What is Raynaud’s syndrome? Raynaud’s syndrome is a disease characterized by ischemic changes in the extremities caused by paroxysmal constriction of the small arteries of the extremities after cold or emotional stress, also known as vasospasm of the extremities, first described by Dr. Raynaud in 1862, hence the name. Some patients have Raynaud’s disease without any clear cause; some patients have Raynaud’s disease secondary to rheumatic or connective tissue disease, and the two are collectively called Raynaud’s syndrome. The incidence of Raynaud’s syndrome is not low, and it is more common in women between 20 and 40. What are the clinical manifestations of Raynaud’s syndrome? 1. The typical symptoms are pallor, cyanosis and flushing after encountering cold stimuli. Arterial vasospasm occurs first after the skin of the finger encounters cold, and the skin appears pale; then the arterial spasm disappears, the venous blood stasis, lack of oxygen, and the skin appears cyanotic; then the spasm is all lifted, there is reactive vasodilatation congestion and skin flushing, and finally turns to normal skin color. It usually takes about 15-30 minutes to change from pale to normal color. Numbness, tingling, coldness, and dullness of sensation in the fingertips may be present at the same time. Generally, the symptoms appear at the same time on both hands and are symmetrical. 2. When the disease lasts longer and has frequent attacks, the skin of the fingers gradually becomes thinner and tighter, followed by persistent pain, blackening of the end of the fingers, and even ulcers. How to diagnose Raynaud’s syndrome? The diagnosis of Raynaud’s syndrome is based on the typical clinical manifestations (pallor, cyanosis and flushing) and a history of recurrent episodes. A common ancillary test is the cold water stimulation test, which involves immersing the hands in 4°C water for 1 minute to see if skin changes are induced; or measuring the skin temperature of the fingers at 20°C room temperature and then immersing the hands in 4°C water for 2 minutes to observe the skin temperature recovery time, and more than 30 minutes is considered positive. Cold water stimulation test is helpful for diagnosis. Rheumatic immune function index and biochemical examination are mainly used to identify whether it is primary Raynaud’s disease or Raynaud’s phenomenon secondary to other diseases. Arteriography is rarely used and is mainly used to exclude other occlusive diseases. How to prevent Raynaud’s syndrome? 1, the mood should be relaxed, sleep must be sufficient, try not to give yourself stress. 2, absolutely do not smoke, while away from the harm of second-hand smoke. 3, avoid cold stimulation, keep the room warm in winter, wear gloves when you go out; use hot water when doing housework such as laundry; if conditions allow, move to live in the warm south. How to treat Raynaud’s syndrome? Most patients with mild symptoms will usually get significant improvement in their symptoms after taking the above preventive measures actively. For patients whose preventive measures alone are ineffective, treatment mainly relies on medications, including two types of drugs to relieve spasm and improve circulation. Commonly used medications to relieve spasticity include nifedipine, reserpine and tolazurin, which need to be taken for a long time to reduce the number and extent of symptom attacks. Drugs that improve microcirculation include prostaglandins, hexaconitine and cilostazol, which can improve microcirculatory perfusion and have a certain degree of antispasticity and antiplatelet aggregation, and are more helpful for patients with terminal gangrene of the fingers. In addition, local application of nitroglycerin ointment can also significantly reduce the number of Raynaud’s syndrome episodes, numbness and pain and other symptoms significantly relieved. In the vast majority of patients, symptoms are effectively improved with active prophylaxis and with the addition of the above mentioned medications. In very rare cases, sympathectomy can be considered in severe cases, with the disadvantage that the results are uncertain. In patients with Raynaud’s syndrome secondary to other diseases, aggressive treatment of the primary cause is also very important.