Rheumatoid arthritis diagnostic criteria.
(1) Morning stiffness for at least 1 hour.
(2) Swelling of 3 or more joints.
(3) Swelling of the wrist, metacarpophalangeal joints or proximal interphalangeal joints.
(4) Symmetrical arthrogryposis.
All 4 of the above must last for 6 weeks or more.
(5) rheumatoid nodules.
(6) Hand x-ray changes.
(7) Positive rheumatoid factor.
As long as four or more of the above seven criteria are present, rheumatoid arthritis can be diagnosed.
Second, the functional classification of joints.
Class I: the joints can move freely and can perform their usual tasks without hindrance.
Grade II: moderate restriction of joint movement, pain and discomfort in one or several joints, but able to manage daily life.
Grade III: Significant restriction of joint movement, unable to perform work, and difficulty in managing daily life.
Grade IV: most or complete loss of mobility, the patient is bedridden or wheelchair dependent for a long time and cannot take care of himself.
Third, rheumatoid arthritis treatment.
First-line drugs: non-steroidal anti-inflammatory drugs (SAIDS) for the first or mild cases, to relieve pain, but can not stop the natural course of rheumatoid arthritis lesions.
Second-line drugs: disease-relieving anti-rheumatic drugs (DMARD), gold preparations such as gold sodium thiomalate, and oral gold preparations of gold novocaine.
Methotrexate (MTX) has immunosuppressive and anti-inflammatory effects, can lower blood sedimentation, improve bone erosion, 5-15mg per week intramuscularly or orally, side effects include anorexia, nausea, vomiting, stomatitis, hair loss, leukocyte or thrombocytopenia, drug interstitial pneumonia and skin rash.
Leigongteng has good efficacy after years of clinical application and experimental research in China. It has non-steroidal anti-inflammatory effect and immunosuppressive or cytotoxic effect, which can improve the symptoms and make the blood sedimentation and RF potency decrease. 60mg/d of Radix Polygala can show clinical effect in 1~4 weeks.
Biological therapies for RA: tumor necrosis factor (TF)-α antagonists: infliximab (IFX, trade name: class gram®), etanercept (ETA) and adalimumab (ADA).
Glucocorticoids are also a DMARD, short-term (no more than 3 months) and low-dose therapy (prednisone dose no more than 10 mg daily).
The main cause is the attack of wind, cold, damp and heat and the injury caused by drugs. The main cause of the disease is the attack of wind, dampness and heat and the injury of drugs. The disease is divided into walking paralysis, pain paralysis, and paralysis.
Running paralysis
Symptoms: Soreness and pain in the joints and muscles of the limbs, the joints up and down, left and right, but the upper limbs are the most common, with cold pain, but also slight heat pain, or see evil wind and cold, thin white or thin greasy tongue coating, floating or tight pulse.
Treatment: Dispel wind and clear channels, disperse cold and remove dampness.
Prescription: Xuan Piao Da Jing Tang.
This formula is based on beehive, wuzhang snake, turtle shell and praying mantis to promote paralysis by activating the meridians; wei ling xian, qiang wu, fang feng, gentiana, scarlet and green wind vine to dispel wind and evil; angelica to nourish blood and invigorate blood circulation; and panax quercus to remove stagnation in the veins.
Painful paralysis
Symptoms: Pain in the joints of the limbs is severe, even the joints cannot be flexed or extended, the pain is worse when cold, and decreases when hot, the pain is mostly fixed or can wander, the skin is not red, not hot when touched, the moss is thin and white, the pulse is tight.
Treatment: Warming the meridians and dispersing cold, dispelling wind and removing dampness.
Remedy: Wu Tou Tang.
The formula uses Chuan Wu and Ephedra to warm the meridians and disperse cold, promote paralysis and relieve pain; Paeonia lactiflora and Glycyrrhiza glabra to ease the pain; Astragalus astragalus to benefit the Qi and strengthen the surface, and can benefit the blood and promote paralysis; Honey is sweet and slow, benefits the blood and nourishes the tendons, and restrains the poison of Wu Tau. It is optional to add Qiang Wu, Dou Wu, Fang Feng, Gentiana, and Wei Ling Xian to dispel wind and remove dampness. Add turmeric and angelica to invigorate blood circulation. In case of severe cold, we can add Pieces of Radix Aconiti, Cinnamomum Cassiae, and Sinew to warm the meridians and disperse cold.
Paralysis
Symptoms: Painful, sore, or swollen joints of the limbs, pain with a fixed location, numbness of the skin, heavy hands and feet, difficulty in moving, white and greasy coating, moist and slow pulse.
Treatment: Removing dampness, clearing channels, dispelling wind and dispersing cold.
Formula: Coix Seed Soup with Addition and Reduction.
The formula is based on Job’s Tears and Atractylodes macrocephala to strengthen the spleen and permeate dampness; Qiangwu, Dushu and Fangfeng to dispel wind and overcome dampness; Chuanwu, Mahuang and Gui Zhi to warm the menstruation and disperse cold; Angelica sinensis and Chuanxiong to nourish blood and invigorate blood; ginger and licorice to strengthen the spleen and harmonize the middle.
Heat paralysis
Symptoms: pain in the joints of the limbs, redness and burning in the painful areas, severe swelling and pain, relieved by cold, restrained tendons and veins, light day and heavy night, mostly accompanied by fever, thirst, boredom and restlessness, red tongue, yellow greasy moss or yellow dryness, slippery pulse.
Treatment: Clearing heat, promoting circulation, dispelling wind and removing dampness.
Remedy: Bai Hu plus Gui Zhi Tang.
This formula is based on Bai Hu Tang to clear heat and remove restlessness; Gui Zhi to remove wind and dampness. Can add Yinhua vine, forsythia, yellow cypress to clear heat and detoxify; Haitongpi, turmeric, wood forsythia, wei lingxian, etc. to invigorate blood and promote circulation.
繁 (wāg bone bending irregularities)
Symptoms: pain in the joints of the limbs, flexion and extension are unfavorable, the joints are enlarged, stiff, deformed, and even the muscles are atrophied, the tendons and veins are constricted, the elbows and knees cannot be stretched, or the jiri is replaced by the heel, the spine is replaced by the head and becomes invalid, the tongue is dark red, the pulse is thin and astringent.
Treatment: Tonify the kidneys to dispel cold, invigorate blood circulation.
Remedies: tonifying the kidney to dispel cold and treating slander
The formula is based on Chuan Xuehe, bone flesh, bone shredder, Epimedium, to tonify the kidney and strengthen the tendons and bones; the system of Pieces of Pine to tonify the kidney and Yang to remove the cold; Shu Di to fill the essence and nourish the liver and kidney; Gui Zhi, Dou Wu, Wei Ling Xian to dispel the wind and dispel the cold and dampness; Bai Shao to nourish the blood and ease the tendons.
Deficiency of Qi and Blood
Symptoms: weakness of the limbs, soreness and pain in the joints, numbness, sweating and fear of cold, palpitations, dullness, slight blue and white face, weakness of the body, light red tongue without lubrication, yellow or thin white fur, sunken and slow pulse.
Treatment: Benefit qi and nourish blood, relax tendons and activate collaterals.
Formula: Qi and blood together to nourish the tendons.
The formula is based on raw Coix Seed, Poria, Atractylodes, Radix et Rhizoma, Radix Angelicae Sinensis, Radix et Rhizoma, Radix et Rhizoma, Rhizoma Polygonati, Rhizoma Polygonati, Rhizoma Polygonati, Rhizoma Polygonati and Rhizoma Polygonati.