Rheumatism is a relatively stubborn chronic disease, recurrent, lingering and difficult to heal, while the mood of the affected person is often transformed with the progress and decline of the disease, so in the treatment of rheumatism at the same time, the care and conditioning of rheumatism can not be ignored, often said: “three points of treatment, seven points of care”, indicating that in the correct treatment of rheumatism It shows that while treating rheumatism correctly, there must be appropriate care closely to achieve good results. With the appropriate care, so that patients can correctly treat the disease. Have the confidence to overcome the disease, and how to take medication, how to exercise, etc. have the right guidance, is greatly conducive to the recovery of patients with rheumatic diseases.
1.Life care
Life care includes living, diet and other aspects of care, under the influence of the disease, rheumatic patients have a lot of inconvenience in life, such as muscle, joint pain, or joint stiffness, walking inconvenience, often need the help of others. Therefore, life care is an important part of rheumatism care, must do the following aspects.
(1) rheumatism patients are most afraid of wind and cold, damp, so the best way to live in the house to the sun, ventilation, dry, keep the indoor air fresh, beds should be flat, bedding light, warm and dry, often wash and dry, especially for patients with ankylosing spondylitis, it is best to sleep on wooden beds, beds can not be placed in the wind, to prevent sleep in the cold.
(2) wash your face and hands with warm water, and wash your feet at night with hot water to invade above the ankle joint for about fifteen minutes to promote blood flow in the lower extremities.
(3) Patients who sweat a lot should be dried with dry towels, and those whose clothes and bedding are wet with sweat should be replaced with dry clothes and bedding in time to avoid getting cold and wet because of it. For those who have night sweats, in addition to internal medication, use five times seed powder mixed with water and put it on the umbilicus before bedtime. For those who have dry stools, they must be instructed to drink more water and eat more fruits and vegetables to keep their stools open.
(4) For those who have basically lost the function of their limbs and are bedridden for a long time, care should be taken to help change the position frequently to prevent the occurrence of bedsores.
(5) For those with deformed finger joints, or elbow flexion and contracture, or those who cannot brush their teeth, wash their faces or hold chopsticks to eat, take care of them in time, or design some simple utensils, such as small towels without twisting, using spoons instead of chopsticks, using long-handled toothbrushes, etc., so that patients can feel convenient and feel relieved that they can take care of themselves.
(6) For those who have deformed knees and ankles and have difficulty walking, attention should be paid to preventing them from falling or designing some appropriate crutches so that they can support and facilitate indoor activities. Toilets are equipped with handles in appropriate places to facilitate standing up after squatting. We must understand the pain of patients who cannot take care of themselves and put ourselves in their shoes to help them in every way possible.
(7) For diseases such as systemic erythema vera, because of its poor resistance, easy to cause skin damage, to do a good job of skin care, the use of chlorhexidine wash wounds, etc..
(8) Rheumatism patients often have mouth ulcers, pay attention to oral care, use boric acid water to rinse the mouth several times, etc.
(9) pay attention to climate change, when the weather changes dramatically cold, add clothes in a timely manner. Pay attention to keep warm and prevent colds.
(10) Insist on exercising to enhance physical fitness and improve your ability to resist diseases.
2.Emotional and spiritual care
Chinese medicine has a long history of emotional and spiritual care. In the Nei Jing, there is: “calmness and emptiness, the true energy from it, the spirit within the guard, disease from the safe”, “the spirit does not enter, will not cure, so the disease can not be cured”. It also laid the theoretical foundation for emotional care, and later medical practitioners have enriched and developed it to varying degrees on the basis of the Nei Jing.
People have thoughts and feelings. Chinese medicine believes that the seven emotions of joy, anger, worry, thought, grief, fear and fear are normal mental talk, but human thoughts and feelings are often affected by changes in the surrounding environment and changes in the health of the internal body, especially after the disease by the plant physical pain also brings mental distress, it will produce a different mental state than healthy people, such as fear of disease, anxiety about treatment, etc., this seven emotions too much activity In some cases, it will in turn contribute to the progress and deterioration of the disease.
