Why is the treatment of SLE getting better?

  Rheumatology is a young discipline in China (although it is already a long-established discipline abroad), and it has been only 30 years since the formal establishment of rheumatology in China. Having been engaged in the diagnosis and treatment of rheumatologic diseases for more than 20 years, I have personally experienced the great development and progress in the diagnosis and treatment of this discipline, and I would like to talk to you about the effectiveness of rheumatologic treatment.  First of all, I feel that the treatment effect of SLE has become better and better over the past 20 years. At present, most patients (more than 90%) can recover by adhering to reasonable treatment and go to school, work, get married and have children like healthy people. Why? I think there are the following reasons: (1) The level of disease awareness and diagnosis has improved, promoting early detection, early diagnosis and early treatment. In the 1980s, patients with SLE were very rare (in fact, there were many missed diagnoses), and most of them were critically ill and had poor treatment results. I witnessed the rapid deterioration of my colleague’s condition after he was diagnosed with the disease. In retrospect, at that time, due to the scarcity of specialist physicians, the few hospitals in the country that opened specialties, and the backwardness of various diagnostic techniques, many patients were actually unable to seek medical help, or were transferred to many places, and their conditions were delayed until they were diagnosed when multiple organs were damaged, missing the best time for treatment. If we could turn back the clock, many of the critically ill patients at that time would now be in good health and even have children and grandchildren.  (2) Treatment means (drugs) are constantly enriched, and experience (programs) in effective and rational drug use is constantly created and accumulated. From the original glucocorticoid treatment, we now have a wide variety of effective drugs (including new drugs and “new use of old drugs”), such as mycophenolate, FK506, leflunomide, methotrexate, hydroxychloroquine, azathioprine, CTX, etc., as well as various new biological agents (such as Belinumu We can provide strong support for individualized, refined and diversified treatment plans (as well as plan adjustment), and can reasonably use drugs (treating the symptoms and the root cause, side effects and protection, slow and urgent, and combining Chinese and Western medicines) according to the severity and activity of the patient’s disease and different internal organ damage, so as to maximize the benefit and avoid the harm.  (3) The level of social science and cultural knowledge has increased. In the past, the level of social science and culture is low, information is closed, patients and families know little about the disease, or even as a strange disease and no way to seek medical treatment. With the improvement of the scientific and cultural quality of the whole population, and the advent of the information society, the access to disease-related knowledge has never been greater, which is conducive to the prevention and treatment of diseases. But on the other hand, we should also be wary of fraudsters under the banner of high-tech (often very confusing), secret prescriptions, “cure”, “quick cure”, and “medical trusts” at the entrance of various hospitals. “. The key to avoid being deceived is to have a proper attitude and face the disease correctly.  (4) Government policies and support from the health insurance department. In the past, the health administration department to a considerable extent considered rheumatic immune disease simply as “old people’s joint bone pain disease” and failed to pay attention to it. In recent years, although the specific policies of medical insurance departments across the country are different, they have been helping patients with rheumatic immune diseases such as systemic lupus erythematosus and rheumatoid arthritis. For example, many cities in the Pearl River Delta have adopted the policies of “special chronic diseases” and “outpatient reimbursement” to alleviate some of the financial burden. Although still modest (such as the “New Rural Cooperative” in rural areas across the country), these policies are a blessing to patients who are unemployed, poor or have no stable income due to illness; more importantly, these policies also serve to guide patients to seek regular treatment.  Medicine has made great progress in overcoming lupus and will continue to move forward. In the face of lupus, we need to encourage each other, spread the gospel and drive away the gloom of the disease together.