The Treatment of Modern Western - Biblio.nhat-nam.ru

68RHEUMATOID ARTHRITISRheumatoid arthritis (RA) refers to a chronic syndromewhose main manifestation is nonspecific, usually symmetricalinflammation of the peripheral joints. This inflammationmay potentially lead to progressive destruction of the articularand periarticular structures. In Western medicine, RA isusually considered an autoimmune disease, although, like somany autoimmune diseases, its etiology is unknown. Popularsuspects include food allergies due to leaky gut, genetic susceptibility,lifestyle factors, and microorganisms. there mayalso be an association between RA and abnormal bowel function.1 Rheumatoid arthritis affects approximately 2.1 millionpeople in the United States, most often women. This conditionusually starts between 20-50 years of age. 2The onset of this disease may be either abrupt or, more commonly,insidious. Its first signs and symptoms are usuallysimultaneous inflammation of several joints, especially theproximal interphalangeal and metacarpophalangeal joints.Other joints commonly affected include the small joints ofthe feet, wrists, elbows, and ankles. Those joints which areaffected are typically tender to palpation, and there is eventualsynovial thickening in most of the affected joints. In addition,there is stiffness lasting more than 30 minutes initiallyon arising in the morning after sleep or after prolonged inactivity.Early afternoon fatigue and malaise may also occur. Ifjoint tissue degeneration continues, the affected joints maybecome deformed. However, the subcutaneous rheumatoidnodules which are characteristic of this disease usually onlydevelop in advanced disease. If there is accompanying fever, itis typically low-grade. Other accompanying conditions mayinclude visceral nodules, leg ulcers, pleural or pericardial effusions,lymphadenopathy, and Sjögren’s syndrome.In terms of Western medical diagnosis, rheumatoid factors(RFs) are present in 70% of cases, while ESR is elevated in 90%of cases. Synovial fluid is always abnormal during active jointinflammation, being cloudy, sterile, reduced in viscosity, andcontaining 3000-50,000WBCs/cu mm. Radiologically, onlysoft tissue swelling is seen in the first months of this disease.However, as the disease continues, X-rays may show periarticularosteoporosis, joint space narrowing, and marginal erosion.Western physicians treat RA with a combination of rest, nonsteriodalanti-inflammatory drugs (NSAIDs), such as salicylates,indomethacin, and ibuprofen, gold compounds, hydroxychloroquine,corticosteriods, immuno-suppressive drugs,exercise, physical therapy, and surgery.DISEASE CATEGORIZATION: Rheumatoid arthritis is mainlycategorized as bi zheng, impediment condition, in Chinese medicine.If there is fatigue, this is categorized as pi juan, fatigue,while low-grade fever is a species of fa re, emission of heat.DISEASE CAUSES: Habitual bodily righteous vacuity withexternal invasion of evils; long living in a damp environmentand contraction of wind, cold, damp, and/or heat evilsDISEASE MECHANISMS: Due to habitual righteous qivacuity, the interstices may be coursed and slack and the constructiveand defensive may be disharmonious. In that caseexternal evils may take advantage of this vacuity and assailand enter where they impede and obstruct the qi and blood.Hence the movement of the joints is inhibited. It is also possiblethat prolonged living in a damp environment or exposureto rain and cold, damp, chilly weather may lead to contractionof wind, cold, and damp evils. If evil qi lodges in thesinews, bones, and joints, it may congeal there and produceimpediment. And finally, habitual bodily yang exuberancemay transform these evils into heat which may course andpour into the joints where it obstructs and stagnates the qiand blood, thus producing this disease. If enduring heatdamages and consumes yin fluids, this may give rise to liverkidneyyin vacuity. If either spleen qi vacuity reaches the kidneysor yin vacuity affects yang, there may be concomitantkidney yang vacuity. If impediment endures and is not treat-