Because of the long course of rheumatism, the disease repeatedly large, the patient’s mental activities, emotional changes are more complex, such as acute attacks, or aggravation of the disease, mobility, life can not take care of themselves, they feel pessimistic and disappointed, and even the idea of light life; some lack of proper understanding of the disease, but also the eagerness to cure, anxious mood, the demand for high medical effects and other mental state, all seriously affect the Cure the efficacy of the disease, at this time, although there is a “panacea” can hardly work, so the care of rheumatic patients moral to do a good job of emotional care. Specific practices are as follows.
(1) guide and help patients to treat the disease correctly, reduce the patient’s psychological pressure
For patients with rheumatism who are first diagnosed or newcomers to the hospital, we should first observe the shape and color and treat them differently. First, use language to ease, by talking with the patient, to examine their worries, solve their depression, to achieve the mood and will be happy. If the disease is in acute attack, a fashion can not be controlled, impatient, anxious to heal the patient, must be relieved, explain that the disease has recurrent, periodic, if timely treatment, can make the disease gradually remission. If you work closely with the medical staff and do a good job with various treatments, you can gradually expect to recover. Make them release their worries and patiently accept treatment. In severe cases, the patient is often depressed and loses confidence in the treatment, so the medical staff should explain appropriately according to his condition, so that the patient understands that the treatment must go through a certain process and too much worry is not beneficial to the disease, so that he understands the requirements and purposes of the current treatment, follows the guidance of the medical staff and actively cooperates with the treatment. For those who are still light or young. Performance full of care, also do not comply with medical advice, life does not pay attention to warmth, or bedridden, unwilling to make appropriate exercise patients, must be the stubborn nature of rheumatism, complexity, long-term and the current lack of special treatment to inform him, Yi can white disease since the knowledge, so that the bottom of the heart, to promote their correct understanding of the disease, follow medical advice, and cooperation with medical and nursing staff to promote early healing.
(2) to seek the active cooperation of relatives, so that the expected curative effect can be achieved.
Rheumatism patients suffer from long-term disease, if there is a harmonious and beautiful family, give the patient unfailing care and thoughtful care, will be able to bring the patient’s soul caress and hope for recovery, so that the patient emotional stability, alleviate the distress of the mind, conducive to the remission of the disease. Any best treatment, without the active cooperation and assistance of relatives, will not achieve the expected results.
The disease is not only in a certain part of the patient’s body, but in the whole person, so it is important to treat the disease as a whole. The relatives who have been together with the patient for a long time should not only understand the current physical pain of the patient, but also understand the current physical and mental condition of the patient, be good at understanding the patient’s state of mind, and reflect it to the medical staff in time, so that the medical staff can explain and comfort in a targeted manner.
3.Eating care
Diet is an important factor in maintaining human life, a reasonable diet can increase nutrition, after the disease, such as the appropriate diet, can better create favorable conditions for treatment, so the dietary care of rheumatism patients is also very important.
(1) Diet should be selected according to the specific condition. Rheumatism patient’s diet, generally should be into high protein, high heat, easy to digest food, less spicy and stimulating food, as well as cold, greasy things. Chinese medicine to rheumatism patient’s diet should also be adjusted according to the patient’s symptoms. If the patient’s tongue is thick and greasy, appetite, we should avoid eating greasy paste and thick taste, and can eat some coix seeds and so on to dispel dampness; such as wind-cold damp paralysis, tongue white and moist, can eat some appropriate warm food, such as ginger soup, ginger tea, etc. to help its pungency; such as indigestion, tongue thick and greasy, it must be given to soft, light, easy to digest food, such as winter melon soup. If it is rheumatic heat paralysis, red tongue, where hot food such as onion, leek, etc. do not eat.
