Treatment of ankylosing spondylitis

  Treatment goals: 1. Control inflammation and relieve symptoms.  2.Prevent stiff deformity of the spine and hip or maintain the best functional position.  3.Avoid treatment-induced side effects.  Treatment methods: emphasize comprehensive treatment 〈i〉, health education, which is very important. The purpose is: first, early diagnosis, reduce the difficulty and complexity of treatment, reduce the disability rate; second, for diagnosed cases to understand the course of the disease and prognosis, to understand the significance of treatment and its long-term nature, so as to mobilize the patient’s motivation and persistence; third, to help patients understand the role of drugs and possible side effects, and their treatment, so as to avoid unnecessary drug interruptions or adverse consequences; fourth, so that Patients recognize the importance of correct behavior and medical sports and give guidance, such as quitting smoking. Pay attention to sitting, lying, walking and standing posture to ensure the best functional position even if the spine is stiff; fifth, guide patients to choose the doctor and medicine to avoid the “urgent and indiscriminate treatment” and falling for charlatans, which wastes money and delays treatment; sixth, encourage and promote communication among patients to learn from each other’s experience; seventh. Encourage patients to maintain an optimistic spirit, and correctly handle the relationship with society, units, family and friends and obtain support.  〈II〉, medical sports, exercise is particularly important for patients: such as maintaining the physiological curvature of the spine to prevent deformity; maintaining good thoracic mobility to avoid affecting respiratory function; preventing or reducing muscle atrophy due to disuse of limbs, maintaining bone density and strength to prevent osteoporosis, etc.  Exercises include three major types A exercises to maintain thoracic mobility: such as deep breathing, chest expansion exercises, etc.  B exercises to maintain the flexibility of the spine: such as rotation of the neck and waist in all directions.  C physical exercise, a wide variety, the simplest such as walking, push-ups, etc. Swimming includes both physical exercise and chest expansion exercises, but also conducive to maintaining the normal physiological curvature of the spine, worth using.  Some sports are not appropriate for strong spondylitis, such as running, especially those with hip involvement should not be advocated. Exercise may increase pain, but if it can be relieved by short-term rest, should be considered normal and need not be terminated. If the pain increases after exercise, lasting more than 2 hours, or exercise caused by fatigue and discomfort is difficult to recover, it means that the exercise is excessive, should be adjusted appropriately, the type of exercise or temporary rest.  〈Three〉, physical therapy: commonly used are: first, ultraviolet light spinal irradiation, lymph nodes or joint local irradiation.  Second, the spine to apply magnetic therapy, magnetic acupuncture point therapy.  Third, direct current or audio current drug ion introduction therapy.  Fourth, short-wave, ultra-short-wave transthermal therapy.  Fifth, heat therapy such as hot compresses, infrared, hot water baths on the treatment of strong spondylitis is helpful.  〈fourth〉, Western medicine Previously, the treatment of strong spondylitis mainly applied non-steroidal anti-inflammatory drugs, however, in recent years, the observation of certain slow-acting drugs for the treatment of this disease effective.  1, non-steroidal anti-inflammatory drugs, good response to non-steroidal anti-inflammatory drugs is one of the characteristics that distinguish strong spondylitis from other back and leg disorders. The first thing you need to do is to take aspirin, which has been proven to be ineffective in prednisone. The anti-inflammatory pain, naproxen, ibuprofen, inflammatory pain Xikang, on the strong spondylitis has a good anti-inflammatory pain and reduce morning stiffness, but does not affect the natural course of the disease.  2, hormones, also can not affect the course of the disease, and long-term use of side effects, so not for long-term use.  3, slow-acting drugs, our section is also commonly used to treat rheumatoid arthritis antimalarials, gold preparations, penicillamine, azathioprine and other ineffective for strong spondylitis. Sulfasalazine, methotrexate and rheumatism can be used to treat this disease.  (1) Sulfasalazine (SSZ), mainly used for the treatment of ulcerative colitis and segmental colitis. 80’s and then used for the treatment of wind-like Guan to achieve results. It is now considered effective in the treatment of strongyloiditis. It is mainly used in early mild cases, and the side effects mainly affect male fertility.  (2) Methotrexate (MTX) is similar in efficacy to (SSZ), and (3) Radix et Rhizoma, which is used sparingly.