Experience one, the earlier the treatment, the better the efficacy. The first year of the onset of the disease, or even within six months of consultation, to go to the rheumatology department of tertiary hospitals for regular treatment, you can get effective control of the. Many rheumatoid arthritis patients 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 total joint deformation, at this point it is too late to treat. Experience two, it is important to combine a variety of curative drug therapy. For those who have severe symptoms and obvious abnormalities in laboratory indicators, they need to be treated with a combination of curative drugs. The former includes methotrexate, leflunomide, elamorphod, lorazepam, hydroxychloroquine, ramipramine, cyclophosphamide and memantine, while the latter has been marketed as anti-TNF agents (Isep, prednisolone, classical, Xumel and Enzyme) and anti-interleukin-6 (Yamiro). The former are mostly immunosuppressive agents, and there are strong and weak immunosuppressive strengths, among which, methotrexate, leflunomide and cyclophosphamide are stronger, while lutetrapyridine, 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? Is it easy to catch a cold in normal times? Do you have any desire for pregnancy and childbirth? etc. For example, although methotrexate is used as the anchor drug of choice for the treatment of rheumatoid arthritis at home and abroad, it is no longer considered for those who usually catch colds easily, have mild to moderate renal insufficiency, have significantly lower blood white blood cells, 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, for particularly mild cases, it is not uncommon to use only a single drug, such as a special type of rheumatoid arthritis – recurrent rheumatism, where the efficacy of using one drug, Eramod, is better. Experience three, for early rheumatoid arthritis, which is dominated by obvious swelling of the joints, small doses of hormones are more effective. In fact, hormone is a “double-edged sword”, but if used properly, it is beneficial for 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 more widespread 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, prophylactic use of certain drugs is also possible, such as with methotrexate, folic acid can be used, as methotrexate is used once a week, folic acid is also used once a week, and methotrexate can be used one day apart. Experience four, all the therapeutic drugs do not suddenly stop using. This is a mistake that many rheumatoid arthritis patients are prone to make, because they are afraid of the side effects of the drugs, once the symptoms are controlled, they immediately stop all the drugs, so that relapse is certain. Here is a word of advice, drugs can be reduced, and you can also gradually reduce the type of drugs, but do not suddenly stop using all of them. There is an art to reducing the types of drugs, first reducing hormones and NSAIDs, then reducing biologics, and finally reducing traditional curative drugs. Eventually, 1-2 curative drugs are needed for long-term maintenance to ensure both no side effects and control of the disease. Lesson five, it is important to review regularly at the clinic and to adjust the regimen at any time. Most of the drugs used in the treatment of rheumatoid arthritis have a certain degree of toxicity, and regular laboratory tests and follow-up visits are needed to understand the toxicity of the drugs on the one hand and the effectiveness of the treatment on the other hand, and the doctor will adjust the treatment plan at any time according to the symptoms, signs and laboratory tests. Experience six, the combined treatment of Chinese and Western medicine is often more effective. Traditional Chinese medicine and Western medicine should complement each other, and 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 with prominent fear of cold and cold, with a white tongue image, perhaps use some hot proprietary Chinese medicines such as 弊琪 capsule, Dong Zhuo Pa; gnats whack cellar consumption Ran Yan shrimp tirade Experience 7, to take into account the easy combination of other problems such as osteoporosis, osteoporosis, dry syndrome, menopausal syndrome and fibromyalgia syndrome, etc. 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.