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rheumatoid arthritis 類風濕性關節炎 (in English and Chinese 中英文)

by: Joe Hing Kwok Chu   

Rheumatoid arthritis as defined by the American College of Rheumatology in 1987 is when 4 of the following exist is considered as rheumatoid arthritis:

1. Morning stiffness of more than an hour most mornings for at least six weeks.

2. Arthritis and soft-tissue swelling of more than 3 joints.

3. Arthritis of wrists, palms and finger  joints

4. Symmetric swelling of the joints (arthritis). Joints of both sides of the body simultaneously or one after another acting up.

5. Subcutaneous nodules in specific places

6. Rheumatoid factor* at a level above the 95th percentile, high erythrocyte sedimentation rate, positive reaction of anti-nuclear antibody.

7. Radiological changes suggestive of joint erosion, shape changing, bone being less dense, cartilage being smaller, gaps being smaller

*During the first year of the sickness, most of the rheumatoid factor tests will show negative and eventually, 80% of the patients will change into negative reaction in the serum tests.  So, this test is not very accurate.

Therapy:

1.  yi yi ren tang.

2.  yinxu (yin deficient) with heat : zhi bai di huang wan with added sheng di huang, huang qin, cang zhu, yi tiao gen, sang zhi, qin jiu, ren dong teng, hu zhang etc

美國風濕病學院一九八七年所訂的診斷類風濕性關節炎標準，凡出現下列任何四種情況，即可判定罹患了類風濕性關節炎。

1. 晨僵多於一小時。此情形持續六周以上。
2. 觀察到的三個或三個以上關節部位的軟組織腫脹（關節炎）。
3. 腕，掌指和近端指間關節腫脹（關節炎）超過六週以上的時間。
4. 呈現對稱性關節腫脹（關節炎）的外顯表徵，即身體兩側相同關節同時或先後發病。
5. 皮膚發生類風濕結節。
6. 血液抗體的檢查，類風濕因子呈陽性反應*，達至95%分段值，紅血球沉降速率異常，抗核抗體也呈陽性反應。
7. X光檢查可以發現關節的骨頭有磨損，關節會變形，關節處有骨質疏鬆，關節軟骨減少，關節腔變窄。

*在患病的頭一年，類風濕因子測試多會是呈陰性的。其中80%的病人最終會轉為血清反應陰性狀態。所以測試並非十分準確。

按穴法：

膝痛按陽陵泉，

膝前痛，按足三 里，

膝外側痛，按陽陵泉穴,

膝蓋後側的痛，按 委中穴,

膝內側痛，按陰陵泉穴 ，

膝內側的痛，按三 陰交穴，往膝的方向推去。按完穴，動一動膝關節。[1]

內服：

1.薏苡仁湯

2. 陰虛有熱