibustion are applied locally or remotely according to the meridians of the patient's body in order to dredge the meridians and harmonize qi and blood.
Quchi, Hegu, Sanyinjiao, Yinlingquan, Xiexi. Hegu, Sanyinjiao, Guanyuan plus moxibustion.
Spinal Joints Yinmen, Huizhong, Chengshan, Houxi.
Shoulder Joint: Shoulder, Tiantu, Yanglingquan.
Elbow Joint Quchi, Tianjing, Hegu.
Palmar joints: Waiguan, Sanli, Yangxi, Zhongquan, Siwu.
Hip joint: Huanjiu, Yanglingquan, Jiejiao.
Knee joint Foot Sanli, Knee Eye, Yinlingquan.
Ankle Joint Xiexi, Taixi, Kunlun.
Special Nasal Therapy at the Center
After years of clinical research, our center has developed a pure Chinese medicine nasal special therapy, which is based on the patient's symptoms, after identification, to pass, open, clear, strengthen, and progressively as the rule of treatment, in order to remove the patient's phlegm, turbidity, and silt at the same time, but also to adjust the function of the internal organs, so as to achieve the purpose of internal and external co-treatment. This treatment is based on modern medical and anatomical point of view, it is through the local administration of drugs, through the nasal mucosa microvessels directly absorbed and utilized, resulting in the regulation of autonomic nervous system that is, vasodilatation and relaxation and other effects. Generally speaking, the treatment of nasal diseases is mostly an oral method of drug administration, where the active ingredients are absorbed through the gastrointestinal tract and then enter the body circulation through the hepatic portal vein, where the ingredients have been damaged, denatured or detoxified by the liver, which makes it difficult for the active ingredients to reach an effective concentration in the bloodstream. The “Chinese medicine nasal special treatment” utilizes the principle of internal and external treatment and local administration of medicine, the least amount of medicine, to play the best therapeutic effect, the nasal mucosa has a large number of tiny cilia, which can greatly increase the effective surface area of the drug being absorbed, so that the utilization rate of the nasal medication is nearly 99%.
When receiving nasal special treatment at our center, we also recommend patients to take appropriate exercises to reduce joint pain, improve endurance and muscle strength and also increase the supply of cartilage nutrients, but it should be noted that no exercise should be done during the period of acute inflammation, and training can be done when the pain is less severe. Exercises include endurance training, weight training, and exercises to maintain joint mobility and flexibility. For weight training, start with small weights and increase the number of repetitions, and pay attention to movement techniques. If there is an increase in joint pain or stiffness after exercise, reduce the intensity of the exercise or reevaluate the content of the exercise. For example, you can choose low impact exercises such as walking, calisthenics, stationary bicycling, and swimming. Swimming in particular utilizes the buoyancy of the water to reduce the impact on the joints, and the resistance of the water can be used as a weight training exercise. Walking, kicking, and bouncing in the water are all less strenuous and safer exercises.