In recent years, there has been a significant increase in outpatients with ankylosing spondylitis, probably because the disease has become known to many physicians and patients, reducing misdiagnosis, and probably because of the poor environment, causing an increase in morbidity. Last year and this year I went to the European Rheumatology Annual Meeting and the American Rheumatology Annual Meeting in Berlin, Germany and San Diego, USA, respectively, to summarize some advances in the treatment of strong column and to share them with you. First, as I said in an earlier article, strong column is still a benign chronic disease, not a serious disease, and generally has a good prognosis. Although incurable, it does not affect longevity and rarely affects internal organs. Moreover, it is manageable with standardized treatment. Especially after the massive use of biological agents, for new patients or those who have had the disease for several years but still have good joint function, there is no big problem to maintain a normal life and general work, so we should not be overly nervous, especially the parents of young patients, to face the disease objectively, do not worry too much, and do not rush to the doctor, and finally delay the child’s disease, but also It’s a waste of money. Smoking has been clearly proven to be a causative factor in aggravating strong column, so quitting smoking is a must for every patient; functional exercise is more appropriate for stretching joint type, and not very appropriate for strength type; regular functional exercise should be adhered to for a long time to help relieve symptoms, reduce the disease and maintain good joint function; NSAIDS drugs (e.g. Fotarine, Intacrine) are still considered to be the first-line drugs for treating strong column NSAIDS drugs (e.g., Fotarolimus, Inderacin) are still considered the first-line drugs for the treatment of strong column, and long-term moderate doses of these drugs have been confirmed by many experiments to reduce bone bridge formation, so now this class of drugs is not only used as pain medication, but also as long-term maintenance medication, which can be combined with other drugs; however, attention should be paid to renal damage and gastric mucosal damage; thalidomide, lorazepam, leflunomide, and methotrexate tablets are used as slow-acting drugs, which require long-term medication. All are effective for strong columns, but the overall efficiency is about 30-50%, which is relatively low, and attention should also be paid to the associated side effects such as liver and kidney. In patients who do not have the economic conditions to use biological agents, you can choose this class of drugs combined with fotarine tablets, can also achieve certain efficacy; if there are fertility requirements, you need to stop the drug for more than six months; about biological agents, in fact, many international and domestic concepts are inconsistent, but according to internationally recognized guidelines, combined with our national conditions, basically we are more unified (with the commonly used Ixepro or Enzyme as an example. Adalimum dose reduction and maintenance methods and different): 1, is currently the most effective treatment of strong column, the fastest-acting drugs, less adverse reactions, the efficiency of more than 90% (personal experience, the efficiency of more than 95%); 2, the use of this class of drugs before the need for regular treatment with Fotarim 3 months, the effect is not satisfactory before using biological agents. However, for juvenile onset, rapid progression of the disease, obvious activity of patients, can also be used directly; (personal opinion, young men, the onset of heavy try to use biological agents; middle-aged and elderly patients and women, can be suspended, with fotarine and other treatment for a period of time and then see the situation) 3, before use need to be screened for tuberculosis, hepatitis B, acute and chronic infections and tumors; 4, in principle, long-term use, recommended after the disease is stable to reduce the dose of 25mg/week maintenance. (Personal experience, the national economic pressure is too great, you can gradually reduce the dose to 25mg/2 weeks in a year, that is, one injection in half a month, maintain 1-2 years, according to the disease stop, the success rate is higher. (If Ixeprop injection is reduced to 25mg/month, the disease relapse rate will be high; Enzyme injection can be reduced to 25mg/month, the maintenance effect is equivalent to Ixeprop 25mg/half month) 5. If you have fertility requirements, in principle, you can get pregnant after stopping the drug in one month; there are patients who got pregnant during the use of biological agents, the babies born were not found abnormal; biological agents can be used during breastfeeding, because although biological agents 6. No matter what kind of biological agents are used, they cannot cure the disease, and once the drug is stopped, there is a possibility of relapse at any time, so everyone should act according to their ability and do not have too high expectations. Then, for this group of patients who have had the disease for many years and caused consequences such as hunchback, biologics also cannot reverse the disease, but only reduce further progress, so for this group of patients in the middle and late stages, it is more important to prevent complications, such as osteoporosis, fracture, nerve compression and other rare internal organ damage. Then, for this part of patients, if the economic condition is good, of course, biological agents can be used, but it is necessary to supplement calcium and anti-osteoporosis at the same time, and exercise should be done according to the strength, do not do excessive movements, walking, doing exercises, swimming and other non-strength exercises are better. You can also use Yunker (technetium 99-methylene diphosphate) needle treatment. In our hospital, after treating hundreds of patients with Yunker, we conclude that the efficiency is between 50-70%, which is worse than biologics, but significantly better than general oral drugs. What is more recommended is that the “technetium 99” part of Yunker is for the treatment of strong column, but the latter part of “methylene diphosphate” is good for the treatment of osteoporosis. Therefore, even if there is no obvious effect on the strong column after using Yunker, the osteoporosis can be significantly relieved and the fracture can be reduced, so the benefit is obvious in the long run. Especially for old strong column patients over 40-50 years old, we think Yunque is more suitable than biologics and is covered by health insurance reimbursement. The disadvantage is the need for multiple hospitalizations, typically requiring 3 weeks in the hospital, half a month at home, another 2 weeks in the hospital, another half month at home, and another 2 weeks in the hospital. The course of treatment ends with another 2 weeks of hospitalization after 6 months. Various online newspapers are filled with all kinds of special drugs and health products for the treatment of strong column and rheumatism, so you should keep your eyes open. Generally speaking, real prescription drugs are not allowed to be advertised, and really big hospitals and really big specialists do not advertise (they are too busy to do so, and they can’t get by without advertising). The best rheumatology hospitals in China are Peking Union Medical College Hospital, Shanghai Renji Hospital, Beijing 301 Hospital, Peking University People’s Hospital, Nanjing Gulou Hospital, Guangzhou Zhongshan Hospital, etc. The most famous experts are just a dozen or so, and it is not convenient to introduce them all here. The rheumatology and immunology department has been opened in all the tertiary hospitals, the strong column belongs to the rheumatology and immunology department of the common simple diseases, specialist doctors can successfully solve the diagnosis and treatment of the strong column, we can find the regular rheumatology and immunology doctors prescribed tests and drugs are similar, so if the condition is not very complex, there is no need to run to Beijing and Shanghai to see a doctor. If the condition is really difficult, the doctor will usually advise the patient to be transferred to a higher level hospital. Of course, it is not excluded that some regular hospitals occasionally advertise in the media in order to expand their influence, but it is basically impossible to advertise for years and years, so we should pay attention to the distinction. There are no guidelines or expert consensus that any of the health products are effective (except for calcium tablets, which are not actually health products, but only dietary supplements), so eat or not, you are in control; Chinese medicine has no evidence to prove that it is effective for the condition of the strong column, but the Chinese medicine is profound and some drug mechanisms are not known, so in the premise of using Western medicine, in the regular The Chinese medicine can be used in a regular Chinese medicine hospital, and to a certain extent it can reduce the side effects of Western medicine and increase the efficacy.