(2) diet can not be one-sided, the correct approach to the issue of medicine and food supplementation. Fruits, vegetables, fish, meat, chicken, duck, etc. are nutritious, not partial food. Some people believe that the disease is deficient, should take tonic, but some people advocate that “medicine is better than food”, these statements are less comprehensive, to correctly treat the issue of medicine and food tonic. Rheumatism patients in the long disease process, often taking too much medicine, the spleen and stomach function is not good, so the medicine, food supplement issues need more attention. Such as milk, soybean paste, cream of wheat, chocolate and all kinds of nutritional products, although they are good dietary supplements, but if the patient has dampness and heat, tongue mucous, appetite, but the food is full of stomach and abdomen uncomfortable, and even do not think about eating. Ginseng, white fungus, gum, pearl powder, and a myriad of tonic medicines, apparently all indicate that they have the effect of replenishing the qi, blood, nourishing yin, calming the mind, etc., but the disease has not been removed, futile tonic, but increased the burden on the spleen and stomach. Some syrup, punch, taste more sweet and greasy, but take it to congestion to help lust, gastrointestinal stagnation. Some people appreciate the nutritional value of the turtle and believe that its meat has the function of tonifying Yin, cooling blood and benefiting Qi, but it is cold and difficult to be transformed, so it is not suitable for people with weak spleen and stomach. Some family members, out of good intentions, want rheumatism patients to absorb more food nutrition, often advise patients to eat more snapper that negative, in the end, make the patient more wet stagnant difficult to transform, counterproductive. Therefore, the medicine must ask the doctor’s guidance, food supplements should also be based on the patient’s digestive capacity, food and not transformed, but increased trouble.
(3) pay attention to dietary contraindications. At present, there are two views on the issue of dietary taboos for rheumatic patients. -Kind of rheumatism patients think that the taboo is very important, if you eat certain foods, the disease that will develop, aggravate. And also hearsay, which also can not eat, that also can not eat, so that patients can not eat too much food, which affects the absorption of nutrients. However, the other one believes that there is no scientific basis for avoiding food, and does not believe in it or pay attention to it. In fact, these two statements are not comprehensive.
Each kind of food, has its nutritional characteristics, normal people do not need special selection, but with the disease, due to the different types of disease and different types, for the diet should be a certain choice, mainly taking into account the disease and treatment and whether there is a contradiction between certain foods. In general, there are two aspects of food and disease contradiction, one is the nature of the food and the nature of the disease contradiction, such as the disease is hot, you should not eat spicy and stimulating food; the disease is cold, it is not appropriate to eat cold and cool things. Secondly, the nature of food and the treatment of disease drugs have contradictions, such as taking ginseng tonic, do not eat raw radish fear to offset the effect of the medicine; want to gout patients should not eat more greasy and soy products, fear of the development of the disease. Because the nature of food, like drugs, also has a cold, hot, warm, cool nature and pungent, sweet, sour, bitter, salty taste. Therefore, there is no mystery to the issue of taboos, the taste of food and the disease is appropriate, it is beneficial to the disease; contrary to the disease, Liu first love Chuan than off, it increases the suffering.
Rheumatic patients have a long course of disease, if the taboo is too strict, over the years, but affect the absorption of nutrients, to the detriment of the disease. Generally in the acute attack of the disease should not eat hot and spicy food; gastrointestinal disorders or spleen and stomach cold, loose stools should not eat more cold melons and fruits; if the patient feels increased pain after eating a certain food or have a certain allergic reaction should not eat again; after eating thick food, feel full in the stomach, you must pay attention to the diet to lighter.
4.Medication care
Taking medicine is an important means of treating disease, but taking medicine is not medicine to open the mouth, swallow that is, but there are many specific requirements. Rheumatism patients with long disease duration, the time to take medication is also correspondingly long, the types of drugs are also more, the treatment plan is also more, the method of taking medication is also different. Therefore, the care of guiding patients how to take medication and how to observe the reaction after taking medication becomes – a very noteworthy issue.
(1) Decoction, method of taking medicine and time of taking medicine
Except for some proprietary Chinese medicines, most Chinese medicines are taken by decoction. Recently, some patients’ family members think that the medicine must be decocted more often to get the taste, and the thicker the decoction, the better, so that a Chinese medicine is decocted for more than half an hour. This is not a comprehensive understanding. Because a Chinese medicine is made up of many kinds of drugs, and according to different conditions, the Chinese medicine used has different flavors, some drugs should be decocted more, and some drugs need to be decocted less. The decoction method cannot be treated uniformly, and the incorrect decoction method can also affect the efficacy of the medicine.
The correct method is to soak the dried medicine in cold water for l~2 hours (longer in winter and shorter in summer), and the time of decoction must depend on the nature of the medicine. Some drugs containing volatile oil, such as peppermint, sand, etc., must be decocted after, that is, after other drugs are decocted for 1-2 minutes; tonic drugs should be more dipped and decocted, but after the fierce fire decoction, it is appropriate to change to a civilian fire; gold, stone, and other drugs such as magnetite, turtle shell, oyster, stone cassia, etc. must be decocted first. The decoction of aromatic dampness can be done after boiling. If you do not pay attention to the method of decoction, regardless of what drugs. Decoction or decoction without dipping is bound to affect the effectiveness of the medicine.
