Ankylosing spondylitis mainly occurs in the spine and sacroiliac joints. Patients with this disease will have a significant decline in motor function. If you like playing basketball and are very good at it, then you may have lost the skill of picking up girls. If you usually like running and walking, then this disease may prevent you from doing so. The treatment for mandatory spondylitis can help you solve these problems. Ankylosing spondylitis concept: Ankylosing spondylitis (AS) is a disease characterized by inflammation of the sacroiliac joints and spinal attachment points. Strong association with HLA-B27. Some microorganisms (eg, Klebsiella) share common antigens with the susceptible person's own tissues and can trigger an abnormal immune response. It is a chronic inflammatory disease characterized by fibrosis and ossification of the large joints of the limbs, the annulus fibrosus of the intervertebral disc and its surrounding connective tissue, and ankylosis of the joints. Ankylosing spondylitis belongs to the category of rheumatic diseases. The cause is still unclear. It is a chronic disease with the spine as the main site of lesions, involving the sacroiliac joints, causing spinal stiffness and fibrosis, and causing varying degrees of eye, lung, muscle, and bone lesions. It is an autoimmune disease. Treatment 1. The purpose of AS treatment Aims to control inflammation, reduce or relieve symptoms, maintain normal posture and optimal functional position, and prevent deformity. To achieve the above goals, the key lies in early diagnosis and early treatment, and the adoption of comprehensive measures for treatment, including educating patients and their families, physical therapy, physiotherapy, drugs and surgical treatment. (1) The treatment of this disease starts with educating patients and their families so that they understand the nature of the disease, its general course, possible measures to be taken, and future prognosis, in order to enhance their confidence and patience in fighting the disease and gain their understanding and close cooperation. (2) Pay attention to maintaining a normal posture and mobility in daily life. For example, you should keep your chest up and your abdomen in when walking, sitting, and standing. When sleeping, do not use a pillow or use a thin pillow. Sleep on a hardwood bed, lying on your back or prone, and lie prone for half an hour each morning and evening. Participate in labor and sports activities within your ability. Pay attention to your posture when working to prevent spinal curvature and deformity. (3) Maintain an optimistic mood, eliminate tension, anxiety, depression and fear; quit smoking and drinking; maintain a regular work and rest schedule, and participate in medical physical exercise. (4) Understand the effects and side effects of drugs, learn to adjust drug dosage and deal with drug side effects on your own, so as to cooperate with treatment and achieve better results. 2. Physical therapy Physical therapy is beneficial for various chronic diseases, but is even more important for AS. It can maintain the physiological curvature of the spine and prevent deformity. Maintain chest mobility and maintain normal respiratory function. Maintain bone density and strength, prevent osteoporosis and limb disuse muscle atrophy, etc. Patients can adopt appropriate exercise methods and amounts according to their personal circumstances. If the new pain persists for more than 2 hours and cannot be recovered, it indicates excessive exercise and the amount of exercise should be appropriately reduced or the exercise method should be adjusted. 3. Physical therapy Physical therapy can generally use heat therapy, such as hot water baths, basin baths or showers, mineral hot spring baths, etc., to increase local blood circulation, relax muscles, relieve pain, facilitate joint movement, maintain normal function, and prevent deformities. 4. Medication (1) Nonsteroidal anti-inflammatory drugs have anti-inflammatory, analgesic, and stiffness and muscle spasm relieving effects. Side effects include gastrointestinal reactions, kidney damage, prolonged bleeding time, etc. Pregnant and lactating women should pay special attention. (2) Sulfasalazine SSZ is an azo compound of 5-aminosalicylic acid (5-ASA) and sulfapyridine (SP) and has been used to treat AS since the 1980s. The main side effects are gastrointestinal symptoms, rash, changes in blood count and liver function, but they are rare. It is advisable to check blood count and liver and kidney function regularly during medication. (3) Methotrexate is reported to have efficacy similar to that of SSZ. Oral and intravenous administration are similar in efficacy. Side effects include gastrointestinal reactions, bone marrow suppression, stomatitis, hair loss, etc. Check liver function and blood count regularly during medication and avoid drinking alcohol. (4) Adrenal cortical hormones are generally not used to treat AS, but when NSAIDs are ineffective in treating acute iritis or peripheral arthritis, CS can be injected locally or taken orally. (5) Tripterygium wilfordii glycosides have anti-inflammatory and analgesic effects and are easy to take. Side effects include gastrointestinal reactions, leukopenia, menstrual disorders and decreased sperm motility, which can be recovered after stopping the drug. (6) Biological agents Tumor necrosis factor (TNF-α) antagonists (such as etanercept and adalimumab) are currently the best choice for the treatment of AS and other spinal and joint diseases. Those who have the conditions should try to choose them. 5. Surgery For severe spinal kyphosis and deformity, corrective surgery can be performed after the condition stabilizes. For those with lumbar deformity, spinal osteotomy can be performed to correct the kyphosis. C7T1 osteotomy can correct severe cervical deformity. |
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