It is said that rheumatoid arthritis is “the cancer that never dies”, which should be aptly described in terms of its stubbornness and persistence, but everything should not be so pessimistic, as long as regular and active treatment, it can still be effectively controlled and remain stable for a long time. The earlier the treatment, the better the results. The first year of the disease, or even within six months, to go to the rheumatology department of a tertiary hospital for regular treatment, can be effectively controlled. Many patients with rheumatoid arthritis go around looking for charlatans, frequently changing various doctors (the patient’s trust in the doctor is very important), delaying the best treatment time window, which is very unfortunate. We often see many patients with all the deformation of the joints, at this point it is too late to treat. Experience two, the combination of a variety of drug treatment is very important for serious symptoms, laboratory indicators are obviously abnormal, the need for a variety of treatment drugs in combination. The former includes methotrexate, leflunomide, elamorphod, lorazepam, hydroxychloroquine, ramipramine, cyclophosphamide and memantine, while the latter has been marketed as anti-TNF agents (Ixepro, prednisone, classical, Xumile and Enzyme) and anti-interleukin-6 (Yamiro). The former mostly belong to immunosuppressive agents, and there are strong and weak immunosuppressive strengths, among which methotrexate, leflunomide and cyclophosphamide are stronger, while salazosulfapyridine, hydroxychloroquine and memantine are weaker. When choosing the medication, we must consider the patient’s general condition, liver and kidney function and blood and urine routine? Is there any co-infection or tumor? Are you prone to colds? Do you have any desire to get pregnant and have children? etc. For example, although methotrexate is used as the first choice anchor drug for rheumatoid arthritis treatment at home and abroad, it is no longer considered for those who usually catch cold easily, have mild to moderate renal insufficiency, have significantly lower blood leukocytes, have hepatitis B virus infection or interstitial pneumonia, but mainly consider using hydroxychloroquine and salazosulfapyridine, which have weaker immunosuppressive effects. Biological agents are more expensive drugs, and the imported classics, Xumile, Enzyme and Yamiro are more expensive than the domestic drugs, in fact, they have both curative and curative effects, and many patients have obvious effects in the first 2 injections, and the immunosuppressive strength of these drugs is also relatively strong. Johnek, but the side effects will also be slightly more. Therefore, before using them, on the one hand, some screening tests can be done, such as anti-tuberculosis antibody, chest X-ray, TB-SPOT, hepatitis B two-to-one and TORCH-IgM, etc. On the other hand, it is necessary to know whether there is a history of tumor and hepatitis to prevent the rekindling or aggravation of the original disease in case of excessive immunosuppression. Most combination therapy regimens are centered on the use of either leflunomide or methotrexate, going in combination with other drugs, either in duplex or triplex, and in particularly severe cases, triplex is more effective than duplex. Of course, especially light, only use a single drug is not uncommon, such as a special type of rheumatoid arthritis – recurrent rheumatism, the use of Elamod a drug, its efficacy is better. Experience three, for the early rheumatoid arthritis with obvious joint swelling, small doses of hormones are more effective Many people are pale when they hear hormones, in fact, hormones are a “double-edged sword”, used well, is beneficial to disease control. For the main purpose of controlling joint symptoms, hormones are suitable in small doses (within 15 mg per day) and can be used 2-3 times a day at first, and the duration of use should not be too long, usually several months. The main reason why hormones should not be used for a long time is that the side effects of long-term use are extensive and large, while the drugs for treating the root cause also have side effects, but they are within the scope of monitoring and can be understood by regular checks of liver and kidney functions and blood and urine routines. Of course, some traditional curative drugs also need to be monitored for other adverse effects, such as the use of hydroxychloroquine, which requires an annual electrocardiogram and fundus examination, and long-term use of leflunomide, which requires attention to blood pressure checks. To prevent adverse drug reactions, preventive use of certain drugs is also possible, such as with methotrexate, available folic acid, as methotrexate is used once a week, folic acid is also used once a week, with methotrexate interval of one day can be. This is a mistake that many rheumatoid arthritis patients are prone to make, for fear of the side effects of the drugs, once the symptoms are controlled, all drugs are immediately discontinued, so that relapse is certain. Here is a word of advice: you can reduce the dosage of your medication and gradually reduce the type of medication, but do not suddenly stop using all of them. There is an art to reducing the type of drugs, first reducing hormones and non-steroidal anti-inflammatory drugs, then reducing biologics, and finally reducing traditional curative drugs, and eventually, 1-2 curative drugs are needed for long-term maintenance to ensure that there are no side effects, but also to control the disease. Experience five, regular outpatient review and adjust the program at any time is very important rheumatoid arthritis treatment with most drugs have a certain degree of toxicity, need regular laboratory tests and follow-up, on the one hand, to understand the toxicity of drugs, on the one hand, to understand the effectiveness of treatment, the doctor according to the symptoms, signs and laboratory tests, adjust the treatment program at any time. Experience six, the combined treatment of Chinese and Western medicine is often more effective Chinese medicine and Western medicine should complement each other, combined treatment may be better. Many side effects of western medicine can be relieved by herbal conditioning, such as excessive sweating and hair loss caused by hormones, which can be effectively relieved by using Liu Wei Di Huang Wan. As a Western medicine doctor, it is possible to use some proprietary Chinese medicines appropriately, although it is not possible to precisely dialectic, but at least to distinguish between hot or cold symptoms, because this is the strongest experience for the patient. For patients who are afraid of cold and cold prominently, with a white tongue image, perhaps use some hot proprietary Chinese medicines such as 弊琪 capsule, Dong Zhuo Pa; gnats whack cellar consume Ran Yan shrimp tirade Experience 7, to take into account the easy combination of other problems such as osteoporosis, osteophytes, dry syndrome, menopausal syndrome and fibromyalgia syndrome. Rheumatoid arthritis is a systemic disease, and the disease can present with visceral involvement such as pulmonary fibrosis, and is also prone to comorbidities with other diseases. When these diseases appear, they should be treated accordingly. Many patients with advanced rheumatoid arthritis have joint pain that is not necessarily caused by rheumatoid activity, but perhaps by osteoarthritis or osteoporosis, and their laboratory tests for blood sedimentation and C-reactive protein are often normal, requiring careful differentiation.