In the method of taking medicine, not uniformly a prescription decoction twice, but also according to the nature of the drug, such as some drugs, must be taken 3-4 times a day, so that the drug in the body to maintain a certain concentration; some drugs must be taken at once, so that the concentration of the drug; some drugs, after taking the effect, can be taken again; some drugs for chronic diseases, although not immediately after taking the effect, but Some drugs are not effective immediately after taking them, but the effect will be produced gradually if they are taken for a continuous period of time. Some drugs must be taken on an empty stomach, so that the drug can be quickly absorbed and play a pastoral effect; some drugs must be taken after meals to avoid stimulating the stomach, which can reduce side effects. Some of them are even taken halfway through the diet, and then eat the diet, which can reduce the stimulation of the stomach; some tranquilizers must be taken before bedtime, which can make the night sleepy; some laxatives, taken before bedtime, can make the next morning bowel movement smooth. In short, the method of taking drugs depends on the holding nature of the drug. For rheumatism patients, generally take blood circulation drugs must continue to take – for a period of time, in order to gradually take effect; but in the case of severe pain must stop pain, then after serving pain relief can gradually stop taking. When taking decoction, it is best to take the medicine about 2 hours after meal, one can avoid stomach discomfort; the other can facilitate absorption. For the temperature of taking the soup, it is generally believed that warm drugs are better served hot, tonic drugs should be served warm, fire-clearing and detoxifying drugs should be served slightly cold, and fire-heat evidence can be served cold. However, when it comes to false hot and cold, false cold and hot evidence, according to the nature of the disease, hot drugs should be served cool or cool drugs served warm to prevent rejection.
(2) Pay attention to the reaction after taking the medicine
After taking the medicine, we should closely observe whether there is any reaction, from the reaction situation, we can detect whether the effect of the medicine reaches, or the precursor of the seriousness of the disease. Generally, for patients who have taken a large pungent and hot agent, we must ask them if they have dry mouth, dry tongue, throat surge, stool knot, bleeding and other symptoms. After taking antipyretic drugs, attention should be paid to whether there is any stomach discomfort and loose stools, diarrhea and other conditions. At present, there are many Chinese and Western medicines used together in the treatment of rheumatism, so it is necessary to promptly explain the current situation of the medicines taken by the patient and be familiar with the side effects of various medicines.
Since the treatment of rheumatic diseases so far lack of special drugs, because of this new research out of the drug is very much, there are also many Chinese herbs purified made of tablets. There are many side effects, such as menstrual disorders, amenorrhea, skin rashes on the mucous membranes, capillary dilation on the face and extremities, pigmentation on the eyelids and cheeks, and especially gastrointestinal irritation symptoms such as vomiting and diarrhea. Some patients take after effective, unauthorized to increase the dose.
(3) Do not throw miscellaneous drugs
Rheumatic diseases are complex, often not quickly after the use of drugs, and patients and families are eager to heal. Often the wind heard that a drug is effective, or watch the drug advertising, a drug for a disease has 100%, 90% efficiency, and mistaken efficiency as a cure rate, that the effect must be significant after taking the drug. Some patients even believe in some overstatement of the propaganda, for – some “nemesis” and other claims confused. Soon after taking a drug, the effect is not fast, that is, replace a drug, or even change the drug, miscellaneous drugs, often not cured, but the drug reaction, so that the symptoms of the disease and drug reactions are complicated, cross, to the doctor’s prescription of drugs has brought a lot of trouble. Some drugs take a certain amount of time to take effect, if the shallow taste, the efficacy of the drug is not seen that stop, the condition is not beneficial. Sometimes several drugs are taken together, but the disease is not cured, but the stomach pain is already unbearable. Therefore, the long course of the disease, complex rheumatism patients must have patience to take drugs, and in taking a certain drug or add a certain drug after a period of time, what reaction, nursing staff should note interest, the patient package has the responsibility to reflect truthfully to the doctor, and then under the guidance of the doctor to replace into increase or decrease the drug, so that the disease is beneficial. To understand the “medicine can cure the disease, but also can cause disease” reason. The nursing staff should not only understand the variety of drugs taken by the patient, but also the number of drugs taken, and whether to follow the medical advice to implement, do not miscellaneous drugs than the patient throw, produce adverse reactions are their own consequences.
