Ankylosing spondylitis
is a chronic progressive inflammatory disease, if not standardized treatment, will seriously affect the quality of life and physical function of patients. Standardized treatment is essential for controlling the disease, reducing symptoms and preventing disability.
In the principle of treatment, ankylosing spondylitis emphasizes early treatment. Once diagnosed, treatment should be initiated as soon as possible. Early inflammation is relatively mild, joint destruction is not yet serious, at this time active intervention can effectively delay the progress of the disease. At the same time, the treatment should follow the principle of individualization, taking into account the patient’s age, gender, severity of illness, complications and other factors.
Drug treatment is the core means. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first line of treatment. Such as ibuprofen and diclofenac, which can effectively relieve pain, relieve morning stiffness and improve joint function. NSAIDs can not only relieve symptoms, but also control the progress of the disease when used in sufficient doses for a long time, so they need to be used regularly. Disease-modifying antirheumatic drugs (DMARDs) should be considered when NSAIDs do not respond well or when the patient’s condition is severe. Traditional DMARDs, such as sulfasalazine, have a certain effect on patients with peripheral joint involvement; methotrexate can also be used in some patients, but the effect varies greatly among individuals. In recent years, the application of biological agents has brought a major breakthrough in the treatment of ankylosing spondylitis. Tumor necrosis factor-alpha (TNF-α) antagonists, such as etanercept and infliximab, specifically inhibit TNF-α, resulting in rapid and significant reduction of inflammation and improvement of symptoms in the spine and peripheral joints, especially in patients with high disease activity and poor response to traditional drugs. In addition, there are new biological agents such as interleukin-17 A inhibitors, which provide more options for treatment.
For patients with extra-articular manifestations, targeted treatment is needed. If acute anterior uveitis occurs, timely ophthalmic consultation and local use of glucocorticoid eye drops should be carried out for anti-inflammatory treatment. For patients with cardiovascular and pulmonary complications, the relevant departments need to cooperate to deal with them.
Rehabilitation treatment is indispensable in the standard treatment of ankylosing spondylitis. Patients should take moderate functional exercises, including spinal extension, thoracic expansion and flexion and extension of peripheral joints such as hip and knee joints. Swimming is a very suitable exercise for patients with ankylosing spondylitis. It can reduce the pressure on the spine and joints, while enhancing muscle strength and maintaining joint mobility. Physical therapy, such as hot compress, massage and acupuncture, can relieve muscle spasm and pain.
Surgical treatment is suitable for advanced patients with severe spinal deformity and hip ankylosis. Spinal orthopedic surgery can improve the posture and partial function of patients, but the operation is risky and needs strict evaluation. Hip replacement can restore joint function and improve the ability of patients to take care of themselves.
Regular monitoring is also the key link to standardize treatment. Doctors should evaluate the patient’s condition and treatment effect according to the patient’s symptoms, signs, laboratory tests (such as erythrocyte sedimentation rate, C-reactive protein and other inflammatory indicators) and imaging examinations (such as sacroiliac joint CT, spine X-ray, etc.), and adjust the treatment plan in time to ensure the effectiveness and safety of the treatment.
