High risk group.
80% of the incidence is in the age of 35-50 years, with a male to female ratio of about 3:1; currently there are about 5 million patients in China, with an average prevalence of 0.41%. The occurrence of rheumatoid may be related to endocrine, metabolic, nutritional, geographical, occupational, psychological and social environmental differences, bacterial and viral infections and genetic factors.
Clinical presentation.
Rheumatoid arthritis is characterized by chronic, symmetric, multisynovial arthritis (e.g., small joints of the hands, wrists, and feet) with recurrent episodes and a symmetrical distribution. In the early stage, there is redness, swelling, heat and pain in the joints and dysfunction. In advanced stages, the joints may have different degrees of stiffness and deformity, accompanied by atrophy of bone and skeletal muscle, which is very likely to cause disability.
Treatment: 74% of rheumatoid arthritis patients believe that the disease has a serious negative impact on their mood, so it is important for patients to maintain a healthy state of mind. “Follow medical advice, control your life, and have a healthy mind” are three principles that rheumatoid patients should follow.
1. Drug treatment
Current domestic and foreign applications of drugs, as well as plant drugs can not completely control joint destruction, but only relieve pain, reduce or delay the development of inflammation. Commonly used drugs for the treatment of rheumatoid arthritis are divided into five categories, namely non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs) such as: methotrexate, salbutamol, etc., glucocorticoids and botanicals.
There are also biological agents, which are effective in targeted therapy, such as TNF-α antagonists (infliximab, Enzyme, etc.), IL-1 antagonists, CD20 monoclonal antibodies, etc.
2. Surgical treatment
Commonly used surgeries include synovectomy, arthroplasty, soft tissue release or repair surgery, joint replacement and joint fusion.
3. Home maintenance
Dietary management: Quit smoking, recommend a Mediterranean-style diet: a diet rich in fruits and vegetables, grains and legumes, fish and olive oil; for example: tomatoes, carrots, peppers, broccoli, pumpkin, blueberries, blackberries, oranges, lemons, etc.
Vitamin B should be used routinely if methotrexate is used and alcohol should be avoided; calcium and vitamin D should be supplemented if glucocorticoids are used.
Pay attention to protection against cold and warmth, to prevent cold, rain and moisture, and not to wear wet clothes, wet shoes, wet socks, etc.
4. Exercise therapy: first of all, high-intensity exercise, such as racing, running, lifting heavy objects, etc., should be avoided; the following exercise modalities are recommended.
(1) Perform low-intensity aerobic exercise.
Patients can do exercises such as walking, dancing, climbing stairs; start with a few minutes, wait until the body adapts to that amount of exercise or feels good about itself, then extend the exercise time to 30-60 minutes appropriately, which can be done several times a week.
Fist-extension exercises, doing 20 times per cycle, 2 cycles per day.
Wrist exercises: place one hand on the table, bend the other hand to grasp the 4 fingers and do inward bending exercises, do 20 times per cycle, 2 cycles per day.
hip exercises: sit on the ground as shown, legs slightly apart, hold both feet outward for 5 seconds first, then inward for 5 seconds, gradually increase to 20 times from 5 times per day, 2 cycles per day.
Foot stretching exercise: palms pushing the wall, one foot in front, one foot in the back; two toes off the ground, the back foot toe force. Make the calf muscles are in a tense state, adhere to 30 seconds, repeat 3 times.
Practice Tai Chi
Tai Chi is a soothing and low-intensity exercise that is very suitable for rheumatoid arthritis patients. Learning Tai Chi not only allows patients to cultivate their bodies, but also reduces their anxiety.
(5) Fast walking and backward walking.
Fast walking, that is, walking 120 steps per minute. And the so-called backward walking, that is, walking backwards. Patients can walk 100 to 200 steps at a time and choose to do it on a flat path or in a square. It can also be done alternately with fast walking. It should be carried out in the early stage of the disease, not strenuous activities at the beginning, and should gradually increase the amount of exercise. If possible, the activity can be performed under the premise of local insulation. Do 1 or 2 exercises a day and keep insisting on it, trying to make the exercise beneficial and interesting.
5. Emotional management.
74% of patients will have combined emotional problems. Patients themselves can reduce the impact of the disease on themselves by participating in more amateur activities, improving their lifestyle, and distracting themselves; family members need to accurately grasp the patient’s psychological state in daily care and give corresponding psychological guidance to eliminate the patient’s nervousness and fear, so that they can maintain optimism. In case of recurrence of the disease, timely communication with the doctor should be made to discuss the causes and treatment methods.