5.Functional exercise care
Rheumatic patients must be functional exercise, the purpose is to avoid joint stiffness and contracture by moving the joints, to prevent muscle atrophy, restore joint function, the so-called “to move to prevent disability”. Exercise can also promote the body’s blood circulation, improve the local nutritional status, invigorate the spirit, to preserve the body and promote early recovery, so how to guide rheumatism patients to rest and exercise is also an important part of rheumatism care work.
It is necessary to give rheumatic patients the necessary rest so that the whole body and diseased joints can get sufficient recuperation for a period of time and reduce the pain caused by the activity. However, the practice of allowing rheumatic patients to rest for a long period of time in bed teams is less beneficial and more harmful to the disease. In addition, only pay attention to drug treatment, and ignore the exercise of limb activities, often due to too little activity and make the joint fixed in a certain position, eventually leading to joint deformation, stiffness, adhesion, to life, work brings great inconvenience. Therefore, in the treatment process of rheumatism, rest and exercise, static and dynamic close combination is beneficial to the disease. Therefore, there are good reasons for the saying “prevent disability by moving”, but the following points must be noted when guiding rheumatism patients to perform functional exercises.
(1) functional exercise when there is a disease and physical exercise requirements when there is no disease can not be the same
People are an organic whole, regular physical exercise can make the body strong, but because of the different physical, age and gender, the exercise requirements and methods are not the same. Once the body is attacked by disease, especially rheumatic patients, exercise is to maintain and restore the function of the joints. If rheumatic patients have obvious systemic symptoms or serious swelling of joints during acute attacks, they should rest in bed at this time, and those who are serious can rest for a period of time. To pay attention to the functional position of the hand and foot joints, once the condition is relieved, you can do some functional exercises in bed, plus joint flexion and extension exercises, massage the swollen and painful joints, etc.
After the condition is stabilized, you can start to get out of bed, walk slowly, and also do some simple exercises. After the pain and swelling of the joint is eliminated, the functional exercise must be focused on restoring the function of the joint, in accordance with the physiological function of the diseased joint. You can also use some simple tools and equipment, such as hand squeezing walnut, elastic fitness circle to exercise finger function, two hands to hold the ring to practice the rotation function to exercise wrist function, foot pedal white walking car to exercise the knee joint, rolling logs, treadmill sewing machine to exercise the ankle joint; pulley rope activities to exercise the shoulder joint, etc.
(2) The place, form and time of functional exercise
Rheumatism patients functional exercise in what occasion, but also according to the person according to the disease, such as those who can not get up in bed exercise, can get out of bed in the indoor, the condition of walking in the outdoor or park side of the activity – and suck fresh air, ornamental flowers and plants can increase interest in exercise.
The form of exercise, one person can exercise alone, but also several patients with similar conditions can exercise together, so that they can communicate with each other, increase the fun, the mood is more relaxed. At the beginning, the nursing staff can lead the exercise, put forward the requirements, after skilled as far as possible to carry out their own. Some of the more serious conditions, you can not rush to exercise, once the condition is alleviated by nursing staff to assist in passive exercise, and then exercise on their own after the improvement.
Exercise time, some people advocate early in the morning, even before dawn first go out for outdoor activities, but for rheumatic patients, because of the cold weather, different seasons, not all requirements. Because the cold winter too early to go out, vulnerable to wind and cold, against the disease is not good. Because rheumatism patients, the body is weaker, unable to resist external evil, if ignore the difference in the season, regardless of climate change, – the law of the day is not yet bright that to outdoor exercise, if therefore again by the wind and the cold, again feel in the evil can aggravate the disease.
In short, rheumatism patients, functional exercise, do not be too hasty, more than their tolerance, to stop, according to their ability, exercise the amount of activity should also gradually increase, step by step, do not start with too much activity, not only can not achieve the desired effect, but also cause tendon pain, body weakness. Must be a combination of static and dynamic, persistent exercise, before the effectiveness of